“Theranostics” is the name given to an emerging methodology for imaging and delivering therapy with a single compound, usually a molecule, nanoparticle or a peptide (or vector). Usually, different labels are added to the vector for pre-therapeutic imaging and for therapy. Common examples of some of the labels used are radionuclides such as PET or SPECT imaging labels (e.g., Gallium-68, Technetium-99m, Iodine-124, Copper-64) and therapy with a beta particle emitting radionuclide (e.g., Iodine-131, Lutetium-177, Yttrium-90, Copper-67). Other non-radionuclide labels that can be imaged are also available, such as fluorescent compounds. The imaging often serves to establish that the disease targeted by the therapy demonstrates sufficient uptake of the theranostic vector before proceeding with the treatment.
Flagship 2 focuses on bringing new theranostic pairs into clinical use by facilitating rapid translation from the design and pre-clinical testing phase into clinical trials & patient use. Current examples include:
• the clinical management of neuroendocrine tumours (NETs) including the development of biomarkers, Quality of Life assessments and databases to assist in defining prognostic markers, collaborating with the Pharma industry to run first-in-man imaging trials of new theranostic radiolabel pairings and new peptide antagonists,
• providing an appropriate trial framework for introducing new theranostics to examine their efficacy and applying new imaging methodologies to better inform treatment decisions (e.g., in lymphoedema, functional pituitary lesions, brain tumours),
• developing new radiolabelled forms of anti-cancer pharmaceuticals to image with prior to therapy to demonstrate in vivo targeting,
• studying the sequencing or combination of therapies combining chemotherapy and immunotherapy with a theranostic approach.
The flagship will now address new emerging theranostic approaches in NETs, prostate cancer and other cellular markers including:
- New agonists and antagonists in NETs;
- Peptide receptor therapies in prostate cancer targeting the Prostate Specific Membrane Antigen (PSMA);
- C-X-C chemokine receptor 4 in myeloma.