A comprehensive review published in the Medical Journal of Peking Union Medical College Hospital in July 2025 details the evolution of radionuclide drug conjugates (RDCs) over the past 15 years, underscoring their role as a transformative approach in oncology that merges diagnosis and therapy into a single clinical workflow. The study, led 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 are designed 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 review highlights the emergence of cyclic peptide conjugates, which exhibit low toxicity and high tumor selectivity, making them particularly promising for clinical applications.
According to the review, policy reforms have played a crucial role in advancing RDC development. Since 2020, regulatory agencies have issued technical guidelines that standardize clinical evaluation, non-clinical research, and radiochemical quality control, creating a more predictable environment for innovation. These developments, combined with an expanding number of clinical trials and new therapeutic targets, position RDCs as a cornerstone technology for achieving precision oncology through theranostic integration.
“RDCs represent the only class of therapeutics capable of achieving true integration of diagnosis and treatment,” said Prof. Hongyun Wang, senior author of the review. “Despite challenges in radiochemical synthesis, stability, and regulatory alignment, we are witnessing unprecedented enthusiasm and cross-disciplinary collaboration in this field. With continued innovation in targeting ligands and isotope design, RDCs will redefine how we approach tumor detection, treatment monitoring, and personalized therapy.”
The review underscores that RDCs hold vast potential to transform cancer management by enabling simultaneous imaging, treatment, and response monitoring within a single platform. As aging populations and cancer incidence continue to rise, demand for next-generation radiopharmaceuticals is expected to grow. The authors emphasize 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 full review is available at https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0577.
