Preface

This is a remarkable book honoring Professor Kalevi Kairemo’s work, and it is fitting that the articles for the book were received by the World Theragnostics Day on 31.3.2021, which is precisely 80 years after the first radioiodine treatment was performed by Saul Hertz on 31.3.1941. The idea for the topic/title of this book came from discussions about the partially unrecognized role of radioisotopes in the development of targeted drug development. In fact, the radionuclide approach is nearly always included in the first tools used in research when in vitro findings are transferred to the in vivo level. Usually, new cellular elements are needed for applications to determine their location in vivo in preclinical animal models and, ultimately, in humans. In these applications, radioactive isotopes have had a major role. Protein targeting was the first step towards more specific targeting, starting from the concept of receptors in the cell membrane with specific binding and functional capacity. The use of antibody-augmented targeting increased further, and evolution continued towards increasingly small cell structures. Nanotargeting has been derived even against DNA and RNA and thus shows extreme specificity. Gene therapy and antisense radionucleotide therapies are examples of the highest specificity possible against cell structures. Radionuclides and their molecular constructs have the potential to be developed into therapies involving in vivo imaging of targets followed by the application of active agents with higher radioactive doses. Radioactivity makes visualization possible and may augment therapeutic effects. Thus, radionanotargeting has a large application base and is developing towards theragnostics. All this research is based on multiomics, which involves multiple elements: genomics, transcriptomics, proteomics, metabolomics, microbiomics, epigenomics, exposome, imaging, and precision medicine. Multiomics is an approach that is also featured on the cover of this book.

This book contains a unique collection of articles that will deepen the understanding of targeting with radioactive isotopes. Radioactivity with low trace doses can enable one to visualize targets, providing the possibility of simulating events before using higher doses with stronger effects. This is a perfect situation for cancer therapy. Radiotargeting has evolved from targeting proteins through other cellular macromolecules, e.g., DNA, towards specific gene targeting with antisense techniques. Hopefully, we will see gene silencing therapeutics in clinical oncology in the near future. This development has already been fascinating, and radiotargeting has had a major role in it.

This book starts with a foreword to this research field by Andrew M. Scott, Homer A. Macapinlac and Steven M. Larson. Radionanotargeting and theragnostics are subjects for the next segment in the form of four chapters. Imaging is dealt with in three chapters before the therapy segment, which includes sections for thyroid cancer, head and neck cancer, genitourinary cancers and neuroendocrine neoplasms. The segment on theragnostics is covered in four chapters. In addition, nanoparticles and precision oncology have their own segments. The supporting sciences segment consists of four sections: metabolic imaging, cardiovascular radionuclide imaging, combined and bone therapies. Radiobiology is covered in one chapter before three chapters dedicated to a patient experience segment. The final segment consists of Professor Kairemo’s own memoir “Seven decades in health care” and memoirs from colleagues.” Finally, there is a personal introduction to Kalevi Kairemo with a photographic cavalcade of his participation in WARMTH. I am sure that this complex issue will be covered comprehensively and will open up new avenues for future innovations.