Theranostics — a combination of the terms therapeutics and diagnostics — couples molecularly targeted imaging and therapeutic radioactive drugs to identify and kill cancer cells, and is providing increased hope for patients with specific cancers.
One of the most exciting recent theranostic innovations is an FDA-approved drug to treat metastatic prostate cancer. Pluvicto® is a highly targeted therapy that attaches to a specific receptor on the prostate cancer cells, and is then absorbed into the cell and releases radiation destroying the cell with limited damage to the surrounding cells.
“It’s a very efficient way of delivering radiation for these cancers and generally causes fewer side effects,” said Endeavor Health radiation oncologist Najeeb Mohideen, MD, who is thrilled to offer patients this pioneering option. Ongoing clinical trials are exploring the use of this medication sooner in patients diagnosed with prostate cancer. “Our hope is that eventually we will be able to bring this treatment option in earlier,” he added.
The treatment is an outpatient process, and the current protocol calls for infusions every six weeks for a total of six treatments, said Dr. Mohideen.
There are some general radiation precautions necessary for this treatment, but they are not unduly burdensome. Patients may receive anti-nausea medication and will have regular bloodwork to monitor their kidney function and blood counts.
Clinical studies to date have shown significant improvement in overall survival for patients on this treatment. “This is an important option for patients who have progressed through hormonal therapy and chemotherapy,” said Dr. Mohideen. “Our patients are tolerating the treatment well and can have a meaningful response.”
The promise for the technology to be used in many other cancers continues to grow as well, with exciting research underway. “There are many new drugs in the pipeline in clinical trials for other diseases,” said Dr. Mohideen, who predicts more treatment breakthroughs in the coming years.
The therapy is a collaborative effort involving an array of specialists including nuclear medicine, radiologists, medical oncologists and radiation oncologists. There is a lot of preparation work, including providing specially designed spaces and facilities for healthcare systems to be able to offer the treatment to patients.
Areas of much needed research include comparing flat or patient-specific dosing and treatment sequencing to make the therapies even better and more effective for patients, said Dr. Mohideen.
Dr. Mohideen recently treated a man in his mid-80s with metastatic prostate cancer who had symptomatic improvement after his first dose. “It’s gratifying to offer patients like this another option that can help them get their disease under control and improve their quality of life,” he said.
One in eight American men will be diagnosed with prostate cancer in their lifetime. If you or a loved one is diagnosed with prostate cancer, you’ll find expert, comprehensive care close to home at Endeavor Health Cancer Institute. Learn more.
