Background: The convergence of immuno-oncology and tumor imaging represents a paradigmatic shift in cancer management, where therapeutic antibodies serve dual roles as both treatment modalities and diagnostic tools. This field has witnessed unprecedented growth, with bispecific antibodies, antibody-drug conjugates (ADCs), and radioimmunotherapy emerging as transformative approaches.
Methods: Recent advances encompass multiple innovative platforms addressing tumor heterogeneity and resistance mechanisms. Bispecific antibodies demonstrate remarkable versatility by simultaneously engaging immune effector cells and tumor-associated antigens, achieving tumor-specific cytotoxicity without MHC restriction. Next-generation ADCs incorporate dual-payload designs and novel linker technologies, enabling synergistic cytotoxic effects while minimizing off-target toxicity. Radioimmunotherapy has evolved with theranostic strategies utilizing single antibodies conjugated to different radioisotopes for combined imaging and therapy.
Imaging Innovations: Molecular imaging modalities have revolutionized cancer detection through antibody-based approaches. Fluorescence-guided surgery utilizes tumor-specific antibodies conjugated to near-infrared fluorophores, enabling real-time intraoperative tumor visualization. Immuno-PET/SPECT combines nanomolar sensitivity with antibody specificity, enabling the assessment of whole-body biomarker distribution and the prediction of treatment response. These platforms support precision medicine by enabling patient stratification and dynamic monitoring of antigen expression heterogeneity.
Clinical Impact: The integration of therapeutic and diagnostic antibodies has demonstrated clinical success, with over 200 marketed antibody therapeutics currently available. Checkpoint inhibitors targeting PD-1/PD-L1 pathways have established immunotherapy as a cornerstone of cancer treatment, while emerging targets, including LAG-3 and CD47, offer expanded therapeutic opportunities.
Conclusions: The synergistic integration of immuno-oncology and tumor imaging through antibody-based platforms represents a transformative approach to cancer care, enabling personalized treatment strategies based on real-time tumor characterization and overcoming current therapeutic limitations.
