Indic-Origin Radiotheranostics: Integrating Indian Medicinal Botanicals into Next-Generation Radiopharmaceutical Science

Despite radiotheranostics being at the forefront of Precision Oncology, most radiopharmaceuticals in use today are based on synthetic ligands and/or synthetic peptides, which are often costly and unavailable in many geographies (Hofman et al., 2020; Hope et al., 2019). India’s medicinal plants are among the richest sources of bioactive phytochemicals, which remain untapped to develop low-cost and potent radiotheranostic agents (Sharma et al., 2010; Newman & Cragg, 2020). This review presents the first Indo Reflective Radiotheranostic Phytotechnology (IRR) and lays down the science to transform some of the Indian plants to act as a source of radiopharmaceuticals. The methodology begins with high-throughput computational screening, including ADME profiling and receptor docking, to identify phytochemicals with strong tumour-binding potential (Daina et al., 2017; Morris et al., 2009). Radiolabeling feasibility is assessed using established clinical radionuclides—such as ⁹⁹mTc, ⁶⁸Ga, ¹³¹I, ¹⁷⁷Lu, and ²²⁵Ac—supported by rational chelation chemistry (Price & Orvig, 2014; Velikyan, 2015). In vitro evaluation examines receptor affinity, internalization, radiosensitization, and cytotoxicity (Smith et al., 2012; Kunnumakkara et al., 2017). In vivo biodistribution and small-animal imaging establish tumour uptake, pharmacokinetics, and safety profiles (Workman et al., 2010; Bolch et al., 2015). This includes curcumin, withaferin A, nimbolide, eugenol, bacosides, and guggulsterones— these plants are anticancer, and these are compatible with radiochemicals (Aggarwal & Sung, 2009; Kakar et al., 2020; Subapriya & Nagini, 2005; Baliga et al., 2013; Deepak et al., 2014; Shishodia et al., 2003). Key challenges include differences in plants, radiochemicals not being stable, there being no or little of some important substances and issues with regulations (Ekor, 2014; Memon & Jensen, 2020). These include radiolabeling, using nanoparticles, using AI to make the ligands, using plants- using plants that are GMP grade, and using integrated dosimetry (Yallapu et al., 2012; Kratochwil et al., 2019). Overall, IORP is meant to improve and make it cheaper to improve the bioavailability of some radiopharmaceuticals to make them usable in precision oncology.