Making Theranostics a reality in clinical practice

Making theranostics a reality in clinical practice

Cancerous diseases continue to threaten the lives of patients around the globe. The World Health Organization reports more than 10 million new cases of cancer were detected globally in 2020 with more than 10 million cancer-related deaths.[1] An important medical innovation in molecular medicine, Theranostics, is gaining interest as it may transform even advanced-stage cancer outcomes with precision oncology treatments. Experts believe Theranostics is one of the most exciting advances in nuclear medicine and molecular imaging.[2]

As a breakthrough approach to treating cancer, Theranostics integrates imaging diagnostics and targeted therapeutics for individualized management and treatment of disease. To date, radiotherapy agents have been approved for use in metastatic prostate and neuroendocrine cancers, but many other agents are currently in discovery and trials, and more therapeutic agents are widely anticipated. With a bright future on the horizon, clinicians are talking about the changes needed to support these efforts and make them available in daily clinical practice.

“A new era is coming, and we need to work together to build more Theranostics practices,” says Dr. Anthony Chang, founder and CEO of BAMF Health, a dedicated treatment center for precision medicine and Theranostics in Grand Rapids, Michigan. “Our goal is to make this technology affordable and available as well as offer the best treatment to every single patient who needs it.”

Building a Theranostics infrastructure to help transform oncology care

Building a therapeutics program requires access to highly sophisticated cyclotrons, positron emission tomography (PET) radiochemistry systems, and tracer production facility solutions in addition to advanced imaging technologies. Visualization of disease and treatment efficacy is made possible by molecular imaging techniques, such as PET/computed tomography (PET/CT) and single photon emission tomography/computed tomography (SPECT/CT). These molecular imaging technologies are essential to Theranostics because they aid clinicians in staging disease as well as provide ongoing assessments and characterizations of disease over time. PET imaging can detect whether specific targets, known as tumor receptors, are present on tumor cells. If so, a radiotherapy agent can be used to treat the cells. The efficacy of these treatments can be visualized using SPECT/CT imaging, together with artificial intelligence (AI)-based applications to support accurate quantification and efficient dosimetry.  Molecular imaging technologies can enable further progress in Theranostics as more therapeutic agents are discovered and approved for use.

As a leader in the molecular imaging and radiopharmaceutical industry, GE HealthCare supports the production of established and newly discovered research tracers and therapies with powerful tools to streamline tracer production. Cyclotrons, PET radiochemistry systems, and tracer production facility solutions are required to supply a wide range of tracers. Having this support facilitates the efficiency required to operate BAMF Health’s Theranostics program.

“We’re committed to supporting the growth and development of Theranostics programs like BAMF Health by working with clinicians and hospital systems to build the necessary infrastructure,” says Erez Levy, Global General Manager of Molecular Imaging at GE HealthCare. “We understand that providing access to emerging radiopharmaceuticals through cyclotrons and PET radiochemistry systems for tracer development, production, and distribution is essential. We’re also supporting Theranostics with advanced molecular imaging systems like our Omni Legend PET/CT and tools for processing imaging data with sophisticated AI applications.”

Dedication to precision oncology and Theranostics treatments

Chang is an advocate for the practice of Theranostics as it is a very powerful approach, however he questions why these treatments aren’t currently available for more patients.

“It’s because often, we don’t have the infrastructure to support it. We have been thinking about these problems and executed on our ideas with intelligence-based precision medicine,” he explains. “We partnered with GE HealthCare for our radiopharmaceutical production, high-throughput, advanced imaging systems and workflow solutions. We need to make a wide variety of radiopharmaceuticals available for both diagnosis and therapeutic purposes, and at a commercial scale, as well as at affordable prices.”

BAMF Health is currently treating metastatic prostate cancer and neuroendocrine tumors with targeted treatments.

“It’s a simple strategy—we don’t compromise,” Dr. Chang explains. “We have exceptionally advanced radiopharmacy comprising two GE HealthCare cyclotrons for diagnostic and therapeutic radiopharmaceuticals and 21 hot cells for producing long and short half-life tracers. We also have an exceptionally advanced molecular imaging clinic that allows us to identify candidates for Theranostics therapies. And most importantly, we are one of the first groups in the world to have the digital SPECT/CT from GE HealthCare that allows us to evaluate treatment efficacies.”

Redefining the patient experience in oncology care

As a leading Theranostics practice in the US, BAMF Health was designed with the patient experience in mind. Neutral colors and natural light flood the lobby, and patient and staff interactions are designed with care. Additionally, with safety in mind, patients can relax and enjoy the space without radioactivity hazards to the staff.

The financial perspective of the patient experience was also considered. Because the efficacy of Theranostics treatments is monitored throughout the patient’s treatment journey, changes can be made that affect not only health outcomes but also the patient’s cost and insurance reimbursement.*

“Most of our treatments have been paid by insurance,” Dr. Chang notes. “We use our GE HealthCare StarGuide™ SPECT/CT to image patients post-therapy, and it’s an integral part of our program. Radiation therapy is typically a series of six treatments. After a second treatment, if we image the patient and see treatment is effective and also see that a patient’s PSA [prostate-specific antigen] has dropped, we may stop after a third treatment, eliminating extra harm to patients. SPECT/CT helps us make this clinical decision. In another case, the patient’s PSA dropped dramatically after just one treatment and we barely had to do another treatment. We eliminated four radiation treatments, saving around $300,000 for the patient and the insurance.”

SPECT/CT can also assist clinicians in prostate cancer cases where the primary disease is reduced but continued Theranostics treatments may not be effective, for example, because metastases on bone don’t emit the prostate-specific membrane antigen targeted by the therapeutic agent. In these cases, patients are referred for other treatments that may work better.

Enabling a bold future in Theranostics

Theranostics is an exciting field of molecular medicine with significant potential for changing outcomes in oncology. The ability of Theranostics to use precision medicine and imaging technology to identify patients with areas of disease that are more likely to respond to targeted therapies is invaluable to cancer patients. Clinicians are working with trusted partners like GE HealthCare to build the foundation necessary to support the future of precision therapeutics. Persistent disease strongholds in areas such as prostate and other cancers fuel the need to harness precision therapeutics and move these treatments into daily clinical practice, aligning patients with the individualized therapies that will be most effective for improving their quality of life and health outcomes.

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DISCLAIMER

Not all products or features are available in all geographies. Check with your local GE HealthCare representative for availability in your country.

*GE HealthCare does not warrant or guarantee profitability. Ability to achieve profitability is dependent on factors specific to each customer.

 

REFERENCES


[1] Cancer. World Health Organization. Published February 3, 2022. https://www.who.int./news-room/fact-sheets/detail/cancer. Accessed March 2, 2023.

[2] Czernin J, Calais J. Nuclear medicine, molecular imaging, and theranostics: The future is bright. Journal of Nuclear Medicine Technology. June 2020;48(Supplement 1):82S-83S. https://tech.snmjournals.org/content/48/Supplement_1/82S.