UC Davis Health will provide personalized oncology radiotherapeutics that offer diagnosis and treatment simultaneously
Plans to build a theranostics clinic at University of California (UC) Davis Health show the growing potential in this treatment approach—one that hospital leaders and radiology directors focused on precision medicine should evaluate.
Theranostics is a promising field within precision medicine that combines imaging and therapeutics. This approach is used to simultaneously diagnose and treat cancers by using radioactive tracers that indicate where cancer is located, while also treating the cancer itself when it arrives at the sites where a tumor is located. Theranostics allows for very individualized targeting and treatment of multiple cancer types.
Theranostics is a ‘Two-in-One Method’
“Theranostics is a two-in-one method to diagnosing and treating cancer,” said UC Davis Chief of Radiology Elizabeth Morris, MD, in a recent interview with The California Aggie. “This one-stop shop for our patients is a real game changer for medicine, and we’re proud to be at the forefront.”
Theranostics builds on the field of nuclear medicine, which uses radioactive materials to image the body. Unlike many other kinds of imaging, nuclear medicine provides insights into the function of the body instead of focusing solely on structure. While nuclear medicine has been used primarily for imaging, theranostics expands its use to also providing treatment.
The recently announced clinic will be headed by Cameron Foster, MD, Director of the new UC Davis Theranostics Division and Professor of Clinical Nuclear Medicine. Foster will oversee construction and run the clinic once it is complete.
“Modern theranostics is transforming nuclear medicine,” said Foster in a UC Davis news release. “We are moving away from nuclear medicine being used largely for imaging. We’re taking advantage of novel compounds that both pinpoint and target tumors, allowing for removal of diseased tissue with limited side effects while aiming to minimize the chances of the cancer returning.”
UC Davis Theranostics Clinic Capabilities
According to UC Davis, advanced therapies that the new theranostics clinic will provide include:
- Radioiodine therapies for thyroid disorders and cancers
- Strontium-89 and Samarium-153 therapies for bony metastases from a wide variety of cancers
- Radium-223 therapy for bony metastasis from prostate cancer
- Lutetium-177 dotatate therapy (Lutathera) for certain neuroendocrine tumors
The clinic may also eventually administer newly discovered and experimental radiopharmaceutical therapeutic agents as novel treatments continue to emerge.
Theranostics aims to provide care that is ultimately safer for most patients and easier to provide.
“With these classes of therapeutics in the theranostics arena, they tend to have fewer side effects, and they tend to be very easy to administer,” Foster said. “Theranostic treatments are much, much milder. They might get a little bit of nausea during the procedure, and we combat that with anti-nausea medications. Largely, the biggest side effect during the therapy is boredom.”
Another benefit that Foster expects from the new theranostics clinic is improved continuity of care.
“There is a lot more patient interaction with theranostics,” Foster explained. “The same doctor who interpreted patients’ scans identifying their active cancer may now also be the one treating them. That’s exciting for patients because they are getting acute care from a nuclear medicine physician who is intimately aware of the characteristics of their tumor and will monitor it carefully while using targeted radiotherapy to treat.”
Theranostics Advancing Quickly
UC Davis’s theranostics initiative comes at a time of significant advances in the field. One recent study, led by the University of California, Los Angeles (UCLA) and University of California, San Francisco (UCSF), provided new insights on finding metastatic prostate cancer.
This new discovery uses positron emission tomography (PET) scanning technology, coupled with a tracer, that allows it to identify prostate-specific membrane antigen (PSMA) anywhere in the body.
“I anticipate in a near future that physicians will routinely require a PSMA PET scan before making a treatment plan,” Jeremie Calais, MD, MSc, said in a UCLA interview. Calais is Assistant Professor of Nuclear Medicine and Theranostics in the Department of Molecular and Medical Pharmacology at the David Geffen School of Medicine at UCLA and member of the UCLA Jonsson Comprehensive Cancer Center.
Emerging nuclear medicine tests, such as the PSMA PET scan, are ideal candidates to be used for theranostics if treatment capability can be added to newly discovered tracers. The PSMA PET scan, developed by Calais and researchers at UCLA and UCSF, has already been integrated into the 2022 National Comprehensive Cancer Network guidelines and is expected to quickly become a new standard of care for prostate cancer, stated Calais in a recent Q&A.
Rethinking Hospital Nuclear Medicine Programs
While theranostics provides advanced services that will benefit hospitals that offer it, the greatest benefit is ultimately for patients who don’t have any other avenues. “Often we see patients who have exhausted all other options,” Foster explained. “They are at a very expensive stage in their disease and we want to give them the best possible chance of survival while managing their cancer in the most efficient way.”
Hospital leaders and radiology directors that already have a nuclear medicine program in place will be well-positioned to offer theranostic treatments to their patients. This emerging precision medicine treatment option provides cutting edge technology that can bring in potential patients while simultaneously creating a new source of revenue.