What’s next for theranostics?

Theranostics is now a mature cancer treatment modality, and The Journal of Nuclear Medicine (JNM) is capturing the moment in a new supplement: “Theranostics: The State of the Art.” Guest edited by Ken Herrmann, MD, MBA, with JNM Editor-in-Chief Johannes Czernin, MD, the supplement brings together top voices in the field to map out where theranostics stands today and where it’s headed next.

As Dr. Czernin puts it, “We are in the middle of a renaissance in nuclear medicine that is measurable in both scientific output and financial sustainability.” From radionuclide production and supply chains to personalized dosimetry, combination therapies, and phase 3 trials that may define the field’s next approved indications, this supplement covers the full theranostics pipeline in one place. It also tackles two big-picture questions the field can’t ignore: how oncology as a discipline is coming around to theranostics, and how nuclear medicine will train enough specialists to keep up with demand.

“Science is expanding faster than isotope production capacity, production capacity is expanding faster than dosimetric standardization, and clinical adoption is expanding faster than the trained workforce,” said Czernin. “Industry has recognized the opportunity and is funding it accordingly. What remains is for academic nuclear medicine to keep pace on evidence, personalization, and training.”

Whether you’re tracking the newest therapeutic isotopes, keeping an eye on pivotal clinical trials like PSMAcTION and NETTER-3, or thinking about how to build the next generation of nuclear oncology specialists, this supplement is essential reading. The full “Theranostics: The State of the Art” supplement is available now.

In the Supplement

Are Uro-Oncologists Onboard? — Boris Hadaschik and Oliver Sartor look at whether uro-oncologists have embraced nuclear medicine as a true partner in cancer therapy.

Expanding the Theranostic Toolbox: Emerging Therapeutic Isotopes — Cindy Rodriguez, Grace K. Liles, Suzanne E. Lapi, and Jason S. Lewis break down which isotopes can (and can’t) be produced at scale today.

The Supply Chain Conundrum — Richard Zimmermann makes the case that economics, not science, will decide which radionuclides make it to market.

Radiopharmaceutical Combination Therapies in Advanced Prostate Cancer — Yang Wang, Jane McKenzie, and Shahneen Sandhu survey combination strategies and trials targeting monotherapy resistance.

Pivotal Phase 3 Theranostics Trials: Anticipated Future Indications — Wolfgang P. Fendler, Michael S. Hofman, David Kersting, Jeremie Calais, and Thomas A. Hope map the phase 3 landscape, including PSMAcTION, STAMPEDE2, PSMA-DC, PSMAddition, NETTER-3, ACTION-1, and COMPOSE.

Radiopharmaceutical Therapy–Linked Tumor Resistance — Evan R. Abt, Caius G. Radu, Johannes Czernin, and Christine E. Mona explore the biology behind treatment resistance.

The Case for Nuclear Oncology Specialization — Martin Gotthardt, Hossein Jadvar, and David Mankoff argue for a dedicated nuclear oncology subspecialty with tailored training paths.

The State of the Art of Theranostics and Its Future — Caner Civan, Wolfgang P. Fendler, Alina Küper, Lisa Bodei, Wolfgang A. Weber, Louise Emmett, and Ken Herrmann take stock of the field and look ahead to emerging indications.

Dosimetry-Driven Personalization of Radiopharmaceutical Therapies — Richard L. Wahl and Yuni K. Dewaraja examine the evidence for personalized dosimetry.

Sponsor Acknowledgment:
The Journal of Nuclear Medicine gratefully acknowledges the support of Novartis, Siemens, RayzeBio and AstraZeneca for the publication of the supplement, Theranostics: The State of the Art.

Read the full supplement here. Visit the JNM website for the latest research, and follow us on Twitter, Facebook, and LinkedIn.

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