Theranostics

What is Theranostics?

Theranostics is a form of precision medicine that combines radioactive materials (radioisotopes) with molecules designed to target cancer cells. By attaching the radioisotope to the cancer-targeting molecule, UCLA Health physicians are able to see where the cancer is and then deliver therapeutic radiation directly to it. 

By combining small amounts of radioactive material with cancer-targeting molecules, nuclear medicine physicians are able to diagnose, stage, and treat certain types of cancer. This combination of therapeutics and diagnostics is called theranostics.

Clinicians and scientists at the UCLA Health Theranostics Center leverage state-of-the-art technology and cutting-edge research to bring innovative and effective theranostic cancer treatments to our patients. 

How does Theranostics work?

Certain radioisotopes emit radiation which is not harmful to cells and can be imaged using positron emission tomography (PET). This is the diagnostic part of theranostics. Others emit radiation which can damage and even kill cells. This is the therapeutic part.

Imaging 

Therapy

In theranostics, doctors administer a specialized molecule called a radiotracer that can hold a radioisotope and target cancer cells. The radiotracer then binds to the cancer, allowing doctors to see exactly where it is and deliver cell-damaging radiation directly to it. This “see what you treat” approach helps doctors diagnose, stage, and treat cancer while minimizing damage to healthy tissues.

What can you expect before, during & after theranostics imaging and therapy?

Before theranostics imaging and therapy: 

Before beginning theranostics imaging and therapy, you will have a consultation with a UCLA Health Nuclear Medicine physician who will define treatment eligibility and explain side effects and effects of treatment. In addition to your consultation, you should:

• Activate your myUCLAhealth (MyChart) account
• Download the MyChart app to your smartphone
• Read education materials supplied by your health care team
• Contact your UCLA Theranostics care team with any questions
• Attend all appointments and screening tests to prepare for theranostics imaging and therapy
• Identify a contact person and one backup contact
• Review consent forms with your health care provider
• Identify transportation for your commute from the Outpatient Theranostics Center as you may receive anti-nausea medication that can make you drowsy

During theranostics imaging and therapy:

Theranostics is performed in an outpatient setting and consists of imaging (diagnostic) and therapy phases separated by several weeks. Two types of radiotracers are used: an imaging radiotracer which contains a radioisotope that can be imaged with PET, and a therapeutic radiotracer which contains a radioisotope that emits cell-damaging radiation. Throughout the entire process, your safety will be our top concern.

• Diagnostic Phase: To see where the cancer is, an imaging radiotracer will be administered by your health care team in our outpatient clinic. You will then undergo a full-body PET scan which will create pictures showing where the radiotracer goes. The whole process typically takes less than 3 hours, after which you can leave the clinic. 
• Therapy Phase: To treat the cancer identified in the Diagnostic Phase, your health care team will administer a therapeutic radiotracer in our outpatient clinic. Following administration, you will be closely monitored by your care team for two to three hours, after which you will be able to leave the clinic. The number of therapy cycles you undergo will depend on the disease being treated, but can range from one to six.

After theranostics imaging and therapy: 

Once the radiotracer has been administered, the cancer-targeting molecule will bind to the cancer before being naturally cleared from your body over the course of several days. While undergoing theranostics therapy, the therapeutic radiotracer will deliver cell-damaging radiation directly to the cancer cells until it is naturally cleared. 

After completing all treatment cycles, your health care team may perform another PET scan to monitor how the cancer has responded to the treatment. 

What theranostics therapies does UCLA Health offer? 

At the UCLA Health Outpatient Theranostics Center, we offer state-of-the-art theranostics therapies for a number of indications.

• Prostate cancer: PLUVICTO and XOFIGO
• Neuroendocrine tumors (NETs): Lutathera
• Thyroid cancer and Graves’ Disease: RAI (radioactive ¹³¹Iodine)

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