Theranostics 2.0: Target-driven, artificial intelligence-enabled cancer therapy across tumor types.

Area of Science:

• Oncology
• Radiopharmaceuticals
• Precision Medicine

Background:

• Current theranostic trials focus on specific cancers like neuroendocrine tumors and prostate cancer.
• Advancements reveal broader target expression patterns across various malignancies.

Purpose of the Study:

• To discuss the evolving landscape of theranostic agents targeting a wider array of cancers.
• To highlight the potential of pan-cancer targets and AI in patient selection.
• To emphasize the need for well-designed trials for broad regulatory approval and clinical adoption.

Main Methods:

• Review of current theranostic clinical trial designs and emerging agent targets.
• Discussion of the role of positron emission tomography (PET) imaging in patient selection.
• Exploration of artificial intelligence (AI) applications in theranostics.

Main Results:

• Positron emission tomography (PET) shows utility beyond established indications, such as in clear cell renal cell carcinoma.
• Emerging theranostic agents target pan-cancer markers (e.g., fibrinogen-activating protein, CXCR4) or widely over-expressed proteins (e.g., carbonic anhydrase IX).
• AI is poised to enhance patient stratification and biomarker development for theranostics.

Conclusions:

• The field is moving towards theranostic agents with broader applicability across cancer types.
• Future clinical practice will integrate precision medicine to identify target expression for tailored theranostic agent delivery.
• Careful clinical trial design is crucial for regulatory approval and widespread use of next-generation theranostics.