Theranostics in nuclear medicine practice

Abstract

The importance of personalized medicine has been growing, mainly due to a more urgent need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for specific molecular targeting, both for diagnostics and therapy. The visualization of potential targets can help predict if a patient will benefit from a particular treatment. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents has been continually increasing. In this article, important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with a well-known radioiodine therapy in patients with thyroid cancer and then progresses through various approaches for the treatment of advanced cancer with targeted therapies. The aim of this review was to provide a summary of background knowledge and current applications, and to identify the advantages of targeted therapies and imaging in nuclear medicine practices.

DNA Microsystems for Biodiagnosis

“…Although theranostics is currently more commonly focused on cancer treatments, its methods could also be applied to other disorders [41]. The advantage of implementing a specialized treatment is minimizing the side-effects of chemotherapy or chemotherapeutics in patients by reducing the levels of toxicity due to the use of radioisotopes [12]. Moreover, DNA nanocarriers are employed in theranostics for drug-delivery in a "key-lock" mode, i.e., the nanostructures are designed with aptamers to match lock-like receptors displayed on tumor tissue only, leaving healthy cells unaffected [42].…”

“…and it can also be used as a biomarker of drug resistance [11]. In addition, the specificity of medication and treatment is another significant concern in the medical field, since it is crucial to targeting only the problematic cells while preserving healthy tissue and reducing side effects of treatments [12]. Certain medical conditions, however, need further attention.…”

Developing a Roadmap for Interventional Oncology

“…The premise is that the linked companion diagnostic test will monitor therapy in real time or determine whether a patient will benefit from a specific treatment. Examples include nuclear medicine approaches [23,42,43], ultrasound contrast agents, and MR-imageable, drug-loaded nanostructures [44,45]. Theranostics is an actively growing field with its own journal and rapid advances, several of which can now enter clinical testing.…”

Drafting of comprehensive harmonized regulatory guideline for storage and disposal of radiopharmaceuticals

“…It is estimated that as much as 95% of the original radioactive material during manufacturing of radiopharmaceuticals may be rejected as waste. Moreover, many radiopharmaceuticals consisting of radionuclides chiefly carbon-14, phosphorus-32, phosphorus-33, sulfur-35 and iodine-125 finds their applications in various theranostic procedures in nuclear medicine centres, leading to the production of wastes in various forms of matter 4,5 .…”