Theranostic imaging of cancer

Abstract

The most pressing need in cancer is to design effective treatments that minimize damage to normal tissue especially against metastastic lesions that become refractory to treatment. Molecular imaging in cancer can drive both discovery and optimization of treatment. It can be applied to identify targets specific to cancer with imaging, design agents against targets and visualize their delivery, monitor response to treatment, and minimize collateral damage to normal tissue. Theranostic imaging, where diagnosis is combined with therapy, is a rapidly growing application of cancer molecular imaging. It is particularly suitable for a disease that is as complex as cancer, especially since genomic and proteomic profiling can provide an extensive ‘fingerprint’ of each tumor. Using this information, theranostic agents can be designed to personalize treatment, and minimize damage to normal tissue. Some of the challenges in theranostic imaging are quantitative image analyses, cost of synthesizing theranostic agents, solving immunogenicity problems associated with these agents, challenges with cGMP synthesis, obtaining FDA/IRB approval, and the costs of clinical trials. Despite these challenges, the exciting opportunities in theranostic imaging that are occurring at the interface of chemistry, molecular biology, and imaging provide tangible advances in finding effective treatments against cancer.