Theranostics and how it works

Theranostics is a treatment using diagnostic imaging to identify if target receptors are present on cancer cells, followed by precision radiation treatment that target these receptors.

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Theranostics

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Theranostics can be used to treat cancers that have spread (metastasised), or where cancer is advanced and/or hasn’t responded to other treatments.

While in the future theranostics may be used for different cancers, to date most experience and success has been in metastatic prostate cancer and neuroendocrine tumours.

Metastatic prostate cancer

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How it works

Theranostics is a personalised approach to treating cancer, using both diagnosis and therapy tools as part of the treatment. Theranostics uses PET scan imaging (a special type of scan) to see if specific targets, known as tumour receptors, are present on tumour cells.

If these targets are present and visible on the scan, a radioactive drug is used to treat the tumours. The drug is given as an injection and selectively targets the tumour cells while avoiding healthy areas. Most of the radioactive drug that doesn’t reach the target is quickly passed out of the body.

Limited clinical trial evidence is available for the use of theranostics in prostate cancer and the treatment has not yet been reviewed by the Australian Medicines Regulator – The Therapeutic Goods Administration (TGA).

Access to treatment is authorised via the TGA Special Access Scheme, a scheme for compassionate access to medicines before registration. It is an out of pocket expense for patients as theranostics is not currently covered by Medicare or private health insurance.

Theranostics treatments we offer

Treatment for advanced prostate cancer

Lutetium-177 PSMA therapy (Lu-PSMA) is a new treatment for advanced prostate cancer. It delivers high doses of targeted radiation to the cancer sites. It’s used to specifically target the abnormal cells while limiting damage to surrounding healthy tissue.

Treatment for advanced neuroendocrine tumours

Lutetium-177 Octreotate therapy (Lu-Octreotate) is a treatment for advanced neuroendocrine tumours (NETs) or carcinoids.

It delivers high doses of targeted radiation to the cancer sites. It’s used to specifically target the abnormal cells while limiting damage to surrounding healthy tissue. This therapy has been used for almost 20 years in this tumour type and is now approved for the treatment of progressive advanced neuroendocrine tumours in Europe and the USA.

Theranostics patient journey

It is important that you feel informed and supported on your Theranostics treatment journey. We are here to answer any questions or concerns you may have. Here are questions that others often ask:

Before treatment commences, your Nuclear Medicine Physician will explain the treatment process, treatment options and any potential side effects. You will receive a care plan tailored to your needs.

Any out of pocket costs associated with your treatment will be discussed with you in a clear and simple way before you commence treatment.

In order to develop your treatment plan, you will be required to attend a few appointments.
These will include a visit to an imaging department and pathology centre for your blood tests.

Prior to receiving your cycle of treatment, your Nuclear medical Medicine Physician will review your results and confirm your treatment plan.

A nurse will assess your overall health status.

You will be given a tour of the department and an overview of what to expect.

A nuclear medicine technologist or nuclear medicine physician will deliver your treatment via an injection and monitor you regularly. A nurse will check that you are hydrated throughout the day by ensuring you have enough liquids or may put you on a drip if necessary. The treatment will last approximately 4 hours.

Where is theranostics offered?

We currently have five centres in Australia offering theranostics treatment for our patients.

  1. Hollywood Private Hospital, Perth, WA

  2. Waratah Private Hospital, Sydney, NSW

  3. John Flynn Private Hospital, Gold Coast, QLD

  4. Chermside Medical Complex, Brisbane, QLD

  5. North Shore Health Hub, Sydney, NSW

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Our partnerships

For enquiries regarding partnership opportunities, please contact us via theranosticsreception@genesiscare.com.au

News on Theranostics

We have entered a clinical alliance with Noxopharm to offer a compassionate access program with Noxopharm’s novel lead product candidate, Veyonda®, for patients with advanced, treatment-resistant, metastatic prostate cancer (mCRPC) being treated with theranostics. Following promising clinical outcomes from the compassionate use program and early clinical research, we have formalised an arrangement to make the therapy available for use in patients with few treatment alternatives. For more information click here.

Publications

Title Author/s Journal & date
Title

Combining External Beam Radiation and Radionuclide Therapies: Rationale, Radiobiology, Results and Roadblocks

Author/s

Abbott EM et al.

Journal & date

Clinical Oncology, https://doi.org/10.1016/j.clon.2021.09.004

Title

Recurrent Prostate Cancer

Author/s

Lenzo N, Sohi J.S, Lim T.S.

Journal & date

Appl Radiol 2021; Jul/Aug:40-43.

Title

Patterns of disease detection using [18F]DCFPyL PET/CT imaging in patients with detectable PSA post prostatectomy being considered for salvage radiotherapy: a prospective trial

Author/s

Koschel S, Taubman K, Sutherland T, Yap K, Chao M, Guerrieri M, Benson A, Starmans M, Byrne G, Ong G, Macleod C, Foo M, Wong LM, Gyomber D, Ng M.

Journal & date

April 2021

Title

Efficacy and Haematologic Toxicity of Palliative Radioligand Therapy of Metastatic Castrate-Resistant Prostate Cancer with Lutetium-177-Labeled Prostate-Specific Membrane Antigen in Heavily Pre-Treated Patients

Author/s

Kesavan M, Meyrick D, Gallyamov M, Turner JH, Yeo S, Cardaci G, Lenzo NP.

Journal & date

March 2021

Title

Real-World Data Analysis of Efficacy and Survival After Lutetium-177 Labelled PSMA Ligand Therapy in Metastatic Castration-Resistant Prostate Cancer

Author/s

Meyrick D, Gallyamov M, Sabarimurugan S, Falzone N, Lenzo N.

Journal & date

March 2021

Title

Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography compared with diagnostic computed tomography in relapsed prostate cancer

Author/s

Asokendaran ME, Meyrick DP, Skelly LA, Lenzo NP, Henderson A.

Journal & date

August 2019

Title

Renal outcomes of radioligand therapy: experience of 177lutetium-prostate-specific membrane antigen ligand therapy in metastatic castrate-resistant prostate cancer

Author/s

Gallyamov M, Meyrick D, Barley J, Lenzo N.

Journal & date

August 2019

Title

177Lu-PSMA radioligand therapy of predominant lymph node metastatic prostate cancer

Author/s

by Eyben FE, Singh A, Zhang J, Nipsch K, Meyrick D, Lenzo N, Kairemo K, Joensuu T, Virgolini I, Soydal C, Kulkarni HR, Baum RP.

Journal & date

March 2019

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North Shore - Now open

North Shore Health Hub, Tower A, Level 1, 7 Westbourne Street, St Leonards NSW 2065, Australia

(02) 8037 4100

Murdoch (Oncology)

St John of God Murdoch Hospital, Barry Marshall Parade, Murdoch WA 6150

John Flynn Private Hospital (Theranostics)

Nuclear Medicine & Therapy Centre, 42 Inland Drive, Tugun QLD 4224

(08) 9438 8500

Hollywood Private Hospital (Theranostics)

Hollywood Private Hospital, Diagnostic Nuclear Imaging, Monash Ave, Nedlands WA 6009

(08) 9438 8500

Chermside (Oncology)

Chermside Medical Complex, Lower Ground Floor, 956 Gympie Road, Chermside Brisbane, QLD, 4032

(07) 3917 4400

Hurstville (Oncology)

Waratah Private Hospital, Level 6, 31 Dora Street, Hurstville, NSW, 2220

(02) 8568 7600

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