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Theranostics
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Please note that a referral letter is required before an appointment can be confirmed.
Useful Information
About theranostics
The term “theranostics” comes from combining “therapy” and “diagnostics.” This cutting-edge approach uses advanced imaging techniques to locate cancer cells and then delivers treatment directly into them. Theranostics using radiopharmaceuticals (radioactive drugs) for imaging and treatment is called Radiopharmaceutical Therapy (RPT).
Radioligand Therapy (RLT) is a type of radiopharmaceutical therapy. A radioligand is made of a radioactive particle (isotope) which is linked to a cancer-targeting molecule (ligand). The cancer-targeting molecule seeks out PSMA (prostate specific membrane antigen) that is often found in larger quantities on prostate cancer cells, and the radioactive particle, depending on the type used, can either confirm the presence of PSMA or be used to treat the prostate cancer cells . Fluorine-18 (F-18) or Gallium-68 (Ga-68) are the radioactive isotopes used to diagnose the presence of PSMA and Lutetium-177 (Lu-177) is used to treat the prostate cancer. Lutetium-177 PSMA therapy is a type of RLT.
Who is theranostics for?
Theranostics is of particular benefit to:
- Patients with advanced prostate cancer or neuroendocrine tumours (NETs).
- Patients with advanced or metastatic disease for whom standard therapies like chemotherapy or surgery are no longer effective.
- Patients whose cancer cells have certain markers, such as PSMA (prostate-specific membrane antigen) for prostate cancer or somatostatin receptors for NETs.
- Lutetium-177 (Lu-177) PSMA Therapy: this is used to treat prostate cancer by targeting PSMA markers on cancer cells.
- Lutetium-177 D OTATATE Therapy: this is used to treat neuroendocrine tumours by targeting somatostatin receptor markers.*
- Radium-223 (Xofigo): this is used to treat prostate cancer that has spread to the bones.
- Radioactive Iodine (RAI) Therapy: this is used to treat thyroid cancer and also overactive thyroid disease, leveraging the fact that iodine is absorbed well by the thyroid.
*The European Medicines Agency approved Lu-177 DOTATATE therapy for NET tumours in 2015 and subsequently approved Lu-177 PSMA-617 therapy (Novartis’s Pluvicto (R)) for prostate cancer in 2022. A non-licensed but pharmacologically manufactured GMP standard PSMA I&T is produced by another manufacturer Curium and is in use all over Europe.
Radiopharmaceutical therapy is considered a safe and well-tolerated treatment option for most patients. Side effects vary depending on the specific therapy and may include:
- Mild fatigue
- Nausea
- Temporary changes in blood counts
Because the radioactive material is precisely targeted, the risk to healthy tissues is minimal. Before starting treatment, a team of specialists ensures that the benefits outweigh any risks for the patient.
Theranostics is part of a multidisciplinary cancer care plan involving collaboration between oncologists, nuclear medicine specialists, and radiologists. Together they use it in the following ways:
- Diagnosis: a preliminary PET/CT scan helps the team to decide whether you are a candidate for theranostic therapy.
- Treatment planning: the scan outputs are used by your medical team to create a personalised treatment plan.
- Therapy sessions: when the radioactive treatment you require is administered, usually as an outpatient procedure.
- Follow-up care: post-treatment scans are used to assess the therapy’s effectiveness.
Theranostics offers a level of precision and treatment personalisation that is not otherwise possible in cancer care. It has particular value for patients with advanced cancer, and offers:
- Improved survival rates and quality of life.
- Reduced side effects compared to traditional therapies.
