Abstract
Cancer treatment has advanced significantly, yet traditional modalities such as radiotherapy still encounter challenges, including damage to healthy tissues and limited tumor specificity. Monoclonal antibodies (mAbs) have emerged as powerful tools in oncology, offering particular therapeutic options with reduced toxicity. Their capacity to enhance the efficacy of radiotherapy through radiosensitization presents a promising strategy for improving cancer outcomes. This review synthesizes findings from the past decade, providing an in-depth analysis of the diverse roles of mAbs in radiosensitization. Key mechanisms are discussed, including targeting molecular pathways, modulation of immune responses, and integration with novel platforms such as nanoparticles and antibody-drug conjugates (ADCs). The review also highlights the successes of preclinical and clinical studies while addressing ongoing challenges like delivery inefficiencies, tumor resistance, and antigen heterogeneity. Additionally, emerging alternatives including aptamers, nanobodies, and engineered proteins are explored as potential solutions to these barriers. Advancements in mAb-based delivery systems and combination therapies remain crucial for achieving more personalized and effective cancer treatments.