Theranostics is an emerging field of cancer diagnosis and treatment that uses targeted radiation. Doctors at MU Health Care have experience using theranostics to help people treat tumors that are inoperable or resist other forms of treatment.
The word “theranostics” is a combination of the words therapeutics (treating or healing a disease) and diagnostics (discovering the nature of an illness). It is a form of precision medicine that uses radioligands — a radioactive substance added to a ligand, a naturally-occurring biochemical material — to target and kill cancer cells.
When treating certain kinds of cancers such as neuroendocrine tumors, theranostics can benefit patients who have tumors that are surgically inoperable, or who choose not to have surgery. The targeted nature of the radiation may also be more efficient, and more effective, than chemotherapy or external radiation treatments at reducing the size of tumors.
Location and experience are important factors in making decisions about your medical care. MU Health Care’s Ellis Fischel Cancer Center has doctors who have expertise and training in treating cancer with injectable radiation therapies. MU Health Care is the only hospital system in mid-Missouri that offers theranostic cancer treatment.
Ellis Fischel is also home to specialists, including surgeons, hematologists and oncologists, and interventional radiologists. This gives you access to complete, high-quality cancer care in one place, and means your care is coordinated so that you don't have to worry about scheduling many different appointments.
Theranostics at MU Health Care
One treatment option available at MU Health Care is Lutathera, which is used to treat adults who have surgically inoperable, progressive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that are positive for somatostatin, a common hormone produced by the body’s digestive and nervous systems.
Because GEP-NETs grow in hormone-producing cells, Lutathera targets the hormone receptor somatostatin, attaching to the receptor and passing through the cell membrane — similar to a key fitting a particular lock. Once inside, the medication releases a dose of radiation designed to damage the targeted cell and its neighbors.
Lutathera is the first, and currently the only, FDA-approved radioligand therapy to treat somatostatin-positive GEP-NETs. The treatment is an injection administered up to four times, with doses spaced eight to 16 weeks apart depending on your body’s reaction to the medication.
During an international clinical trial, Lutathera was used with a peptide drug called octreotide to treat advanced, inoperable midgut neuroendocrine tumors. It increased progression-free survival by 79% when compared to treatment with octreotide alone.
Doctors at MU Health Care have used Lutathera to treat GEP-NETs since 2021. The radioisotope Lutetium-177, or Lu-177, a key ingredient in Lutathera, has been produced at the University of Missouri Research Reactor (MURR) since 2017. MURR scientists identified Lu-177 as a potential cancer treatment in the early 2000s.
What to consider before starting treatment
Because theranostics use radiation, there are important safety considerations. You should discuss your complete medical history with your doctor before starting treatment, including:
- Current symptoms.
- Other medical conditions.
- Any medications you take, including over-the-counter medication.
- Changes in your daily routine.
- Difficulty controlling urination or bowel movements.
- If you are trying to get pregnant, if you are already pregnant or if you are breastfeeding.
The most common side effects of Lutathera treatment include vomiting, nausea, decreased blood cell counts and blood potassium levels, and increased liver enzymes and blood glucose. Other side effects are possible.
Exposure to radiation treatment can also have serious side effects, which may include:
- Increased risk of other cancers, including leukemia and myelodysplastic syndromes.
- Myelosuppression, which can prevent normal bone marrow function. This may impact your red and white blood cell counts and your body’s ability to clot.
- Kidney problems, including kidney failure.
Fertility issues, including infertility and fetal harm. You should not breastfeed during treatment or within six weeks of your final Lutathera treatment. Women with male partners should use effective birth control measures during treatment and for seven months after completing treatment. Men with female partners should use effective birth control measures during treatment and for four months after completing treatment.