Major advances in radioligand therapy and cancer care

Radioligands are an innovation driven by our increasing understanding of the molecular biology of cancer and the role of radiation in cancer care. This timeline explores the history and future of radioligand therapy (on the right) alongside other innovations in oncology (on the left).

First approval of gene therapy (alters the person’s immune cells (T-cells) to fight cancer, also known as CAR-T therapy)1 2


Approval of radioligand therapy for progressive midgut NETs in the EU3


Approval of bone-directed radiotherapy for mCRPC in the EU4

First approval of immune checkpoint inhibitor (for malignant melanoma)5


Further studies into radioligand therapy for bone metastases6

First monoclonal antibody immunotherapy treatment approved5


Approval of internal radiation therapy for pain in bone metastases in EU countries7 8


Early studies and use of radioligand therapy for NETs9-12


Early trials of radioligand therapy for bone metastases13


First scans of endocrine-related tumours using targeted radioisotopes14 15

First anti-cancer vaccine against hepatitis B virus (a risk factor for liver cancer)1 2


First hormone therapy approved that blocks the effect of oestrogen5


First use of chemotherapy after surgery (known as adjuvant chemotherapy)1


First PET scanner developed16

First use of chemotherapy1


Early trials of radioactive strontium to treat metastatic bone cancer17

Discovery of hormone therapy for prostate cancer5


First use of radioiodine to treat thyroid cancer (this was the first example of using a radionuclide for cancer treatment)18

First approach combining surgery and radiation5


First use of radiotherapy to cure cancer1

  1. American Society of Clinical Oncology. Cancer progress timeline. Available from: [Accessed 08/09/19]
  2. Immunotherapy: Timeline of key events. Available from: [Accessed 09/09/2019]
  3. European Medicines Agency. Lutathera. [Updated 02/04/19]. Available from: [Accessed 21/01/20]
  4. European Medicines Agency. Xofigo. [Updated 10/01/20]. Available from: [Accessed 21/01/20]
  5. National Cancer institute at the National Institutes of Health. Milestones in cancer research and discovery. Available from: [Accessed 08/09/2019]
  6. Bander NH, Milowsky MI, Nanus DM, et al. 2005. Phase I trial of 177lutetium-labeled J591, a monoclonal antibody to prostate-specific membrane antigen, in patients with androgen-independent prostate cancer. J Clin Oncol 23(21): 4591-601
  7. Medicines and Healthcare products Regulatory Agency. 2016. SUMMARY OF PRODUCT CHARACTERISTICS: METASTRON. Available from: [Accessed 08/01/20]
  8. Haute Autorite de Sante – Medical EaPHAD. 2014. TRANSPARENCY COMMITTEE: Opinion 1 October 2014 METASTRON. Available from: [Accessed 08/12/19]
  9. Levine R, Krenning EP. 2017. Clinical history of the theranostic radionuclide approach to neuroendocrine tumors and other types of cancer: historical review based on an interview of Eric P. Krenning by Rachel Levine. J Nucl Med 58(Supplement 2): 3S-9S
  10. Krenning EP, Bakker WH, Breeman WA, et al. 1989. Localisation of endocrine-related tumours with radioiodinated analogue of somatostatin. Lancet 1(8632): 242-4
  11. 2019. What is PRRT? Available from: [Accessed 08/09/19]
  12. Krenning EP, Kooij PP, Bakker WH, et al. 1994. Radiotherapy with a radiolabeled somatostatin analogue, [111In-DTPA-D-Phe1]-octreotide. A case history. Ann N Y Acad Sci 733: 496-506
  13. Reddy EK, Robinson RG, Mansfield CM. 1986. Strontium 89 for palliation of bone metastases. J Natl Med Assoc 78(1): 27-32
  14. Nakajo M, Shapiro B, Copp J, et al. 1983. The normal and abnormal distribution of the adrenomedullary imaging agent m-[I-131]iodobenzylguanidine (I-131 MIBG) in man: evaluation by scintigraphy. J Nucl Med 24(8): 672-82
  15. Francis IR, Glazer GM, Shapiro B, et al. 1983. Complementary roles of CT and 131I-MIBG scintigraphy in diagnosing pheochromocytoma. AJR Am J Roentgenol 141(4): 719-25
  16. US Department of Energy – Molecular Nuclear Medicine Legacy. History of PET and MRI. Available from: [Accessed 08/09/2019]
  17. Pecher C. 1942. Biological investigations with radioactive calcium and strontium; preliminary report on the use of radioactive strontium in the treatment of metastatic bone cancer. Berkeley, Los Angeles, USA: University of California Press
  18. McCready VR. 2017. Radioiodine – the success story of Nuclear Medicine. Eur J Nucl Med Mol Imaging 44(2): 179-82

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