What is Theranostics?
Theranostics is a new field of medicine which combines specific targeted therapy based on specific targeted diagnostic tests. With a key focus on patient centred care, theranostics provides a transition from conventional medicine to a contemporary personalised and precision medicine approach. The theranostics paradigm involves using nanoscience to unite diagnostic and therapeutic applications to form a single agent, allowing for diagnosis, drug delivery and treatment response monitoring.
Theranostics uses specific biological pathways in the human body, to acquire diagnostic images and also to deliver a therapeutic dose of radiation to the patient. A specific diagnostic test shows a particular molecular target on a tumour, allowing a therapy agent to specifically target that receptor on the tumour, rather than more broadly the disease and location it presents. This contemporary form of treatment moves away from the one-medicine-fits-all and trial and error medicine approach, to offering the right treatment, for the right patient, at the right time, with the right dose, providing a more targeted, efficient pharmacotherapy in the form of theranostics.
The development of molecular diagnostic tests and targeted therapeutics in an interdependent and collaborative manner, particularly focusing on individualising treatment by targeting therapy to an individual’s specific disease subtype and genetic profile, enables optimisation of drug efficacy and safety, assisting in streamlining the drug development process. The companion diagnostic is a tool that helps in determining the subtype of the disease, its progression, and the characteristics of a patient. This information allows decisions to be made on timing, quantity, type of drugs, and choice of treatment procedure, as well as helping to evaluate a patient’s response to treatment.
Theranostics is in reality, 75 years old, with the use of radioactive iodine (I-131) or Iodine-131 Therapy for the diagnosis and treatment of thyroid cancer – a well-established, effective and safe treatment available throughout the world. In the last decade a similar paradigm has developed for neuroendocrine tumours using Ga-68 octreotate (a positron emitter) to assess extent of disease, somatostatin receptor density and tracer avidity via PET-CT (Positron Emission Tomography – Computer Tomography) hybrid scanners. In patients with Ga-octreotate avid disease, treatment with Lu-177 octreotate (also known as Lutate) – a beta emitting therapeutic radiopharmaceutical, can be offered (Lutetium Octreotate Therapy). This type of therapy has also been used in combination with radiosensitising chemotherapy, with impressive results. This combined chemo-targeted radiopeptide therapy approach was developed under the research programme of Professor Harvey Turner and Dr Phil Claringbold at Fremantle Hospital in Perth Australia.
Over the past few years, further development in this field has seen an increasing number of theranostic treatments being made available. Theranostics Australia is currently offering Lutetium Octreotate Therapy for somatostatin positive tumours, Lutetium PSMA Therapy for metastatic or treatment resistant prostate cancer, Yttrium-90 SIRT Therapy for liver cancer, Iodine-131 Therapy for thyrotoxicosis and thyroid cancer, Radium-223 Therapy for metastatic prostate cancer to bones and Yttrium-90 Radiosynovectomy Therapy for inflammatory synovitis of joints.
To learn more about theranostics and its benefits, watch the 3-part series produced by Dr. Geoffrey Currie and students from Charles Sturt University (CSU) in New South Wales, Australia. To switch between videos, click the menu icon in the top left corner, or alternatively, use the previous/next arrow icons at the bottom of the player. To switch to full screen mode, click the full screen icon in the bottom right corner of the video player. To exit out of full screen mode, press ‘Esc’ on your keyboard or click the full screen icon again.