A Look to the Future: Potential Theranostic Applications in Head and Neck Tumors

Theranostics, the practice of using a diagnostic radiopharmaceutical to guide radiotherapy with a chemically identical (or nearly identical) therapeutic radiopharmaceutical, is an exciting new field under development within the auspices of nuclear medicine. We aim to provide a narrative review of the areas of theranostics use and development which are occurring specifically in the head and neck, with attention to the therapeutic use of existing diagnostically used radiotracers such as agents that target prostate-specific membrane antigen (PSMA) and somatostatin receptors (e.g., DOTATATE derivatives), as well as developing classes of radiotracers such as those targeting fibrinogen-activating protein (FAP) and carbonic anhydrase IX (CAIX), as well as new meta-iodo-benzylguanidine (MIBG) derivatives. Most of those agents are still at the preclinical or early clinical stages of development, but as this is an emerging field, we aim to both outline current progress and suggest future directions.