Theranostics
| Theranostics | |
|---|---|
 A pictorial representation of a conventional nanotheranostic agent | |
| Other names | Theragnostics |
| Specialty | In Theranostics, therapeutic and diagnostic moieties are embedded in a single entity. |
The concept of theranostics or theragnostics broadly comes under personalized treatment method. The term theranostics represents the combination of therapeutic and diagnostic agents into a single entity.[1] Nowadays, cancer theranostics are getting attention, where targeted cancer therapy can be achieved and monitored efficiently by a diagnostic imaging tool. This cancer theranostics can also be considered as a novel subclass of image guided therapy.[2]
History[edit]
In 2002, J. Funkhouser coined the term theranostics. He defined theranostics as a material that combines modalities of therapy and diagnostic imaging.[1] In 1941 itself the concept of diagnostic imaging associated with treatment were started by using radioactive iodine. The Iodine-131 were used in the treatment of thyroid cancer and thyrotoxicosis.[3] Especially after World War II the radioactive iodine became familiar and cost-effective for diagnosis and treatment of thyroid cancer, so iodine-131 can be considered as the first theranostic agent.[4] In 1951, The American Journal of Medicine reported a clinical study of I131 in the treatment of thyroid carcinoma.[5]
Later fast emergence of nanotechnology in the medical field resulted Nanotheranostics. In conventional nanotheranostics, three different components: imaging, targeting and therapeutic agents were assembled as a single nanomaterial.[6] Utilization of these three in nanoform will result in non-invasive imaging and targeted therapy without affecting the surrounding healthy cells.[7] After successful acceptance of liposomal doxorubicin (Doxil) by USFDA in 1995, 99mTc-Labelled Liposomal doxorubicin were evaluated its theranostic ability and conducted phase I clinical study.[8]
A lot of researchers attracted to the field of theranostics and Ivyspring International Publisher started an independent journal named Theranostics. The current impact factor of the journal is 11.556[9] and later in 2017, they started a sister journal named Nanotheranostics,[10] this clearly indicates the huge research output generated in the field of theranostics research.
In December 2020, the USFDA approved Gallium 68Ga PSMA-11 as a targeted PET imaging and radiation therapy drug for Men with Prostate Cancer.[11][12]
Concepts[edit]
As we mentioned early in nanotheranostics, separate diagnostic and therapeutic agents are designed as a single nanoentity. To achieve the theranostic ability, currently using therapeutic and diagnostic approaches are,[6]
Diagnostic methods[edit]
- Positron emission tomography (PET): utilize radioisotopes such as 64Cu and 68Ga as visualizing tools.
- Magnetic resonance imaging (MRI): widely used Medical imaging technique, use Gd3+, Mn2+ and iron oxide nanoparticles as contrasting agents.
- Ultrasound imaging: Explore medical ultrasound as a diagnostic imaging tool, same time utilize its therapeutic benefits.
- Computed tomography: radiation assisted imaging, I and Au can be used as contrast agents.
- Medical optical imaging: visible light as an imaging tool, various quantum dots and NIR fluorophores can be used.
- Single-photon emission computed tomography (SPECT): gamma rays produced from nuclear medicine such as 99mTc and 123I, give tomographic imaging.
- Photoacoustic imaging: Non ionizing laser pulses and utilize the principle of Photoacoustic effect, different Au nanostructures and porphyrins can be used.
Therapeutic methods[edit]
- Chemotherapy: Various chemotherapeutic agents such as doxorubicin, paclitaxel etc.
- Radiation therapy: Ionizing radiations are used in treatment of cancer.
- Immunotherapy: cancer vaccines and Checkpoint inhibitors are used.
- Photodynamic therapy (PDT): utilizes 3 nontoxic components: light, Photosensitizer and tissue oxygen produce a toxic effect. Photosensitizer such as Temoporfin, Motexafin lutetium etc.
- Photothermal therapy (PTT): Photosensitizer such as Gold Nanoshells, excites by visible light and while relaxing it produces heat and that heat kills the targeted cells.
- Gene therapy: utilize small interfering RNA, plasmids and CRISPR
Radiotheranostics[edit]
Radiopharmaceuticals gained considerable attention as a diagnostic and therapeutic aid.[13] In past decades these radiopharmaceuticals gained attention as radiotheranostics, few of the formulations were already approved by FDA.[14]
| Ingredient (trade name) | Ligand | Therapeutic Isotope | Imaging Isotope | Target | Disease | FDA Approval date / Ref |
|---|---|---|---|---|---|---|
| Dotatate (Lutathera) | Peptide | 177Lu | 68Ga, 111In | SSTR2 | Neuroendocrine tumor | Approved, 2018[15] |
| Lexidronam (Quadramet) | EDTMP | 153Sm | 99Tc, Na18F | New bone formation | Bone metastasis, Osteosarcoma | Approved, 1997[16] |
| Radium-223(Xofigo) | dichloride | 223Ra | 99Tc, Na18F | Calcimimetic | Prostate cancer and bone metastasis | Approved, 2013[17] |
| Strontium-89 (Metastron) | None | 89Sr | Na18F | New bone formation | Bone pain | Approved, 1993[18] |
| Tositumomab (Bexxar) | Monoclonal antibody | 131I | 124I, 131I | CD20 | follicular large-cell lymphoma | Approved, 2003 withdrawn, 2014[19] |
| Iobenguane (Azedra) | None | 131I | 123I, 124I | Norepinephrine transporter | Pheochromocytoma and paraganglioma | Approved, 2018[15] |
| Gallium 68 PSMA-11 (68Ga PSMA-11) | PSMA | 68Ga | 68Ga | Prostate-specific antigen | prostate cancer | Approved, 2020[12] |
Nanotheranostics[edit]
Nanotheranostics are one of the greatest outcomes of nanomedicine, still the research outputs are in infancy, so far there is no clinically approved nanotheranostics.[6][20] Various nanotheranostics developed for Triple-negative breast cancer (TNBC) and few are in clinical trial.[21]
Imaging-guided focal therapy[edit]
Various nanoparticles designed as photodynamic therapy (PDT) and photothermal therapy (PTT) probes, these designed photosensitizers have reduced systemic toxicity, cannot form induced resistance and have high targeting efficiency.[22][23][24]
Future and outlook[edit]
- Major scope of theranostics is cost-effective treatment along with early cancer diagnosis.
- Theranostics may help in achieving high efficacy and low toxicity of medicines[6]
- Reports shows the global market for theranostics will make a big impact in upcoming years.[25]
References[edit]
- ↑ 1.0 1.1 Kelkar, Sneha S.; Reineke, Theresa M. (29 August 2011). "Theranostics: Combining Imaging and Therapy". Bioconjugate Chemistry. 22 (10): 1879–1903. doi:10.1021/bc200151q. ISSN 1043-1802. PMID 21830812.
- ↑ Hapuarachchige, Sudath; Artemov, Dmitri (2020). "Theranostic Pretargeting Drug Delivery and Imaging Platforms in Cancer Precision Medicine". Frontiers in Oncology. 10: 1131. doi:10.3389/fonc.2020.01131. ISSN 2234-943X. PMC 7387661 Check
|pmc=value (help). PMID 32793481 Check|pmid=value (help). - ↑ Cassen, B.; Curtis, L. (22 July 1949). "Measurement of Ionizing Radiations in Vivo". Science. 110 (2847): 94–95. doi:10.1126/science.110.2847.94. PMID 17837667.
- ↑ Silberstein, Edward B. (1 May 2012). "Radioiodine: The Classic Theranostic Agent". Seminars in Nuclear Medicine. 42 (3): 164–170. doi:10.1053/j.semnuclmed.2011.12.002. ISSN 0001-2998. PMID 22475425.
- ↑ Freedberg, A. Stone; Ureles, Alvin L.; Lesses, Mark F.; Gargill, Samuel L. (1 July 1951). "Treatment of thyroid carcinoma with radioactive iodine (I131)". The American Journal of Medicine. 11 (1): 44–54. doi:10.1016/0002-9343(51)90007-1. ISSN 0002-9343. PMID 14837925.
- ↑ 6.0 6.1 6.2 6.3 Chen, Hongmin; Zhang, Weizhong; Zhu, Guizhi; Xie, Jin; Chen, Xiaoyuan (July 2017). "Rethinking cancer nanotheranostics". Nature Reviews Materials. 2 (7): 17024. doi:10.1038/natrevmats.2017.24. PMC 5654564. PMID 29075517.
- ↑ Wong, Xin Yi; Sena-Torralba, Amadeo; Álvarez-Diduk, Ruslan; Muthoosamy, Kasturi; Merkoçi, Arben (7 February 2020). "Nanomaterials for Nanotheranostics: Tuning Their Properties According to Disease Needs". ACS Nano. 14 (3): 2585–2627. doi:10.1021/acsnano.9b08133. ISSN 1936-0851. PMID 32031781 Check
|pmid=value (help). Unknown parameter|s2cid=ignored (help) - ↑ Koukourakis, M. I.; Koukouraki, S.; Giatromanolaki, A.; Archimandritis, S. C.; Skarlatos, J.; Beroukas, K.; Bizakis, J. G.; Retalis, G.; Karkavitsas, N.; Helidonis, E. S. (November 1999). "Liposomal Doxorubicin and Conventionally Fractionated Radiotherapy in the Treatment of Locally Advanced Non–Small-Cell Lung Cancer and Head and Neck Cancer". Journal of Clinical Oncology. 17 (11): 3512–3521. doi:10.1200/JCO.1999.17.11.3512. PMID 10550149.
- ↑ "Theranostics". thno.org.
- ↑ "Nanotheranostics". ntno.org.
- ↑ Commissioner, Office of the (2 December 2020). "FDA Approves First PSMA-Targeted PET Imaging Drug for Men with Prostate Cancer". FDA.
- ↑ 12.0 12.1 "Drug Approval Package: GALLIUM GA 68 PSMA-11". accessdata.fda.gov. US FDA.
- ↑ Brugarolas, Pedro; Comstock, Jessica; Dick, David W.; Ellmer, Teresa; Engle, Jonathan W.; Lapi, Suzanne E.; Liang, Steven H.; Parent, Ephraim E.; Pillarsetty, Naga Vara Kishore; Selivanova, Svetlana; Sun, Xiankai; Vavere, Amy; Scott, Peter J. H. (1 June 2020). "Fifty Years of Radiopharmaceuticals". Journal of Nuclear Medicine Technology. 48 (Supplement 1): 34S–39S. ISSN 0091-4916. PMID 32605944 Check
|pmid=value (help). - ↑ Herrmann, Ken; Schwaiger, Markus; Lewis, Jason S; Solomon, Stephen B; McNeil, Barbara J; Baumann, Michael; Gambhir, Sanjiv S; Hricak, Hedvig; Weissleder, Ralph (1 March 2020). "Radiotheranostics: a roadmap for future development". The Lancet Oncology. 21 (3): e146–e156. doi:10.1016/S1470-2045(19)30821-6. ISSN 1470-2045. PMC 7367151 Check
|pmc=value (help). PMID 32135118 Check|pmid=value (help). - ↑ 15.0 15.1 "ADVANCING HEALTH THROUGH INNOVATION 2018 NEW DRUG THERAPY APPROVALS". fda.gov. US Food & Drug Administration (FDA).
- ↑ "Drugs@FDA: FDA-Approved Drugs". accessdata.fda.gov. FDA.
- ↑ "Drugs@FDA: FDA-Approved Drugs". accessdata.fda.gov.
- ↑ "Drugs@FDA: FDA-Approved Drugs". accessdata.fda.gov.
- ↑ "Drug Approval Package: Brand Name (Generic Name) NDA #". accessdata.fda.gov.
- ↑ Wong, Xin Yi; Sena-Torralba, Amadeo; Álvarez-Diduk, Ruslan; Muthoosamy, Kasturi; Merkoçi, Arben (24 March 2020). "Nanomaterials for Nanotheranostics: Tuning Their Properties According to Disease Needs". ACS Nano. 14 (3): 2585–2627. doi:10.1021/acsnano.9b08133. PMID 32031781 Check
|pmid=value (help). Unknown parameter|s2cid=ignored (help) - ↑ Kim, TH; Lee, S; Chen, X (April 2013). "Nanotheranostics for personalized medicine". Expert Review of Molecular Diagnostics. 13 (3): 257–69. doi:10.1586/erm.13.15. PMC 3696508. PMID 23570404.
- ↑ Idris, NM; Gnanasammandhan, MK; Zhang, J; Ho, PC; Mahendran, R; Zhang, Y (October 2012). "In vivo photodynamic therapy using upconversion nanoparticles as remote-controlled nanotransducers". Nature Medicine. 18 (10): 1580–5. doi:10.1038/nm.2933. PMID 22983397. Unknown parameter
|s2cid=ignored (help) - ↑ "A Study of MRI/US Fusion Imaging and Biopsy in Combination With Nanoparticle Directed Focal Therapy for Ablation of Prostate Tissue". clinicaltrials.gov. 1 March 2021.
- ↑ Jin, CS; Overchuk, M; Cui, L; Wilson, BC; Bristow, RG; Chen, J; Zheng, G (September 2016). "Nanoparticle-Enabled Selective Destruction of Prostate Tumor Using MRI-Guided Focal Photothermal Therapy". The Prostate. 76 (13): 1169–81. doi:10.1002/pros.23203. PMID 27198587. Unknown parameter
|s2cid=ignored (help) - ↑ "Theranostics Market Size, Share, Trends & Industry Report". bccresearch.com.
Category:Medical diagnosis Category:Nanomedicine Category:Medical tests Category:Radiology Category:Therapy Category:Nanomedicine Category:Medicine]
This article "Theranostics" is from Wikipedia. The list of its authors can be seen in its historical and/or the page Edithistory:Theranostics. Articles copied from Draft Namespace on Wikipedia could be seen on the Draft Namespace of Wikipedia and not main one.
|
This page exists already on Wikipedia. |
