Molecular theranostics: principles, challenges and controversies.

Area of Science:

• Nuclear Medicine
• Oncology
• Radiochemistry

Background:

• Theranostics principles are long-established in nuclear medicine but broadly applied.
• The term 'molecular theranostics' more accurately reflects its nuclear medicine applications.
• Historical context includes radioiodine for thyroid conditions.

Purpose of the Study:

• To clarify the definition and scope of molecular theranostics.
• To discuss challenges and controversies in molecular theranostics.
• To highlight the role of dosimetry in precision medicine.

Main Methods:

• Review of historical nuclear medicine principles.
• Analysis of the ⁶⁸Ga/¹⁷⁷Lu DOTATATE pair as a prototype.
• Discussion of radiation dosimetry in molecular theranostics.

Main Results:

• ⁶⁸Ga/¹⁷⁷Lu DOTATATE targeting somatostatin receptor subtype 2 is a key example.
• Balancing reactive and predictive dosimetry is crucial for precision medicine.
• Molecular theranostics presents significant opportunities despite challenges.

Conclusions:

• Molecular theranostics is a powerful tool in precision medicine.
• It offers improved outcomes for cancer patients.
• Future applications hold significant promise.