Neuropeptides and their receptors in CNS cancer imaging/theranostics: Review of recent advances and increased interest with emphasis on the somatostatin/bombesin/substance P peptide receptor families

This paper includes a summary of the main points of our recent presentation at the 2025 RegPep meeting in Washington, DC. In the invitation to make this presentation by the meeting organizers, we were asked to include a discussion of peptide directed imaging and theranostics to areas that would be of interest to the attendees, which primarily includes studies related to the CNS. The interest in the possible application of peptide theranostics to oncology both generally and in the case of the CNS tumors has markedly increased over the last few years because of its successful application in both neuroendocrine tumors and prostate cancer, leading to FDA approved novel tumor approaches for both imaging these tumors as well as for its theranostic approach. In this paper we review the scientific basis for the successful application of peptide theranostics to neuroendocrine and prostate cancer, and the current status of its application to CNS tumors, particularly meningiomas, glioblastomas including glioblastoma multiforme, and medulloblastomas. We particularly concentrate on the possible use of the somatostatin, bombesin (Bn), and substance P (SP)/neurokinin (NK) family of receptors as targets, which have received the most attention and show the most promise in applying peptide receptor imaging/theranostics to CNS tumors. We also discuss the specific problems that the CNS presents in applying this approach to CNS tumors because of the blood-brain barrier in addition to the progress made. Clinical Trial Registry: NCT01578239 (NETTER-1)(NET), NCT03972488 (NETTER-2)(NET): VISION Trial (NCT03511664)[Lu-177-PSMA-617] (Pluvicto) in advanced prostate cancer.