Target Absorbed Dose, Not Activity? Personalizing Radiopharmaceutical Therapy: A Challenge to Current Practice
- Reframing the target: Dose ≠ Activity. Define terms, show where fixed-activity regimens fall short, and summarize evidence that absorbed dose correlates better with efficacy and toxicity than administered activity
- Personalization levers: Intervals, cycle count, and per-cycle activity. Walk through practical, response-adaptive scheduling using early imaging and dosimetry to hit tumor dose goals while respecting organ-at-risk limits
- What industry should test next: Pragmatic designs and infrastructure. Dose-targeted arms vs activity presets, feasible dosimetry workflows, safety stopping rules, manufacturing, regulatory and operational implications, and the key unknowns to resolve