Chapter 1 - Cancer theranostics: recent global advances

Abstract

The incidence of cancer and its subsequent morbidity and mortality are increasing dramatically all over the world. Early diagnosis and treatment of cancer substantially improve treatment efficacy and patient survival. Limitations and shortcomings in cancer diagnosis and treatment could be one of the important causes of high cancer mortality. Theranostics, as a novel approach, can open a new window toward accurate, correct, and simultaneous diagnosis and treatment of cancer in patients. A theranostic is made of a single particle, usually, a nanoparticle, which contains a therapeutic modality coupled with an imaging modality. Herein, we discuss the structure of theranostics, including the imaging moieties (radionuclides, paramagnetic metals, fluorescent dyes, ultrasound and photoacoustic agents, contrast agents, and multimodal imaging agents), the therapeutic moieties (chemotherapy, radioisotopes, immunotherapy, gene therapy, boron neutron capture therapy, photothermal therapy, and photodynamic therapy), and the delivery systems for theranostics (lipid- and polymer-based nanotheranostics, bio-inspired protein-based nanotheranostics, bioimaging hybrid nanocrystals, nano-integrated theranostics, self-assembling drug-diagnostic moiety conjugates, self-assembling drug-drug conjugates, and nanostructures with intrinsic therapeutic/imaging properties) as well as the application of theranostics, Food and Drug Administration-approved theranostic agents, and toxicity of theranostics. It is believed that the integration of cancer diagnosis and treatment as cancer theranostics can promise more effective treatment and even eradication of cancer in the future. However, more extensive studies are required to realize this expectation.