When Cancer Has Spread (Metastasized), and If Other Treatments does not Work, Theranostics Can Be Helpful

 

Theranostics

Theranostics is the use of targeted diagnostic tests in conjunction with targeted therapy. Companion diagnostics, integrated medicine, Dx/Rx partnering, and pharmacodiagnostics are other terms for it. The incorporation of Theranostics into the patient care plan (in the case of selected diseases for which diagnostic tests are available alongside respective therapy) may result in personalised therapy, which may improve medical outcomes even further. Theranostics refers to the use of specific diagnostic tests that reveal a specific molecular target on a tumour or other disease-causing agent.

Any disease pathophysiology involves specific biological pathways that can be targeted using diagnostic tests. Diagnostic images of the specific molecule then identify the presence of a specific mutation or receptors (in the case of cancer), which can then be targeted with therapeutic agents. This method avoids trial and error and could be used to provide patient-specific treatment at the right time. Accurate dose calibration and a precisely targeted approach could be extremely beneficial in the treatment of chronic diseases like cancer.

For example, neuroendocrine tumours can be diagnosed and the extent of disease assessed using PET-CT (Positron Emission Tomography - Computer Tomography) and Ga-68 DOTATOC (a radioactive positron emitter). Ga-68 is injected through a vein and targets the somatostatin receptor (SSTR2) on the tumour cell membrane, indicating the presence of tumour on a PET scan. Furthermore, Ga-68 can be replaced by a therapeutic agent to target the tumour.

The term Theranostics is a combination of therapeutics and diagnostics. The term "Theranostics" refers to the use of one radioactive drug to identify (diagnose) and a second radioactive drug to deliver therapy to treat the primary tumour and any metastatic tumours. Tumor cells have a shell called a membrane; certain proteins on the tumour cell membrane, such as the somatostatin receptor (SSTR2), can serve as a target for cancer drugs. The radioactive diagnostic drug Ga-68 DOTATOC targets SSTR2. Ga-68 DOTATOC is injected into a patient's vein and circulates throughout the bloodstream to all organs and tissues. If the patient has a neuroendocrine tumor with SSTR2 on the tumor cell membranes, the Ga-68 DOTATOC will bind to the SSTR2 and the tumor will light up on a PET scan.

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