Half-Life, High Cost, High Stakes: Radiopharmaceuticals in Oncology Practice

For decades, systemic cancer therapy relied heavily on broadly cytotoxic chemotherapy, which indiscriminately damages rapidly dividing cells and is associated with substantial off-target toxicity. Advances in molecular biology led to the development of targeted therapies and immunotherapies, allowing clinicians to exploit tumor-specific biomarkers and immune pathways to improve efficacy and limit toxicities. However, even these agents have limitations. Patient resistance, T-cell exhaustion, and tumor heterogeneity continue to impair responses and curative intent.