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Theranostics: Reimagining the standard of care

July 02, 2021
Molecular Imaging
From the June 2021 issue of HealthCare Business News magazine

By Tiffany Olson

It may be one of the most elusive questions in all of medicine: How can healthcare providers tailor treatment to better meet the unique needs of each individual patient?
Enter precision medicine and the growing field of theranostics. Precision medicine is an area of healthcare that targets treatment for a well-defined patient population, with the goal of improving safety, efficacy and outcomes. Theranostics take the concept of precision medicine a step further, targeting care for individual patients. In fact, the field has been called the epitome of personalized medicine.

Simply put, theranostics combine a diagnostic radiopharmaceutical and therapeutic radiopharmaceutical, which are tailored to the patient at the cellular level. Using specific biological pathways, a theranostic uses similar molecules to first produce diagnostic information in order to confirm the presence of a target, and then deliver a therapeutic dose of radiation to the same target. The approach is tailored based on the individual patient’s predicted response or risk of disease. The rationale is as simple as it is compelling: the more targeted and personalized the treatment, the better the potential outcome.

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Theranostics were first developed for relatively rare conditions that could lead to serious morbidity and mortality — such as some cancers — and are often used when other lines of treatment haven’t been effective. In some cases, utilizing theranostics may allow some patients to avoid undergoing surgery or other more invasive treatments.

Overall, theranostics by themselves or in combination with other therapies have produced very encouraging results, including the ability to monitor treatment response and adjust it accordingly. This is particularly important with fast-progressing cancers such as glioblastoma. As a result, some healthcare providers have been quick to adopt new theranostics.

What should healthcare providers consider as they prepare for an expanding pipeline of theranostics? First, many of these therapies require dedicated space, as well as Radioactive Material Program (RAM) licensing. There are also equipment essentials such as Positron Emission Tomography (PET) cameras, as well as the need for targeted expertise in reimbursement management and other business operations. Theranostics in nuclear medicine demand just-in-time supply management due to their short shelf-lives; therefore, healthcare providers will want a strategic partner who can provide reliable access through manufacturing and logistics capabilities, while providing resources and expertise to help navigate a complex and highly regulated environment.

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