Theranostic radiopharmaceuticals: established agents in current use

Area of Science:

• Nuclear Medicine
• Radiopharmaceutical Therapy
• Molecular Imaging

Background:

• The concept of theranostics, combining diagnosis and therapy, has historical roots in nuclear medicine.
• Radioiodine treatment for thyroid disease is a prime example of successful molecular radiotherapy.
• Early applications include radioiodine for thyroid cancer and metaiodobenzylguanidine for adrenergic tumors.

Purpose of the Study:

• To review the historical development and current applications of theranostic radiopharmaceuticals.
• To highlight the expansion of theranostic agents beyond radioiodine.
• To discuss emerging theranostic agents targeting prostate-specific membrane antigen and somatostatin receptors.

Main Methods:

• Review of historical and recent theranostic applications in nuclear medicine.
• Discussion of specific radiopharmaceuticals used for diagnosis and therapy.
• Analysis of the clinical and commercial success of various theranostic agents.

Main Results:

• Radioiodine therapy for thyroid disease remains a highly successful molecular radiotherapy.
• Emerging theranostics include somatostatin receptor targeting agents (e.g., 68Ga/177Lu-DOTATATE) and prostate-specific membrane antigen (PSMA) targeting agents.
• The field is rapidly expanding with new agents and increasing availability of theranostic radiopharmaceuticals.

Conclusions:

• Theranostics leverages diagnostic imaging to guide targeted radionuclide therapy.
• The successful application of radioiodine has paved the way for newer, more sophisticated theranostic agents.
• The growing availability of agents like DOTATATE and PSMA-targeting compounds signifies a major expansion in theranostic nuclear medicine.