Contemporary Opportunities and Potential of Auger Electron-Emitting Theranostics

Authors

Seok-Yong Lee
H Charles Manning

Language

English

Publication Date

1-1-2026

Journal

Theranostics

DOI

10.7150/thno.124671

PMID

41608578

PMCID

PMC12846756

PubMedCentral® Posted Date

1-14-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Recent breakthroughs in radiopharmaceutical (RP) therapy have emerged interest in employing Auger electron (AE)-emitting radionuclides as potential agents for precise theranostics. AE provides energy with exceptional localization due to their short tissue penetration range (TPR, < 10 nm), rendering them particularly effective for targeting nuclear DNA in tumor cells. In this context, AE-emitting radionuclide therapy (AE-emitting RLT) enables the targeted destruction of tumor cells while reducing harm to adjacent healthy tissue, a significant challenge in this field. Preclinical and early clinical investigations reveal the efficacy of AE-emitting RLTs in the theranostics of diverse malignancies, such as glioblastoma, prostate cancer, and neuroendocrine tumors. Notwithstanding these developments, challenges and limitations persist regarding dosimetry, delivery efficiency, and the treatment of radiotoxicity. A new paradigm is being developed to tackle the obstacles encountered by integrating molecular target markers (e.g., PARP) that function near the nucleus to improve the intranuclear delivery efficiency of AE-emitting radionuclides. Novel radiochemical methods such as these have facilitated the more stable and efficient labeling of biomolecules with AE-emitting radionuclides. Also, recent advances in DNA-molecular targeting, nanoparticles, nucleic acid/protein engineering, click- or bioorthogonal conjugation chemistry, and artificial intelligence (AI)-based structure modeling present concrete opportunities to overcome these limitations. Moreover, the integration of diagnostic imaging companion platforms employing theranostic radioisotope pairings facilitates real-time assessment of therapeutic efficacy and biodistribution, resulting in the formulation of enhanced treatment regimens. This review summarizes the prior development, recent advancements, barriers in clinical implementation, and future perspective of AE-emitting RLTs.

Keywords

Humans, Radiopharmaceuticals, Theranostic Nanomedicine, Electrons, Neoplasms, Animals, Radioisotopes, theranostics, Auger electron-emitting radionuclide therapy, radiopharmaceuticals

Published Open-Access

yes

Recommended Citation

Seok-Yong Lee and H Charles Manning, "Contemporary Opportunities and Potential of Auger Electron-Emitting Theranostics" (2026). Faculty, Staff and Student Publications. 6235.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6235