Toward theragnostics

Abstract

Theragnostics is a treatment strategy that combines therapeutics with diagnostics. It associates both a diagnostic test that identifies patients most likely to be helped or harmed by a new medication, and targeted drug therapy based on the test results. Bioinformatics, genomics, proteomics, and functional genomics are molecular biology tools essential for the progress of molecular theragnostics. These tools generate the genetic and protein information required for the development of diagnostic assays. Theragnostics includes a wide range of subjects, including personalized medicine, pharmacogenomics, and molecular imaging to develop efficient new targeted therapies with adequate benefit/risk to patients and a better molecular understanding of how to optimize drug selection. Furthermore, theragnostics aims to monitor the response to the treatment, to increase drug efficacy and safety. In addition, theragnostics could eliminate the unnecessary treatment of patients for whom therapy is not appropriate, resulting in significant drug cost savings for the healthcare system. However, the introduction of theragnostic tests into routine health care requires both a demonstration of cost-effectiveness and the availability of appropriate accessible testing systems. This review reports validation studies in oncology and infectious diseases that have demonstrated the benefits of such approach in well-defined subpopulations of patients, moving the field from the drug development process toward clinical practice and routine application. Theragnostics may change the usual business model of pharmaceutical companies from the classic blockbuster model toward targeted therapies.

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

“…However, it should be restricted to accurately defined problems and pursue the objective to achieve direct benefits for the critically ill patient. Together with new findings in the epigenetic field, the concept of directly linking diagnostic results to an individual therapeutic regime -also termed theragnostics [166] -may be the next step to improve the outcome of patients with sepsis. Thus, beside the need to find valuable diagnostic substances, biomarker-guided therapy approaches should gain further attention.…”

Medical imaging in personalised medicine: a white paper of the research committee of the European Society of Radiology (ESR)

“…perfusion, flow, metabolism, diffusion). Personalised treatment focuses on the identification of patient subgroups likely to give a positive response to a given treatment [11], on the identification of subgroups of patients at risk of side effects during treatment [11], on monitoring of therapy response [11] and on individualised drug delivery systems allowing both real-time modulation of treatment approach and treatment delivery at a specific location. In other words, as Michael Berger so eloquently phrased it, "medical treatment tailored not just to symptoms, but to the biochemical profile of an individual's disease state (gene expression, proteome, dominant metabolic pathways, etc.)"…”

Combining Targeted Therapies: Practical Issues to Consider at the Bench and Bedside

“…"Theragnostics" combines therapeutics with diagnostics [74], so that a diagnostic test that identifies patients most likely to be helped or harmed by a new medication is linked with a targeted drug therapy based on the test results. In oncology, there are few, but illustrative, examples of how to apply this therapeutic approach.…”