Abstract
Theranostics is a precision medicine which integrates diagnostic nuclear medicine and radionuclide therapy for various cancers throughout body using suitable tracers and treatment that target specific biological pathways or receptors. This review covers traditional theranostics for thyroid cancer and pheochromocytoma with radioiodine compounds. In addition, recent theranostics of radioimmunotherapy for non-Hodgkin lymphoma, and treatment of bone metastasis using bone seeking radiopharmaceuticals are described. Furthermore, new radiopharmaceuticals for prostatic cancer and pancreatic cancer have been added. Of particular, F-18 Fluoro-2-Deoxyglucose (FDG) Positron Emission Tomography (PET) is often used for treatment monitoring and estimating patient outcome. A recent clinical study highlighted the ability of alpha-radiotherapy with high linear energy transfer (LET) to overcome treatment resistance to beta--particle therapy. Theranostics will become an ever-increasing part of clinical nuclear medicine.
Highlights
Theranostics is a re-emerging new medical term of combination of diagnostic and therapeutic techniques using suitable drug combination [1]
A number of Positron Emission Tomography (PET) compounds labeled with Ga-68 or F-18 have been used for imaging, while beta- or alfa-emitting sister compounds are applied for therapy [3,4,5]
Theranostics plays an important role for both detection of malignant lesions throughout the body using tumor affinity compounds, and treating lesions with radiotherapy emitted from beta- or alfa-emission from the same targeted radiolabeled compounds
Summary
Theranostics is a re-emerging new medical term of combination of diagnostic and therapeutic techniques using suitable drug combination [1]. There are a number of reports indicating the diagnostic values and better prognostic values of oncology therapy as compared to the conventional systemic chemotherapy [6,7] This is important to find a suitable cell target for specific radionuclide imaging in combination with target radiotherapy. The first three fields cover specific targets accumulated in the cancer cells (internalization) using suitable radiolabeled agents. On the other hand, radiolabeled agents do not go into the cancer cells in non-Hodgkin lymphoma or bone metastasis (not internalization) Instead, these agents accumulate near cancer cells with specific targets, such as CD20 antigen on the surface of tumor cell membranes in lymphoma and bone reaction near tumor cells in osteoblastic bone metastases (Table 1).
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