Abstract
We are continuously progressing in our understanding of cancer and other diseases and learned how they can be heterogeneous among patients. Therefore, there is an increasing need for accurate characterization of diseases at the molecular level. In parallel, medical imaging and image-guided therapies are rapidly developing fields with new interventions and procedures entering constantly in clinical practice. Theranostics, a relatively new branch of medicine, refers to procedures combining diagnosis and treatment, often based on patient and disease-specific features or molecular markers. Interventional oncology which is at the convergence point of diagnosis and treatment employs several methods related to theranostics to provide minimally invasive procedures tailored to the patient characteristics. The aim is to develop more personalized procedures able to identify cancer cells, selectively reach and treat them, and to assess drug delivery and uptake in real-time in order to perform adjustments in the treatment being delivered based on obtained procedure feedback and ultimately predict response. Here, we review several interventional oncology procedures referring to the field of theranostics, and describe innovative methods that are under development as well as future directions in the field.
Highlights
In the past decades, combined efforts have improved our understanding of various diseases at the molecular level, in particular in the field of cancer (Hanahan and Weinberg, 2011)
In this review we detail various theranostic methods applied to interventional oncology as well as future directions in the field
Transarterial chemoembolization (TACE) is one of the first theranostic methods that was used in the field of interventional radiology, combining diagnosis of hepatic tumors with tumor “tagging,” simultaneous tumor treatment and real-time treatment evaluation (Iwai et al, 1984; Konno et al, 1984;Ohishi et al, 1985; Yumoto et al, 1985)
Summary
In the past decades, combined efforts have improved our understanding of various diseases at the molecular level, in particular in the field of cancer (Hanahan and Weinberg, 2011). Numerous targeted therapies have been developed and are a cornerstone in the management of various malignancies, alone or in combination with other treatment such as chemotherapy, radiation therapy, interventional radiology or surgery (Sawyers, 2004; Adam and Kenny, 2015) To address this increasing need for patient-tailored therapies, technological advances have been made in targeted diagnostics, for example using specific radionuclides or nanoparticles (Chen et al, 2014). Molecular imaging may assist for accurate distinction between healthy tissue and tumor, helping surgeons and interventional radiologists to completely eradicate malignancies without affecting surrounding tissue or organs, thereby improving outcomes while reducing morbidity (Willmann et al, 2008) This combined necessity for targeted diagnostics and therapeutics led to the emergence of a new field, named “theranostics,” which refers to methods that couples a therapy or intervention with simultaneous diagnostic information for a specific target (Jo et al, 2016). In this review we detail various theranostic methods applied to interventional oncology as well as future directions in the field
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