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Nuclear Medicine Theranostics: Between Atoms and Patients

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Nuclear Medicine Therapy

Abstract

In the last two decades, the demand for a personalized therapeutic approach has been constantly increasing, mainly due to the need to develop ever more effective therapeutic regimens, to improve outcome, and to avoid unnecessary treatments. Theranostics is an invaluable tool in personalized medicine; it is a treatment strategy in which the same (or very similar) agents are used for both diagnostic and therapeutic purposes. Particularly, theranostics is based on the integration of a diagnostic test and a specific treatment and it relies on the idea of selecting patients through a diagnostic study that could detect whether a patient will benefit from a certain therapy or not. After a brief historical review a critical update on theranostics will be provided in this chapter.

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References

  1. Del Vecchio S, Zannetti A, Fonti R, Pace L, Salvatore M. Nuclear imaging in cancer theranostics. Q J Nucl Med Mol Imaging. 2007;51(2):152–63.

    PubMed  Google Scholar 

  2. Verburg FA, Heinzel A, Hänscheid H, Mottaghy FM, Luster M, Giovanella L. Nothing new under the nuclear sun: towards 80 years of theranostics in nuclear medicine. Eur J Nucl Med Mol Imaging. 2014;41(2):199–201.

    Article  Google Scholar 

  3. De Nardo GL, De Nardo SJ. Concepts, consequences and implications of theranosis. Semin Nucl Med. 2012;42(3):147–50.

    Article  Google Scholar 

  4. Srivastava SC. Paving the way to personalized medicine: production of some promising theragnostic radionuclides at Brookhaven national laboratory. Semin Nucl Med. 2012;42:151–63.

    Article  Google Scholar 

  5. Taïeb D, Hicks RJ, Pacak K. Nuclear medicine in cancer theranostics: beyond the target. J Nucl Med. 2016;57(11):1659–60.

    Article  Google Scholar 

  6. Dagogo-Jack I, Shaw AT. Tumor heterogeneity and resistance to cancer therapies. Nat Rev Clin Oncol. 2018;15(2):81–94.

    Article  CAS  Google Scholar 

  7. Hertz S, Roberts A, Evans RD. Radioactive iodine as an indicator in the study of thyroid physiology. Exp Biol Med. 1938;38(4):510–3.

    Article  Google Scholar 

  8. Livingood JJ, Seaborg GT. Radioactive isotopes of iodine. Phys Rev. 1938;53:775.

    Article  Google Scholar 

  9. Perlman I, Chaikoff IL, Morton ME. Radioactive Iodine as an indicator of the metabolism of iodine I. The turnover of iodine in the tissue of the normal animal, with particular reference to the thyroid. J Biol Chem. 1941;139:433.

    CAS  Google Scholar 

  10. Hertz S, Robert A. Radioactive iodine in the study of thyroid physiology VII. The use of radioactive iodine therapy in hyperthyroidism. JAMA. 1946;131:81.

    Article  CAS  Google Scholar 

  11. Chapman EM, Evans RD. The treatment of hyperthyroidism with the radioactive iodine. JAMA. 1946;131:86.

    Article  CAS  Google Scholar 

  12. Pollard WG. Availability of radioactive isotopes. Science. 1946;103:697.

    Article  Google Scholar 

  13. Seidlin SM, Oshry E, Yalow AA. Spontaneous and experimentally induced uptake of radioactive iodine in metastases from thyroid carcinoma; a preliminary report. J Clin Endocrinol Metab. 1948;8(6):423–32.

    Article  CAS  Google Scholar 

  14. Liu H, Wang X, Yang R, Zeng W, Peng D, Li J, Wang H. Recent development of nuclear molecular imaging in thyroid cancer. Biomed Res Int. 2018;2018:2149532.

    PubMed  PubMed Central  Google Scholar 

  15. Naranjo A, Parisi MT, Shulkin BL, London WB, Matthay KK, Kreissman SG, Yanik GA. Comparison of 123I-metaiodobenzylguanidine (MIBG) and 131I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the children’s oncology group. Pediatr Blood Cancer. 2011;56(7):1041–5.

    Article  Google Scholar 

  16. Sisson JC, Yanik GA. Theranostics: evolution of the radiopharmaceutical meta-iodobenzylguanidine in endocrine tumors. Semin Nucl Med. 2012;42(3):171–84.

    Article  Google Scholar 

  17. Werner RA, Bluemel C, Allen-Auerbach MS, Higuchi T. Herrmann K. 68Gallium- and 90Yttrium-/177Lutetium: “theranostic twins” for diagnosis and treatment of NETs. Ann Nucl Med. 2015;29:1–7.

    Article  CAS  Google Scholar 

  18. Baum RP, Kulkarni HR, Carreras C. Peptides and receptors in image-guided therapy: theranostics for neuroendocrine neoplasms. Semin Nucl Med. 2012;42(3):190–207.

    Article  Google Scholar 

  19. Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O’Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E, NETTER-1 Trial Investigators. Phase 3 trial of 177Lu-dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125–35.

    Article  CAS  Google Scholar 

  20. Afshar-Oromieh A, Hetzheim H, Kratochwil C, Benesova M, Eder M, Neels OC, Eisenhut M, Kübler W, Holland-Letz T, Giesel FL, Mier W, Kopka K, Haberkorn U. The theranostic PSMA ligand PSMA-617 in the diagnosis of prostate cancer by PET/CT: biodistribution in humans, radiation dosimetry, and first evaluation of tumor lesions. J Nucl Med. 2015;56(11):1697–705.

    Article  CAS  Google Scholar 

  21. Umbricht CA, Benesova M, Schmid RM, Turler A, Schibli R, van der Meulen NP, Muller C. 44Sc-PSMA-617 for radiotheragnostics in tandem with 177Lu-PSMA-617-preclinical investigations in comparison with 68Ga-PSMA-11 and 68Ga-PSMA-617. EJNMMI Res. 2017;7(1):9.

    Article  Google Scholar 

  22. Moek KL, Giesen D, Kok IC, de Groot DJA, Jalving M, Fehrmann RSN, Lub-de Hooge MN, Brouwers AH, de Vries EGE. Theranostics using antibodies and antibody-related therapeutics. J Nucl Med. 2017;58:83S–90S.

    Article  CAS  Google Scholar 

  23. Nayak TK, Brechbiel MW. 86Y based PET radiopharmaceuticals: radiochemistry and biological applications. Med Chem. 2011;7(5):380–8.

    Article  CAS  Google Scholar 

  24. Yoshii Y, Yoshimoto M, Matsumoto H, Tashima H, Iwao Y, Takuwa H, Yoshida E, Wakizaka H, Yamaya T, Zhang MR, Sugyo A, Hanadate S, Tsuji AB, Higashi T. Integrated treatment using intraperitoneal radioimmunotherapy and positron emission tomography-guided surgery with 64Cu-labeled cetuximab to treat early- and late-phase peritoneal dissemination in human gastrointestinal cancer xenografts. Oncotarget. 2018;9(48):28935–50.

    Article  Google Scholar 

  25. Claringbold PG, Brayshaw PA, Price RA, Turner JH. Phase II study of radiopeptide 177Lu-octreotate and capecitabine therapy of progressive disseminated neuroendocrine tumors. Eur J Nucl Med Mol Imaging. 2011;38(2):302–11.

    Article  CAS  Google Scholar 

  26. Thakral P, Sen I, Pant V, Gupta SK, Dureja S, Kumari J, Kumar S, Un P, Malasani V. Dosimetric analysis of patients with gastro entero pancreatic neuroendocrine tumors (NETs) treated with PRCRT (peptide receptor chemo radionuclide therapy) using Lu-177 DOTATATE and capecitabine/temozolomide (CAP/TEM). Br J Radiol. 2018;91:20170172.

    Article  Google Scholar 

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Correspondence to Luca Giovanella .

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Lorenzoni, A., Capozza, A., Seregni, E., Giovanella, L. (2019). Nuclear Medicine Theranostics: Between Atoms and Patients. In: Giovanella, L. (eds) Nuclear Medicine Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-17494-1_1

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  • DOI: https://doi.org/10.1007/978-3-030-17494-1_1

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