The term “theragnostics” is derived from the combination of the words “therapeutic” and “diagnostic.” The fundamental premise of theragnostics is to integrate diagnostic and therapeutic approaches to personalize and optimize patient care.
Theragnostics has a significant role in the field of oncology, as it can greatly improve the diagnosis, treatment, and monitoring of different cancer types.
Here are some of the key roles of theragnostics in oncology:
1. Targeted therapy selection:
- Theragnostic approaches can help identify specific molecular targets or biomarkers associated with a patient’s cancer.
- This information can assist in the selection of targeted therapies, such as small-molecule inhibitors or monoclonal antibodies, that are designed to interact with these targets.
2. Companion diagnostics:
- Theragnostics often involves the development of companion diagnostic tests that can identify the presence of specific biomarkers or genetic alterations.
- These diagnostic tests can guide to predict the likelihood of response to a specific targeted therapy, allowing for more personalized treatment decisions.
3. Monitoring treatment response:
- Theragnostic methods, such as imaging techniques or liquid biopsies, can be used to monitor the patient’s response to treatment in real-time.
- This can help guide treatment adjustments, identify emerging resistance mechanisms, and optimize the timing and dosing of therapies.
4. Screening and early detection:
- Theragnostic approaches may contribute to the development of non-invasive or minimally invasive screening tests for the early detection of cancer.
- Early cancer detection can greatly improve the chances of successful treatment and patient outcomes.
5. Combination therapy optimization:
- Theragnostics can aid in the development and optimization of combination therapies, where multiple targeted agents or treatment modalities are used in a coordinated manner.
- By identifying the most effective combinations and their optimal timing, theragnostics can enhance the efficacy of cancer treatment.
6. Disease monitoring and relapse prediction:
- Theragnostic tools can be used to monitor the presence of minimal residual disease or detect the early signs of disease relapse.
- This information can guide post-treatment surveillance and prompt timely interventions to prevent or manage disease recurrence.
Overall, the integration of theragnostic approaches in oncology has the potential to improve cancer diagnosis, treatment selection, response monitoring, and, ultimately, patient outcomes. As the field continues to evolve, theragnostics is expected to play an increasingly important role in the personalized management of cancer.
Theragnostics plays a crucial role in the management of various malignancies, as it allows for personalized and targeted approaches to diagnosis, treatment, and monitoring. Here are some examples of how theragnostics is applied in different types of malignancies:
1. Breast cancer:
- Theragnostic biomarkers, such as HER2, estrogen receptor (ER), and progesterone receptor (PR), are used to guide the selection of targeted therapies, such as trastuzumab, endocrine therapies, and CDK4/6 inhibitors.
- Circulating tumour DNA (ctDNA) analysis can be used to track disease progression and detect the emergence of resistance mutations.
2. Lung cancer:
- Theragnostic biomarkers, including EGFR, ALK, ROS1, and BRAF mutations, are used to identify patients who may benefit from targeted tyrosine kinase inhibitors.
- Liquid biopsies, such as ctDNA analysis, can assist in the early lung cancer detection and monitor treatment response.
3. Prostate cancer:
- Prostate-specific membrane antigen (PSMA) imaging is a theragnostic approach used to detect and stage prostate cancer, as well as guide the selection of PSMA-targeted therapies.
- Genomic profiling of prostate tumors can identify biomarkers that predict response to specific treatments, such as PARP inhibitors.
4. Colorectal cancer:
- Evaluation of RAS and BRAF mutational status is a theragnostic approach used to guide the selection of targeted therapies, such as anti-EGFR monoclonal antibodies.
- Circulating tumour cells and ctDNA analysis can be used to track disease progression and guide treatment decisions.
5. Hematological malignancies:
- Theragnostic biomarkers, such as CD20 in B-cell lymphomas and BCR-ABL fusion in chronic myeloid leukaemia, are used to guide the selection of targeted therapies, such as monoclonal antibodies and tyrosine kinase inhibitors.
- Minimal residual disease monitoring using sensitive molecular techniques can help assess the depth of response and guide treatment decisions.
6. Gynecological cancers:
- BRCA1/2 mutation status is a theragnostic biomarker that can guide the use of PARP inhibitors in ovarian and other gynecological cancers.
- Circulating tumour DNA analysis can be used to monitor disease progression and response to treatment in endometrial and cervical cancers.
These examples illustrate how theragnostics has become an integral part of the management of various malignancies, enabling more personalized and targeted approaches to cancer care. As the understanding of cancer biology and the development of novel targeted therapies continue to evolve, the role of theragnostics in oncology is expected to grow further.