Theranostics in Chennai
What is Theranostics?
Theranostic is combination of two words namely, Therapy and Diagnostic. In Nuclear Medicine, Theranostics refers to the combination of using one radioactive drug to identify and the other radioactive drug to treat the cancerous tumors.
Thus, Theranostics is a patient-centered and personalized concept of seeing what we treat (Diagnostic) and treating what we see (Therapy).
What is the advantage of Theranostics?
It helps to improve patient selection for a specific treatment, reduce the side effects and enhance therapeutic efficacy. This combination of therapy and diagnostic radionuclide pair helps to achieve personalized medicine to an extent.
How is it done?
Therapy and imaging are based on different properties of radioactive material administered to the patient.
Imaging in general are performed with Gamma or Positron emitting radionuclides which travel longer distance without much interaction and thus can be picked up by detectors outside the body.
Therapy on the other hand is achieved with Beta or alpha emitting radionuclides which travel shorter distance with higher damage to interacting cells (Linear Energy Transfer / LET).
Theranostics involves two parts, namely diagnostic and Therapy.
- Diagnostic: A Gamma or Positron Emitting Radionuclide labelled with a targeting molecule to image the disease burden and assess the density of the targeting molecule to exploit subsequently with therapy.
- Therapy: A Beta or alpha emitting radionuclide is labelled with same or similar targeting molecule to treat the malignant cells which were visualized before, during the diagnostic phase.
While diagnostic part can be performed on outpatient basis, therapy requires admission in Isolation ward for radiation protection in compliance with Atomic Energy Regulatory Board (AERB) and the duration of stay depends on radiation exposure.
What different treatments are given under theranostics?
- Radioiodine therapy – Iodine 131: Thyroid cancer
- Peptide Receptor Radionuclide Therapy – Lu177 DOTATE/ Ac225 DOTATATE: NeuroEndocrine Tumor (NET)
- PSMA RadioLigand Therapy (PRLT) – Lu177 PSMA/Ac225 PSMA: Prostate cancer
- Transarterial RadioEmbolisation (TARE): Y90 SIR Spheres: Liver malignancies/Metastases.
- Fibroblast Activated Protein Inhibitor (FAPI) therapy – Lu177 FAPI: Advanced cancers (On compassionate grounds)
