In the intricate world of modern healthcare, few advancements hold as much promise as theranostics. Positioned as the fourth pillar of cancer-related therapy alongside medical oncology, radiation oncology, and surgery, theranostics embodies the future of personalized and precision medicine. With its precise targeting and ability to tailor treatments to individual patients based on their unique biological characteristics, theranostics heralds a new era in oncology care.
The evolution of oncology care
Traditionally, oncology care has relied on a standardized approach, often treating patients based on generalized protocols. However, with the advent of theranostics, this paradigm is rapidly shifting. No longer bound by one-size-fits-all treatments, oncologists can now leverage molecular diagnostics and imaging techniques to tailor therapies to each patient's specific needs. This shift toward precision medicine represents a profound leap forward in the fight against cancer.
After speaking with hundreds of providers in the field of theranostics (healthcare providers, pharmaceutical companies, contract manufacturers, etc.), GE HealthCare has formed a view of the future of theranostics care. We believe that the following 10 core components are needed to drive the necessary clinical, operational, and patient experience innovations. In this article, we discuss each component.
1. Facilitated access to radiopharmaceuticals
One of the key challenges in theranostics is ensuring access to specialized radiopharmaceuticals–both radiodiagnostics and radiotherapeutics. GE HealthCare is driving innovation in the rapid growth in access to radiodiagnostics, through our comprehensive Radiopharmacy Solutions. Partnering with leading clinical, academic, pharmaceutical and research organizations to innovate, streamline production and distribution, and commercialize new radiopharmaceuticals and solutions.
By forming collaborations with pharmaceutical companies to increase access to novel pharmaceuticals, GE HealthCare has a pipeline of radiodiagnostic and radiotherapeutic agents. In 2022, GE HealthCare and Telix announced a partnership at the European Association of Nuclear Medicine to expand immune-diagnostic offerings.
GE HealthCare recently announced collaborative partnerships and strategic investments supporting digital capabilities. By streamlining the process of connecting patients with clinical trials, oncologists will be able to explore novel radiotherapeutic options tailored to individual patients.
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PETtrace™ Cyclotron and Solid Target Platform integrates all components in the production cycle.
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MINItrace™ Magni is GE HealthCare’s next level compact cyclotron focused on addressing space and staffing limitation.
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FASTlab™ 2 New Edition, a one-of-a-kind, plug and play, platform for developing and producing PET tracers.
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TRACERcenter Solutions enables reliable supply of PET imaging tracers produced on demand, reducing your risk of schedule disruption due to delivery issues.
2. On-time reliable supply
It’s not just about access. The world of radiopharmaceuticals will become increasingly complex as more therapies are approved and available for clinical trial or routine clinical use. Handling this complexity and ensuring the on-time reliable supply of the right radiopharmaceutical at the right time for the right patient is going to be critical to scaling in a sustainable manner.
Digital tools that can manage and track the supply chain of radiotherapeutics will become ever important to theranostics care delivery, and GE HealthCare is actively designing a Theranostics Pathway Manager Application (part of the GE HealthCare Command Center Platform) which will have the capability to monitor if doses are ordered. We see opportunity to build Lean practices into the production, management and monitoring processes, and simplify the workflow through integration, automation, and digitization of the radiopharmacy platform.
3. Precise patient selection
The diagnosis and treatment of patients with cancer is less precise than desired, and cancer burden can increase over time as tumors resist generalized therapy based on heterogeneity, immune status, therapeutic dosage, stage of diagnosis and more.
We believe the future of theranostics will include predictive tools that will enable physicians to leverage AI in the precise selection and treatment of patients receiving theranostics care. With longitudinal patient data from multiple sources, AI will be able to help clinicians better predict which patients will best respond to a particular treatment. Data registries will undoubtedly become foundational assets to AI-based tools used in predictive care.
4. Pre-treatment tools
In an ideal world, physicians and patients would know the ideal dose for maximum efficacy and minimum toxicity before the first dose is administered.
Our vision is that pre-treatment AI-based predictive algorithms, based on the PET/CT diagnostic imaging study will determine a truly personalized first dose. GE HealthCare has significant experience in building AI-based predictive algorithms, and we aim to collaborate with healthcare providers to develop these pre-treatment tools.
5. Care pathway
As the field of theranostics continues to evolve, so do the leading practices and standard operating procedures related to the care pathway. Sites of care can be constrained by space and facility design (e.g., dedicated restrooms, sufficient treatment rooms, waste handling, etc.), challenged with staffing shortages, or unable to provide all treatment services in a single location. Specific challenges around ordering, scheduling, and communicating across the care pathway are also common.
GE HealthCare is partnering with healthcare providers to build a set of leading practices to support today’s treatment pathway as well as design what the ideal center of the future looks like (both facility and program design). We are co-creating this guide with our healthcare organizations to establish a practical, streamlined, patient-focused set of operational guidelines. We are also developing digital theranostics application to provide a real-time, intelligent clinical and operational theranostics support.
6. Precision imaging
Advanced imaging platforms further enhance treatment planning by providing precise assessments of tumor burden and treatment response, setting new standards for clinical outcomes and patient satisfaction.
At GE HealthCare, we’re pushing the limits of precise diagnostics and treatment response monitoring with ultra-high sensitivity PET/ CT and PET/MR scanners and a wide range of traditional and cutting- edge digital SPECT/CT systems. We optimize advanced technologies, including proven AI-based deep learning algorithms, in every aspect of the imaging chain. These imaging technologies are built with the future of theranostics in mind and allow right-sized investment today with scalable technology that can grow to support every theranostics program, without compromise, for the life of system.
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Omni Legend™ PET/CT delivers high resolution and an unparalleled increase in true NEMA sensitivity. Greater sensitivity can enable faster scan times and lower dose, but also lesion detectability rivaling top-of- the-line digital platforms.
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StarGuide™ Our most advanced SPECT/ CT was made to help fulfill the promise of nuclear medicine’s Theranostics revolution. StarGuide attains resolution and sensitivity levels critical in monitoring doses from therapy.
7. Personalized dosimetry
At the core of theranostics lies the concept of personalized medicine. Using future scalable, AI-based tools, oncologists will be able to tailor treatment dosages to maximize efficacy while minimizing side effects. GE HealthCare is leveraging our digital and imaging capabilities to make the future of dosimetry robust, reliable, and simple.
The combined portfolio is designed to enhance medical research and clinical workflows to help clinicians improve patient stratification and selection, response prediction, and support the development of new treatments, including alpha therapies.
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MIM SUREPLAN™ maximizes your existing resources and reduces manual effort with our comprehensive workflow that automates the dosimetry process from reconstruction to dose calculation.
8. Remote monitoring for enhanced patient engagement
Cancer care is maturing toward continued observation and safety monitoring using remote monitoring technologies. Wearable devices equipped with intelligent algorithms enable continuous monitoring of vital signs with real-time communication to providers to track patient response to therapy. Remote patient monitoring is already a crucial element of improving patient compliance in some clinical trials.
GE HealthCare is collaborating with University College London on a remote patient monitoring solution for prostate cancer. Our vision is that patient wearables leveraging predictive AI will help predict patient deterioration and escalate the need for a patient to return for treatment. This, combined with our efforts to expand precise dosimetry, will result in a more personalized therapeutic journey.
9. Comprehensive educational initiatives
Central to the success of theranostics is the dissemination of knowledge among healthcare providers, patients, and other professionals. Currently, educational resources are available from a variety of sources including the Society of Nuclear Medicine and Molecular Imaging (SNMMI), radioisotope manufacturers, and conferences sponsored by academic medical centers. The ever-evolving nature of the theranostics industry underscores the need for organizations to obtain current, relevant information and resources for their patients, physicians and communities.
Organizations are focusing on educating in-house providers and staff, and GE HealthCare is actively raising awareness and partnering with healthcare providers to develop community education strategies to promote the understanding of Theranostics and expanding referral networks. These efforts underscore GE HealthCare’s commitment to advancing precision healthcare and fostering collaboration.
10. Practical economic models
In addition to clinical and operational considerations, theranostics also presents unique economic challenges. Reimbursement is still more of an art than science, and the high price of the radiotherapeutics themselves can make hospitals reluctant to pursue theranostics as a treatment tool
for their patients.
To support the growth of radiopharmaceutical therapies, GE HealthCare provides economic models that help decisionmakers assess the financial viability of investments in a theranostics program. These data-driven tools enable healthcare organizations to make informed decisions regarding staffing, facilities, supplies and equipment procurement, ensuring the sustainability of their programs.
Conclusion
In the fight against cancer, theranostics stands as a beacon of hope. With its emphasis on personalized care, facilitated access to innovative therapies, and a comprehensive support infrastructure, theranostics represents a transformative force in oncology. As we continue to unravel the complexities of personalized therapy, theranostics will undoubtedly play a central role in shaping the future of healthcare, one patient at a time.
Today, in this new and growing field, best practices and standard operating procedures for theranostics have not yet been established. Sites are constrained by space and available facilities, challenged with staffing shortages, and often require patients to visit multiple locations for one cycle of treatment.
To help address these challenges and support Theranostics programs throughout the U.S. and Canada, GE HealthCare has established a programmatic approach to Theranostics program enablement and optimization. We consider every aspect required for a successful Theranostics program today while also preparing programs for increased growth and patient complexity. GE HealthCare is proud to support today’s programs while shaping future digital, imaging and programmatic innovations in this exciting field.
