Theranostics: A Powerful Diagnostic Tool and Cancer Treatment in One
Radiation therapy has been used to fight cancer for more than a century. But when cancer has spread to multiple areas of the body, traditional radiation can be limited—because it’s usually aimed at one location at a time and can affect healthy tissue nearby. Memorial Sloan Kettering (MSK) highlights a newer approach that is changing what’s possible for advanced and metastatic cancers: theranostics.
What Is Theranostics?
Theranostics combines the words therapy and diagnostics. It’s a treatment strategy that uses radioactive medicines to first find cancer cells and then treat them—using the same target. MSK’s theranostics motto captures the concept simply: “We see what we treat, and we treat what we see.”
How Theranostics Works
Theranostics typically happens in two steps:
- Find the cancer (“see it”)
Doctors infuse a patient with a radioactive drug containing a diagnostic isotope that binds to a specific target on cancer cells. Then a PET scan “lights up” where the drug has attached, revealing cancer sites that may be hard to see on standard imaging. - Treat the cancer (“treat it”)
If the target is confirmed, doctors give a treatment version of the same approach—this time loaded with a therapeutic isotope. The radiation works like a highly precise “smart bomb,” damaging cancer cell DNA while helping protect surrounding healthy tissue.
Why Theranostics Is Such a Big Deal
MSK notes several practical advantages of theranostics, especially for cancers that have spread:
- It can reveal the exact location of cancer cells that might be missed on conventional scans.
- It can help doctors evaluate whether treatment is working sooner.
- It can help clinical trials move more efficiently from imaging to treatment phases.
- It can treat multiple sites of disease throughout the body, not just one spot at a time.
- Even when it isn’t a cure, theranostics can be meaningful because it may offer effective control with good tolerability—supporting quality of life and daily living for many patients.
A Real Example: Theranostics for Metastatic Prostate Cancer (Pluvicto)
MSK shares the story of a patient with metastatic (stage 4) prostate cancer who joined a clinical trial using lutetium-177 PSMA-targeted therapy (Pluvicto). The treatment targets PSMA, a protein on prostate cancer cells, delivering radiation directly to those cells.
MSK also notes that the FDA approval expanded in 2025 to include more patients—specifically, people who had not yet received chemotherapy, increasing who may be eligible for this type of treatment.
Theranostics Beyond Prostate Cancer
Theranostics is also being developed for other cancers. MSK describes ongoing work to identify new targets, including efforts in neuroendocrine cancers and research into targets like DLL3. MSK researchers are also working toward theranostics applications in cancers such as breast cancer, brain tumors, melanoma, and pancreatic cancer.
What’s Next: A More Powerful Next Wave (Alpha Particles)
MSK highlights a “next wave” of theranostics using alpha-emitting radiopharmaceuticals—described as the most powerful form yet—and notes they opened a facility dedicated to producing these agents for clinical trials.
Questions to Ask Your Care Team
If you or a loved one is living with advanced cancer, you might consider asking:
- Do I have a target (biomarker) that could make me eligible for theranostics?
- Would a PET scan help identify targets or sites of disease more clearly?
- Are there clinical trials involving targeted radionuclide therapy that fit my diagnosis?
- What side effects are typical, and how might this compare to other options?
(This is informational only—your oncology team can help you understand what’s appropriate for your specific diagnosis.)
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Reference:
https://www.mskcc.org/news/theranostics-powerful-diagnostic-tool-and-cancer-treatment-in-one
