In recent years, there has been growing interest in developing therapeutic radiopharmaceuticals for treating various malignancies that express specific receptors on cancer cells. The concept of “Theragnostics” involves combining therapy and diagnostics by using radiopharmaceuticals that target the same receptors on cancer cells. The diagnostic agent, usually a gamma or positron emitter, is used for imaging, while the therapeutic agent emits beta or alpha radiation that binds to the tumor and destroys it. Because the binding is specific to the target receptors, tissue destruction occurs mainly in cancerous lesions, resulting in fewer side effects compared to external radiation or chemotherapy. The Theragnostics principle is illustrated in Figure 1.

Figure 1- Principle of Theragnostics in cancer therapy

Cancer Target for therapy Diagnostic scan to confirm target Therapeutic radio pharmaceutical
Thyroid cancer Iodine symporters on thyroid carcinoma cells Iodine – 131 in
low doses
Iodine – 131 in
high doses
Castration resistant prostate cancer Prostate specific membrane antigen in prostate cancer cells Ga-68 PSMA PET CT
Metastatic or inoperable neuroendocrine tumors Somatostatin / Octreotide receptors in NET cells Ga-68 DOTANOC / DOTATATE PET CT Lu-177 DOTATATE PRRT
Table shows the Theragnostics agents available in our nuclear medicine department for cancer patients.

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