Theranostics: integrating molecular imaging and targeted therapy for precision medicine across oncology and beyond
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263578Keywords:
Theranostics, Precision medicine, Radiotheranostics, Nanotheranostics, Phototheranostics, PET imagingAbstract
To review the principles, mechanisms, clinical applications, safety considerations, challenges and future perspectives of theranostics. Literature from peer-reviewed journals, clinical trials and authoritative sources was reviewed. Theranostics integrates molecular imaging and targeted therapy, demonstrating significant benefits in neuroendocrine tumors, prostate cancer, lymphoma and emerging non-oncologic diseases. Theranostics represents a cornerstone of precision medicine and is expected to expand further with advances in artificial intelligence, nanotechnology and novel radiopharmaceuticals.
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References
Funkhouser J. Reinventing pharma: the theranostic revolution. Curr Drug Discov. 2002;2(2):17-9.
Hertz S, Roberts A, Salter WT. Radioactive iodine as an indicator in thyroid physiology: IV. The metabolism of iodine in Graves' disease. J Clin Invest. 1942;21(1):25-9.
Seidlin SM, Marinelli LD, Oshry E. Radioactive iodine therapy: effect on functioning metastases of adenocarcinoma of the thyroid. JAMA. 1946;132(14):838-47.
Ehrhardt JD Jr, Güleç S. A review of the history of radioactive iodine theranostics: the origin of nuclear oncology. Mol Imaging Radionucl Ther. 2020;29(3):88-97.
Goldsmith SJ. History of 131I therapy. J Nucl Med. 2012;53(11):1839-40.
Bodei L, Iagaru A, Schmidt A, Herrmann K. Theranostics in oncology: from molecular imaging to precision medicine. Eur J Nucl Med Mol Imaging. 2020;47(Suppl 1):1-4.
Kelkar SS, Reineke TM. Theranostics: combining imaging and therapy. Bioconjug Chem. 2011;22(10):1879-903.
Lameijer MAM, Dierckx RAJO, de Vries EGE, Lub-de Hooge MN. Molecular nuclear medicine: the future of molecular imaging and targeted therapy. Lancet Oncol. 2020;21(3):e130-43.
Vikram R, Johnson CB, Kwee TC. Theranostics: a primer for medical students and residents. Semin Nucl Med. 2023;53(4):475-84.
Gorin MA, Rowe SP, Patel HD, Vidal I, Mana-ay M, Javadi MS, et al. Prospective evaluation of 68Ga-PSMA-11 PET/CT for preoperative staging of intermediate- to high-risk prostate cancer. Eur Urol. 2018;73(2):315-6.
Weber WA, Czernin J. From nuclear medicine to theranostics: the long road to precision oncology. J Nucl Med. 2021;62(Suppl 1):17S-22S.
Herrmann K, Larson SM, Weber WA. Theranostics: an overview from concept to clinical implementation. J Nucl Med. 2021;62(Suppl 1):1S-6S.
Pascual TNB, Paez D, Iagaru A, Gnanasegaran G, Lee ST, Sathekge M, et al. Guiding principles on the education and practice of theranostics. Eur J Nucl Med Mol Imaging. 2024;51(8):2320-31.
Lee DY, Li KC. Advanced theranostics for personalized medicine. Invest Radiol. 2011;46(7):438-46.
Sedlack AJH, Meyer C, Mench A, Winters C, Barbon D, Obrzut S, et al. Essentials of theranostics: a guide for physicians and medical physicists. RadioGraphics. 2024;44(1):e230097.
Yordanova A, Eppard E, Kürpig S, Bundschuh RA, Schönberger S, Gonzalez-Carmona M, et al. Theranostics in nuclear medicine practice. Onco Targets Ther. 2017;10:4821-8.
Pouget JP, Navarro-Teulon I, Bardiès M, Chouin N, Cartron G, Pèlegrin A, et al. Clinical radioimmunotherapy--the role of radiobiology. Nat Rev Clin Oncol. 2011;8(12):720-34.
Burkett BJ, Bartlett DJ, McGarrah PW, Lewis AR, Johnson DR, Berberoğlu K, et al. A review of theranostics: perspectives on emerging approaches and clinical advancements. Radiol Imaging Cancer. 2023;5(4):e220157.
Jadvar H, Chen X, Cai W, Mahmood U. Radiotheranostics in oncology: current challenges and emerging opportunities. EMBO Mol Med. 2024;16(2):237-52.
Bailey DL, Willowson KP. An evidence-based review of quantitative SPECT imaging and SPECT/CT. Cancer Imaging. 2014;14(1):33.
Kelkar SS, Reineke TM. Nanomaterials in macromolecular therapeutics and theranostics. In: Davis ME, editor. Comprehensive Biomaterials. Elsevier; 2011. p. 513-31.
Hapuarachchige S, Artemov D. Theranostic pretargeting drug delivery and imaging platforms in cancer precision medicine. Front Oncol. 2020;10:1131.
Pryma DA, Chin BB, Noto RB, Dillon JS, Perkins S, Solnes L, et al. Efficacy and safety of high-specific-activity 131I-MIBG therapy in patients with advanced pheochromocytoma or paraganglioma. J Nucl Med. 2019;60(5):623-30.
Vinjamuri S, Gilbert TM, Banks M, Shannon G, Hall N, Frank J, et al. Peptide receptor radionuclide therapy with 90Y-DOTATATE/90Y-DOTATOC in patients with progressive metastatic neuroendocrine tumours: assessment of response, survival and toxicity. Br J Cancer. 2013;108(7):1440-8.
Choy JS, Sharma R, Seshadri M, Green MC. Incidental uptake of 111In-ibritumomab tiuxetan in surgically treated fracture. Open Med Imaging J. 2010;4:132-4.
Pantel AR, Eiber M, Beyder DD, Bozkurt MF, Bural GG, Baum RP, et al. SNMMI procedure standard/EANM practice guideline for palliative nuclear medicine therapies of bone metastases. J Nucl Med Technol. 2023;51(3):176-87.
Sartor O, de Bono J, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385(12):1091-103.
Assadi M. Emerging preclinical and clinical applications of theranostics. Semin Nucl Med. 2021;51(4):297-304.
Goyal AK, Ramchandani M, Basak T. Recent advancements, challenges, and future prospects in usage of nanoformulation as theranostics in inflammatory diseases. J Nanotheranostics. 2023;4(1):106-26.
Li L, Yin Y, Zhang S, Zhang H, Zhang P, Li Y, et al. Triggerable biomaterials-based osteomyelitis theranostics. BMEMat. 2024;2(4):e12081.
Cicone F, Gnesin S, Santo G, Stokke C, Bartolomei M, Cascini GL, et al. Do we need dosimetry for the optimization of theranostics in CNS tumors? Neuro-Oncology. 2024;26(Suppl 9):S242-58.
Bednarz B. Theranostics and patient-specific dosimetry. Semin Radiat Oncol. 2023;33(3):317-26.
Miller C, Rousseau J, Ramogida CF. Implications of physics, chemistry and biology for dosimetry calculations using theranostic pairs. Theranostics. 2022;12(1):232-59.
Al-Ibraheem A. Theranostics in developing countries: addressing challenges and potentials from training to practice. World J Nucl Med. 2023;22(2):83-8.
Brink A, Sathekge MM. Global challenges in the provision of theranostic services. Radiol Imaging Cancer. 2024;6(2):e230182.
Currie GM, Wheat JM. Molecular theranostics: principles, challenges, and controversies. J Med Radiat Sci. 2024;71(2):221-32.
Pathmaraj K, Lee ST. Approaches to conducting clinical trials in theranostics. Clin Transl Radiat Oncol. 2024;46:100774.
Trpezanovski M, Bailey DL, Willowson KP. Dosimetry in radionuclide therapy: an essential component of clinical trials. Clin Transl Imaging. 2023;11(4):325-37.
Singh D, Sharma R, Sharma S, Negi R, Bisht P. Smart nanomaterials in cancer theranostics: challenges and opportunities. ACS Omega. 2023;8(25):22340-55.
Gomes Marin JF, Nunes RF, Coutinho AM, Zaniboni EC, Costa LB, Pesquero JB, et al. Theranostics in nuclear medicine: emerging and re-emerging integrated imaging and therapies in the era of precision oncology. RadioGraphics. 2020;40(6):1715-40.
Bilgin GB, Al-Nahhas A. Current and future directions in theranostics: from oncology to non-oncology applications. Semin Nucl Med. 2024;54(4):450-62.
Pathmaraj K, Lee ST. Multidisciplinary perspectives of clinical trials in theranostics. World J Nucl Med. 2024;23(1):14-22.
Herrmann K, Schwaiger M, Lewis JS, Solomon SB, Zheng J, Fleming IN, et al. Radiotheranostics: a roadmap for future development. Lancet Oncol. 2020;21(3):e146-56.
Chen X, Gambhir SS, Cheon J. Theranostics: past, present, and future perspectives. Theranostics. 2023;13(15):5559-66.
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