ABSTRACT
From the previous chapter, we see that there are limited numbers of available and willing patients for radiopharmaceutical (RP) trials. Yet, as is emphasized in Chapter 1, there are multiple kinds of RPs as well as an almost astronomical number of variations on each generic type. Only a very restricted subset of the total possible number of radiopharmaceuticals can be taken into the clinic. Additionally, the cost of a clinical imaging or therapy trial involving each novel agent is high and may be wasteful of both patients and funds. There is also the aggravating possibility that the truly optimal RP may be missed completely in the selection process, or, in any event, delayed significantly in arriving in the clinical context. Thus, there is a need for methods to choose, from in vitro and animal data, the best agent for a given tumor type. Beyond oncology, the optimal agent should also be selectable for any particular molecular target. In the case of the RP, this choice must be made in both imaging and therapy. For ordinary pharmaceuticals, therapy is the most probable clinical objective although there is the possibility that novel contrast agents may be developed for future use in computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound.
