Integrating Theranostics Into a Group Practice
David M. Albala, MD, Chief of Urology at Crouse Hospital in Syracuse, New York, discusses theranostics and the role it will play in the future of prostate cancer treatment. He explains that theranostics is a management strategy involving the integration of therapeutics and diagnostics that specifically uses targeting molecules labeled with either diagnostic radionuclides or with therapeutic radionuclides for diagnosis of and therapy for a particular malignancy. Dr. Albala states that theranostics works to overcome trial and error methods of finding “one-size-fits-all” solutions in medicine in order to produce personalized medicine. Dr. Albala also discusses PSA and PSMA, explaining that PSMA is used with different ligands such as PSMA-11 and PSMA-617 to treat specific individuals. He reviews how theranostics are used with radionuclide agents to determine localization, examine molecular biodistribution, aid in determining optimal therapeutic dosage, and monitor the patient’s response to treatment. Dr. Albala then reviews data from a trial of Lutetium-177 and PSMA-617 for metastatic castration-resistant prostate cancer that showed Lutetium-based treatment outdoing standard-of-care in median overall survival by 4 months and skeletal event occurrence by 3%. He concludes with a summary of the implications of theranostics for patient care, stating that theranostics leads to more effective disease management and eliminates unnecessary treatments, enhances diagnosis and disease staging, and reduces costs associated with suboptimal diagnostics and treatments.
Read More