Theranostics Treatment Can Target Difficult Prostate Cancers
- Theranostics, a cutting-edge field in medicine, plays a dual role in detecting and treating certain prostate cancers.
- It specifically targets PSMA, a protein found in prostate cancer cells.
- For diagnosis, doctors use compounds that attach to PSMA, allowing them to locate cancer using PSMA PET imaging, a special type of camera.
- For treatment, theranostics also targets PSMA but employs different radioactive particles to kill cancer cells. This approach saves normal tissue, reducing side effects compared to treatments like chemotherapy.
- Theranostics, including drugs like Pluvicto, is primarily used for an advanced type of prostate cancer known as mCRPC. Veterans with a new diagnosis should consult their healthcare team about this option.
Theranostics combines special methods for diagnosing cancer with targeted therapy to help treat it. It directly finds and damages prostate cancer cells expressing a protein known as Prostate-Specific Membrane Antigen (PSMA). This approach offers new hope for people with advanced prostate cancer.
Theranostics is a major step forward, especially for difficult prostate cancer cases, particularly the diagnosis of metastatic castration-resistant prostate cancer (mCRPC), where the disease has spread and doesn’t respond to usual treatments.
Read MoreWhat is theranostics for prostate cancer?
Theranostics primarily targets the Prostate-Specific Membrane Antigen (PSMA), a protein that is over-expressed in prostate cancer cells, making it an ideal target for both diagnosis and treatment. For diagnosis, theranostics uses compounds that target PSMA as a marker for cancer cells. These compounds, often radiolabeled, highlight cancer cells during a PET imaging scan to pinpoint their exact location.The treatment part of theranostics uses the same PSMA targeting mechanism but a different radioactive isotope that emits therapeutic radiation. These particles deliver localized radiation directly to the prostate cancer cells, killing as many of them as possible with minimal harm to the nearby healthy tissue. By causing DNA damage within the cancer cells, the radiation leads to cell death.
Pluvicto, a drug commonly used in this type of treatment, is increasingly available in VA hospitals. This accessibility is crucial for veterans, who are at a heightened risk for prostate cancer.
What are the advantages of radio-labeled theranostics?
Theranostics combines radioactive elements that emit energy with treatment agents that target cancer accurately. Unlike chemotherapy, which affects both cancerous and healthy cells, this approach minimizes side effects.
This precision is the key to its effectiveness, Dr. David Wise, a medical oncologist at NYU Langone Health told SurvivorNet.
“That’s very important because even if we know that there’s a prostate cancer diagnosis, it makes a big difference to know where exactly has it spread to,” Wise says.
What are the benefits of theranostics?
There are two big benefits to using theranostics to manage prostate cancer, including:
- Better Detection with PSMA PET: This is a specialized imaging test that detects prostate cancer by targeting a specific protein in the cancer cells. It is really good at finding cancer cells, especially in tough cases where other methods might not work well. This helps doctors understand how far the cancer has spread.
- Targeted Treatment: It directly zeros in on the cancer cells, which means less harm to healthy cells and fewer side effects.
Who can get treatment with theranostics?
Only prostate cancer patients with advanced, specific protein-expressing tumors typically qualify for theranostic treatment.
Patients with mCRPC who have progressed despite standard treatments like chemotherapy or androgen deprivation therapy (ADT) are usually considered suitable candidates. PSMA protein must be present in cancer cells for this treatment to work, which is true in the majority of cases.
To confirm high PSMA expression and potential response to PSMA-targeted theranostics, doctors typically conduct a PSMA PET scan.
“That’s the gold standard context in which we need to use a PSMA PET,” Dr. Wise notes.
Following the administration of the theranostic treatment such as Pluvicto in eligible patients, Dr. Wise has seen great results in the majority of cases. He told SurvivorNet that the treatment, “can work spectacularly well, where we see a large and significant reduction in the burden of the cancer and the symptoms from the cancer.”
Risks vs. benefits
Treatment with theranostics, including Pluvicto, have proven to be very effective, especially for managing mCRPC. Clinical studies and trials suggest that the therapy leads to notable improvements in survival rates and quality of life. Patients with mCRPC who have limited treatment options have benefited from theranostics, often showing a reduction in tumor size and slower disease progression.
Dr. Wise notes that patients tolerate Pluvicto especially well but may still lead to side effects, including:
- Fatigue
- Feeling sick
- Dry mouth
Side effects vary depending on how you respond to radiation and where the cancer is located. Everyone reacts differently, you need regular check-ups to manage any issues.
If you or a loved one is navigating prostate cancer treatment, discuss the potential of theranostics with your healthcare team. Keep in mind that, in many cases, VA hospitals have expanded access to advanced treatments like theranostics.
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