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Published in Valerio Voliani, Nanomaterials and Neoplasms, 2021
Eun-Kyung Lim, Taekhoon Kim, Soonmyung Paik, Seungjoo Haam, Yong-Min Huh, Kwangyeol Lee
In 2004, the U.S. Food and Drug Administration (FDA) released an important report entitled “Innovation/Stagnation: Challenge and Opportunity on the Critical Path to New Medical Products.” This “Critical Path Initiative” directly reflects the FDA’s great interest to modernize the manufacturing process of FDA-regulated products. In particular, the FDA reported the declining number of approved innovative medical products and strongly requested a concerted effort to modernize scientific tools [1–3]. On the other hand, John Funkhouser, the Chief Executive Officer of PharmaNetics, used the term “Theranostics” for the first time in 1998 as a concept of “the ability to affect therapy or treatment of a disease state.” Accordingly, theranostics as a treatment strategy for individual patients encompasses a wide range of subjects, including personalized medicine, pharmacogenomics, and molecular imaging, in order to develop an efficient new targeted therapy and optimize drug selection via a better molecular understanding. Furthermore, theranostics aims to monitor the response to the treatment, to increase drug efficacy and safety, and to eliminate the unnecessary treatment of patients, resulting in significant cost savings for the overall healthcare system [2]. Therefore, the emerging science of theranostics seems to provide a unique opportunity to pharmaceutical and diagnostics companies to meet the regulatory and financial constraints imposed by the FDA [1, 2].
Applications for Drug Development
Published in George C. Kagadis, Nancy L. Ford, Dimitrios N. Karnabatidis, George K. Loudos, Handbook of Small Animal Imaging, 2018
Jessica Kalra, Donald T. Yapp, Murray Webb, Marcel B. Bally
Theranostics is an emerging branch of personalized medicine that combines diagnostic, prognostic, and therapeutic capabilities into a single agent. Theranostics aims to produce therapeutic protocols that are specific to individual patients and in addition have the ability for monitoring patient response following treatment. Imaging is the key to the diagnostic strategies employed in theranostics. Small animal imaging studies continue to provide the proof of concept for the utility, accessibility, and cost effectiveness of pursuing theranostics. Several recent reviews highlight theranostic research that has been successful to date (Xie et al. 2010; Kelkar and Reineke 2011; Choi et al. 2012). In 2011, Kalber et al. published an intriguing paper in which they describe a gadolinium-labeled derivative of the tubulin binding agent cholchicinic acid. This group was able to use MR approaches to image cancer in animals bearing subcutaneous ovarian xenografts, while at the same time eliciting cholchicine-mediated tumor cell death (Kalber et al. 2011). Kenny et al. have constructed MR-sensitive liposomal nanoparticles that also act as siRNA delivery vehicles. They were able to silence Survin expression using siRNA, and showed that this treatment was able to slow tumor growth, while at the same time using the nanoparticle to visualize tumors in vivo using MR (Kenny et al. 2011).
Machine Learning Approach to Overcome the Challenges in Theranostics
Published in Shampa Sen, Leonid Datta, Sayak Mitra, Machine Learning and IoT, 2018
Bishwambhar Mishra, Sayak Mitra, Karthikeya Srinivasa Varma Gottimukkala, Shampa Sen
Depending on the application, molecular targeting agents can be combined with a wide variety of imaging agents including radionuclides (single photon emission computed tomography [SPECT], and positron emission tomography [PET]), optical probes (fluorescence), or metal chelates (MRI). The presence of a molecular target, as well as its distribution within a patient, can be provided to the clinicians by combining molecular imaging with a theranostic approach. Furthermore, theranostics has the potential to facilitate patient screening, guide clinical trial enrollment, and monitor the efficacy of therapeutics. A well-studied example of a theranostic target is the human epidermal growth factor receptor, Her-2. Her-2 is overexpressed in aggressive breast cancers with poor prognosis. Breast cancer can be identified in patients using a diagnostic test which detects the large amounts of Her-2, that is, guiding the treatment with a therapeutic monoclonal antibody against this target (Ferber et al. 2014).
Theranostic approaches in nuclear medicine: current status and future prospects
Published in Expert Review of Medical Devices, 2020
Luca Filippi, Agostino Chiaravalloti, Orazio Schillaci, Roberto Cianni, Oreste Bagni
In the panorama of personalized medicine, the theranostic approach aims to identify specific targets in patients in order to define customized pathways of therapy and also monitor the response to treatment. Targeted therapy represents a crucial role for the management of neuroendocrine tumors (NET) through the peptide receptor radionuclide therapy (PRRT) [7]. Furthermore, theranostics is providing promising results in patients affected by metastatic castration-resistant prostate cancer (mCRPC) [8]. In the following, we will review the more consolidated applications of targeted imaging and therapy in nuclear medicine, also providing an overview of the more innovative applications that are moving the theranostic field forward. Table 1 summarizes the main manuscripts on the clinical application of theranostics.
Aptamer-based technology for radionuclide targeted imaging and therapy: a promising weapon against cancer
Published in Expert Review of Medical Devices, 2020
Luca Filippi, Oreste Bagni, Clara Nervi
In the view of the above, theranostics represents an innovative medical approach combining diagnosis and therapy. The majority of the previously cited researches, especially those concerning the application of radiolabeled aptamers for the imaging of EGRF/HER2 status, actually constitutes a theranostic approach since the detection of these molecular signatures has deep implications on patients’ therapeutic management.