Theranostics for Prostate Cancer

Theranostics for Prostate Cancer

Theranostics is the combination of diagnosis and therapy using radiopharmaceuticals to image and provide radioactive targeted therapy. Theranostics is an approach used in several cancer types including prostate cancer, neuroendocrine tumors and differentiated thyroid cancers among others.  

Theranostics’ targeted approach to cancer care combines: 

  • high-resolution imaging from positron emission tomography (PET) or single photon emission computed tomography (SPECT) with a 
  • highly specialized, radioactive, cancer-specific pharmaceutical, called a “radiopharmaceutical.” 

Who is eligible for theranostics? 

Theranostics works well for a few different cancer types, including advanced stages of prostate cancer. Washington University Physicians in the Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, and Department of Radiation Oncology assess if the specific radiopharmaceutical used in theranostics is a good treatment option for a patient with prostate cancer. Unlike external beam radiation therapy, the targeted radiopharmaceutical therapy delivers short-range beta or alpha particles directly to the tumor.  

To see if a patient is eligible for radiopharmaceutical therapy, oncologists look for the presence (or absence) of a specific target on their cancer cells through specialized imaging, such as positron emission tomography (PET). If PET imaging shows enough targets on the cancer cells, then the radiopharmaceutical will be able to attach itself and deliver a high radiation dose to the cancerous tissue.  

What radiopharmaceuticals are used in treating prostate cancer? 

Currently there are two pharmaceuticals being used with different stages of prostate cancer, Pluvicto (also called Lu-177 PSMA) and Xofigo (also called Ra-223). Both drugs are delivered by intravenous injection. As part of the therapy, the patient will be imaged by single photon emission computed tomography (SPECT) to confirm the therapy has reached the cancer cells.  

Learn more about Siteman’s prostate cancer treatments.