Gamma-H2AX as a biomarker to assess individual radiosensitivity for radiopharmaceutical therapy in cancer patients: a systematic review

Radiopharmaceutical therapy offers targeted and potent cancer treatment, but individual responses vary, necessitating personalized approaches for optimal outcomes. Gamma-H2AX, a phosphorylated form of histone, has become a sensitive indicator of DNA double-strand breaks caused by ionizing radiation. Gamma-H2AX assays in radiopharmaceutical therapy offer a non-invasive way to assess individual radiosensitivity, improving treatment optimization and patient classification. This systematic review examines the use of gamma-H2AX as a biomarker for determining individual radiosensitivity in cancer patients receiving radiopharmaceutical therapy. An in-depth search for supporting publications utilized three popular electronic databases: PubMed Central (PMC), ScienceDirect, and Scopus. Specific keywords determine article limits. Every existing article was examined and appraised independently using the PICO method (participants, intervention/exposure, comparison, and outcome). Eighty-one articles were identified, 49 were screened based on title and abstract, and 32 were excluded. Six articles were worthy, but only two were considered in this research. Based on these two articles, it is possible to conclude that the gamma-H2AX foci marker in peripheral blood cells of patients receiving radiopharmaceutical therapy was promising for predicting treatment response and individual radiosensitivity. However, this research must be validated with more patients for a higher prospective value in future investigations.