# CopperNostics—Here We Are Now, Entertain Us!

## TL;DR

This review explores the use of copper radioisotopes in precision medicine for diagnosis and treatment, highlighting recent developments and challenges.

## Contribution

The paper provides a comprehensive overview of CopperNostics, focusing on production, regulation, and clinical applications of copper radioisotopes.

## Key findings

- Copper radioisotopes like 64Cu are FDA-approved for clinical use in nuclear medicine.
- Challenges in production and regulation hinder the widespread adoption of copper-based theranostics.
- Copper-based radiopharmaceuticals address unmet medical needs in molecular imaging and therapy.

## Abstract

Diagnosis and endoradiotherapy using copper radioisotopes—defined as Theranostics or, more specifically, CopperNostics—have the potential to play a prominent role in modern precision medicine, as demonstrated by the FDA approval of [64Cu]Cu-DOTA-TATE (Detectnet). In this review we highlight current developments in the production, radiochemical purification, quality control, availability, logistics, and regulatory hurdles of the most relevant copper radioisotopes, 60Cu, 61Cu, 62Cu, 64Cu, and 67Cu, for nuclear medicine. Radiopharmaceuticals based on their application in registered clinical trials, either as molecular imaging agents, companion diagnostics or therapeutic agents, are also presented addressing unmet medical needs.