Theranostics

Some cancers are difficult to diagnose because the tumors are hard to find. Other cancers are difficult to treat because they cannot be removed by a surgeon. And, they do not respond to chemotherapy. Theranostics is a new tool in our cancer-fighting arsenal. It can find and treat cancers that can be difficult to diagnose or treat.

Step 1: Diagnosis

The first step of Theranostic treatment is finding cancer cells. A positron emission tomography/computed tomography (PET/CT) scan is used. Before the scan, a drug containing a two-part molecule is injected into your vein.

One part of the molecule binds to a site on a cancer cell’s surface. The other part is a radioactive atom. The radioactive atom can give off low-energy radioactive particles. These particles light up on the computer screen to diagnose and measure the cancer.

The PET/CT scan with this two-part molecule delivers sharper tumor images. It can find smaller amounts of hidden cancer than conventional imaging can find.

Step 2: Treatment

The second step of Theranostic treatment is killing the cancer cells. Again, a two-part molecule is used.

The part that binds to a site on a cancer cell’s surface is the same as in the first step. But the other part is a different radioactive atom that emits high-energy radiation.

The high-energy radiation kills cancer cells but doesn’t travel far within the body. Only a small number of nearby normal cells are affected. This type of treatment can precisely kill cancer cells.

Theranostics, derived from the words therapy and diagnostic, uses a two-part molecule. One part binds to certain receptors on cancer cells, while the other part is a radioactive ion. 

Lutathera® Treatment for Neuroendocrine Tumors

In 2018, the US Food and Drug Administration (FDA) approved Lutathera® for treating neuroendocrine tumors. Lutathera uses a molecule called dotatate to bind to neuroendocrine cancer cell surfaces. The dotatate is attached to copper 64 (64Cu) for diagnosis and to lutetium 177 (177Lu) for treatment.

Like all drugs, Lutathera carries risks. It is given as an infusion, along with amino acids to protect the kidneys. Each of the four infusions can take as long as eight hours. And, you will have to restrict some activities for a week after each infusion.

Some people have side effects, such as nausea and feeling tired. The treatment also carries a small risk for leukemia and toxicity in the kidneys and liver. Lutathera is not for everyone. You, your doctor, and our team can jointly decide if it will benefit you.

Pluvicto™ Treatment for Prostate Cancer

In 2022, the FDA approved Pluvicto™ for treating metastatic prostate cancer. One part of the drug molecule binds to prostate cancer cells. For diagnosis, this molecule is attached to either a gallium 68 (68Ga) atom or to a fluorine 18 (18F) atom. For treatment, the molecule is attached to lutetium 177 (177Lu).

Pluvicto treatment has a different, shorter schedule than Lutathera. It also carries risks. The most common side effects are feeling tired (fatigue), dry mouth, and nausea. A less common side effect is a drop in blood cell counts, called bone marrow suppression. Bone marrow suppression can cause other effects. Pluvicto is not for everyone. You, your doctor, and our team can help you decide if it will benefit you.