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Role of theranostics in thoracic oncology

Authors
  • Filippov, Aleksandr
  • Bonjoc, Kimberley-Jane C.
  • Chea, Junie
  • Bowles, Nicole
  • Poku, Erasmus
  • Chaudhry, Ammar
Type
Published Article
Journal
Journal of Thoracic Disease
Publisher
AME Publishing Company
Publication Date
Sep 01, 2020
Volume
12
Issue
9
Pages
5140–5146
Identifiers
DOI: 10.21037/jtd-2019-pitd-13
PMID: 33145091
PMCID: PMC7578517
Source
PubMed Central
Keywords
License
Unknown

Abstract

Theranostics is a re-emerging field of medicine that aims to create targeted agents that can be used for diagnostic and/or therapeutic indications. In the past, theranostics has been used to treat neoplasms, such as thyroid cancer and neuroblastomas. More recently, theranostics has seen a resurgence with advent of new therapeutic antibodies and small molecules which can be transformed into Theranostic agents through radioconjugating with a radioactive isotope. Positron emitting radioisotopes can be used for diagnostic purposes while alpha- and beta-emitting radioisotopes can be used for therapy. The technique of radiolabeling an existing therapeutic agent (small molecule or antibody) leverages the existing qualities of that drug, and potentiates therapeutic effect by conjugating it with a cytotoxic-energy bearing radioisotope (e.g., 131-iodine, 177-lutetium). Theranostics have been used for a few decades now, starting with 131-iodine for therapy of autoimmune thyroiditis (Graves’ disease, Hashimoto’s thyroiditis) as well as for thyroid cancer. Additionally, 131-iodine-meta-iodobenzylguanidine (131-I-MIBG) initially had been used for gastroenteropancreatic neuroendocrine (carcinoid) tumors. However, recently clinical trials have start enrolling patients to evaluate efficacy of 131-I-MIBG in patients with small cell carcinoma of the lung. In the era of precision medicine and personalized targeted therapeutics, Theranostics can play a key pivotal in improving diagnostic and therapeutic specificity by increasing potency of these targeted small molecules and antibodies with radioisotopes. In this review, we will review various clinically relevant Theranostics agent and their utility in thoracic disorders, notably within oncology.

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