A comprehensive review published in the Medical Journal of Peking Union Medical College Hospital in July 2025 examines 15 years of advances in radionuclide drug conjugates (RDCs), a class of therapeutics that combine diagnostic imaging and targeted radiotherapy into a single platform. The study, conducted by researchers at Peking Union Medical College Hospital, provides an in-depth analysis of RDC classifications, clinical development trends, and supportive policy frameworks that are shaping the next generation of precision radiopharmaceuticals.
RDCs work by coupling radioactive isotopes with antibodies, peptides, or small molecules, enabling precise tumor targeting, high diagnostic sensitivity, and effective localized radiotherapy. The review categorizes RDCs into antibody-, peptide-, and small-molecule–based conjugates, each offering unique pharmacological advantages. Notably, the authors highlight the rise of cyclic peptide conjugates, which exhibit low toxicity and high tumor selectivity, making them promising candidates for clinical translation.
The review also underscores the impact of policy reforms since 2020, including technical guidelines issued by regulatory agencies that have standardized clinical evaluation, non-clinical research, and radiochemical quality control. These reforms have created a more predictable environment for innovation, leading to an expanding number of clinical trials and new therapeutic targets. According to Prof. Hongyun Wang, senior author of the review, "RDCs represent the only class of therapeutics capable of achieving true integration of diagnosis and treatment. Despite challenges in radiochemical synthesis, stability, and regulatory alignment, we are witnessing unprecedented enthusiasm and cross-disciplinary collaboration in this field."
As aging populations and cancer incidence continue to rise, demand for next-generation radiopharmaceuticals is expected to grow. The review emphasizes the need for stronger innovation capacity, improved isotope supply chains, and streamlined approval processes to support RDC translation from laboratory to clinic. Through coordinated scientific, industrial, and regulatory efforts, RDCs are expected to become a central component of future oncology care, offering patients more accurate diagnoses and safer, more effective treatment pathways.
The study was supported by funding from Capital's Funds for Health Improvement and Research (2022-2Z-4018) and the National High-Level Hospital Clinical Research Funding (2022-PUMCH-B-118). The full review is available at https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0577.
