Fig. 2.

Precision Otolaryngology for HNSCC. The HN-1 peptide as a the ranostic agent (i.e., demonstrates both therapeutic and diagnostic attributes). HN-1 (center) can potentially be conjugated with NIR fluorescence dyes, PET radioisotopes and non-PET diagnostic radioisotopes for tumor-specific diagnostic imaging applications. In terms of therapeutics, HN-1 can potentially be conjugated with various types of chemotherapeutic agents like peptides, toxins and siRNA or therapeutic radioisotopes for PRRT mediated via alpha or beta particle emissions. In fact, HN-1 has already demonstrated its potential for labeling with multiple diagnostic and therapeutic moieties. Dual-labeling of HN-1 with fluorescent dyes and chemotherapeutic agents has already been described in the literature and evaluated in vitro and, to some extent, in vivo. There is potential for dual-labeling HN-1 with both fluorescent dyes and diagnostic radioisotopes to enable more precise image-guided surgery or fluorescence-augmented radioguided surgery. There is also potential for dual-labeling HN-1 with diagnostic radioisotopes and chemotherapeutic agents to precisely localize and quantify the delivery of the theranostic agent to the target lesions. Dual-labeled HN-1 with therapeutic radioisotopes and chemotherapeutic radiosensitizers is another approach to precisely deliver a high-yield chemoradiotherapy payload to target tumor lesions.