theranostik

Theranostik, commonly spelled theranostics in English, is a medical concept that integrates diagnostic testing with targeted therapy to diagnose, treat, and monitor disease using a coordinated set of agents and methods. The aim is to personalize care by selecting patients most likely to benefit, guiding therapy, and tracking response in real time.

The approach relies on agents that can both detect disease and deliver treatment, or on paired diagnostic and therapeutic tools that share a common target. This enables imaging-based patient stratification, dose optimization, and early assessment of effectiveness, with adjustments made as needed. Widely used modalities include molecular imaging with PET or SPECT, MRI, or optical techniques, often employing radiolabeled compounds, antibodies, peptides, or nanoparticles.

In oncology, theranostik has produced notable clinical examples. Radiopharmaceuticals such as Lutetium-177 DOTATATE for neuroendocrine tumors exemplify targeted therapy guided by diagnostic imaging. The PSMA-directed theranostic paradigm combines Ga-68 labeled diagnostic tracers for PET imaging with Lu-177 or Actinium-225 labeled therapies for prostate cancer. Other platforms use antibody- or peptide-based constructs to image tumors and deliver cytotoxic or immunomodulatory treatment.

Challenges include high development and manufacturing costs, regulatory complexity, need for specialized imaging and radiochemistry infrastructure, uncertain long-term benefits across diverse populations, and management of organ-specific toxicities. Reproducibility of imaging, standardization of protocols, and access disparities also pose barriers.

Looking ahead, theranostik aims to expand across cancer types and non-oncologic diseases, integrate genomic and proteomic data, and leverage advanced imaging analytics and nanomedicine to enhance precision, safety, and patient outcomes.