David versus Goliath: radiotheranostic nanomedicine as a weapon against melanoma

Malignant melanoma (MM), especially when diagnosed at an advanced stage, still represents a challenge for physicians. In recent years, immune check point inhibitors (ICI) have thoroughly changed MM landscape, although only 20–40% of MM patients respond to ICI. In MM progressing after ICI, treatment options, especially in case of MM not bearing V600 mutation, are limited. In this scenario, radionuclide theranostics, based on the sequential administration of a radiopharmaceuticals’ pair, the first labeled with a radionuclide emitting energy suitable for imaging (i.e. positrons or gamma-rays), the second bound to another nuclide emitting particles for therapy, is particularly welcome. Melanocortin 1 Receptor (MC1R), strongly overexpressed by MM cells, has recently emerged as an interesting target for radionuclide theranostics. In the following, we briefly cover some emerging applications of MC1R-targeted radionuclide theranostics, also with reference to the potential of implementing some innovative nanotechnologies, such as gold nanoparticles, to move the field forward.