New Delhi: Specialists at AIIMS are researching actively about theranostics, a gamechanger coined from ‘seeing and treating’, using molecules labeled with radionuclides to bring together internal radiation and chemotherapy’s selectivity.
In the realm of cancer treatment, traditional methods like surgery, radiation, and chemotherapy have long been the primary pillars. But as cancer advances to distant organs, their effectiveness diminishes.
However with theranostics, this approach delivers targeted doses while sparing healthy tissues, a stark contrast to external radiation’s indiscriminate impact.
Dr CS Bal, Professor & Head, Department of Nuclear Medicine, AIIMS, New Delhi spoke to Millennium Post, saying “Radiopharmaceuticals employing beta
or alpha radiation have shown promise, albeit hindered by challenges in accessing specific radionuclides, leading to costly imports.”
He elaborated that India, despite obstacles in procuring certain radionuclides locally, has emerged as a leader in theranostics. Breakthrough treatments like 177Lu/225Ac-DOTATATE for neuroendocrine tumors and 177Lu/225Ac-PSMA617 for prostate cancer have extended survival rates and improved life quality, showcasing India’s prowess in innovative
cancer care.
Dr Bal spoke about the shift towards targeting the cancer micro-environment, particularly Cancer-Associated Fibroblasts (CAFs) and their influential Fibroblast Activation Proteins (FAPs), that has opened new avenues for imaging and therapies.
This evolving paradigm promises innovative cancer treatments by addressing the very environment fostering tumor growth.
He also elaborated on how this approach aims to assess and treat using the same or similar biomolecules, enabling selective receptor-based dose delivery. This results in sparing surrounding healthy tissues, a notable advantage over external beam radiotherapy where excessive toxicity to healthy tissue is a limiting factor.
He further explained how the cost to import is a lot and India’s journey in theranostics faces hurdles - from supply chain constraints to regulatory demands and treatment costs.
Dr Bal revealed that the cost for a single dose is roughly over Rs five lakh, but the treatment using that dose is free at AIIMS, thus more research to find an indigenous substitute is being encouraged.
He also spoke about the possibility of repurposing and reengineering existing drugs and molecules for thernostic applications in order to make up for the scarcity.