2024-01-10 23:00:00
Patients with prostate or breast cancer can now benefit from a new therapeutic approach using radionuclides. This technique not only makes it possible to identify tumors very precisely using imaging but also to treat them directly. Radionuclides are therefore used both for diagnosis and for therapy: this is theranostics.
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What is theranostics?
To locate tumors in the body, an examination is usually carried out using positron emission tomography (PET or PET scan). To do this, the doctor injects a slightly radioactive substance into the patient’s body. This product attaches to cancer cells to temporarily emit radiation (light spots) visible on a PET scan.
Theranostics uses this same product, with some minimal modifications. When the product attaches to the tumor cells, it breaks them into pieces.
Dr. Simone Dalm, biomedical scientist, explains how theranostics works: “To carry out the treatment, we make a substance radioactive (radionuclides), which we call a radiotracer. This substance binds precisely to proteins in cancer cells. The radiotracer is like a key that fits into a lock.” These radiotracers then destroy cancer cells using their radioactive material.
Healthy cells spared by radionuclides
Healthy cells are therefore spared by this treatment. “The key only fits in the lock,” adds Dr. Simone Dalm. “In other words, the treatment only responds to the protein in cancer cells, not the protein in healthy cells. Therefore, radioactivity is delivered exclusively to cancer cells and healthy parts of the body are spared.”
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The benefits of theranostics
Compared to other cancer treatments, theranostics has certain advantages:
Detection of cancer cells. Radioactive tracers are visible on the scanner. Because they bind to cancer cells, we can see exactly where the tumors are. It is therefore possible to precisely map the extent of cancer in the body. Theranostics makes it possible to irradiate cancer cells in a targeted manner. Radionuclides only bind to the protein on cancer cells. Unlike other treatments such as traditional chemotherapy or radiotherapy, healthy cells are not affected. It is possible to check afterwards whether the treatment was effective. As tracers can reveal tumors, they also make it possible to subsequently check whether there are still cancer cells in the body. Theranostics is very personalized. If a doctor scans five patients and four of them see their tumors light up, he knows that these four patients can be treated with the radioactive substance. Doctors thus avoid treating patients unnecessarily.
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Research issues
Although the treatment is promising, it also has challenges. Indeed, theranostics can only work if we find the protein which is mainly present in cancer cells and not in healthy cells. Otherwise, healthy cells will also be damaged. It is sometimes difficult to find such a specific protein. In addition, they can vary according to the type of cancer or according to the subtypes of the same type of cancer.
In addition, there is a group of patients who do not respond well to treatment: the tumor returns after therapy or, in some cases, the tumor is not visible at all, although it is present.
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Last updated: January 2024
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