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.

New Theranostic Treatment for Prostate Cancer Comes to UNM Cancer Center

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.

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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.

Joanna Fair image demonstrating theranostics for neuro-endocrine tumors

Theranostics Target Cancer

We have an atom that targets a particular kind of cancer cell. We can trade out the atom for a different kind of radioactive atom that can be used to treat the patient. And we know that it will go to the tumor because we already have pictures that show exactly where the agent is going to go. — Joanna Fair, MD, PhD

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Meet the Theranostics Team

Many experts collaborate to offer you the best treatment.

What Each Team Member Offers

Medical Oncologists

Oversee the delivery of PRRT and, along with the nuclear medicine physicians, decide whether you are a good candidate for PRRT. PRRT is delivered by infusion, similar to how chemotherapy is delivered. Our medical oncologists will manage the delivery process and help you to manage any side effects that you may have.

Nuclear Medicine Physicians

Determine the dose plan for PRRT and, along with the medical oncologists, decide whether you are a good candidate for PRRT. PRRT is radioactive yet must be infused in a clinic. Our nuclear medicine physicians oversee all procedures to safely measure and deliver your treatment.

Radiation Safety Team Members

Establish processes for people to enter and leave the treatment room and to handle the drug safely. The day before the treatment, the room is covered in a protective paper and plastic barrier to keep the radiation contained.

Prepare the special amino acid solution and help in mixing the drugs for the PRRT treatment.

Infusion Nursing Team Members

Watch over you as you receive the amino acid and PRRT infusions. Under the medical oncologists’ direction, they may also administer drugs to help reduce side effects.

What Each Team Member Offers

Physicians

Medical Oncologists

Nuclear Medicine Physicians

Radiation Safety

Radiation Safety Team Members

Pharmacists

Prepare the special amino acid solution and help in mixing the drugs for the PRRT treatment.

Infusion Nursing

Infusion Nursing Team Members

Watch over you as you receive the amino acid and PRRT infusions. Under the medical oncologists’ direction, they may also administer drugs to help reduce side effects.