Theranostics and Radiopharmaceutical Use May Enhance Cancer Care

In an interview with CancerNetwork®, Brandon Mancini, MD, MBA, FACRO, medical director at Bold Advanced Medical Future Health and clinical associate professor of medicine at Michigan State University College of Human Medicine, discussed highlights from the radiation oncology field, contextualized by his recent attendance of the 2025 American College of Radiation Oncology Summit.

Mancini began by expressing excitement in the theranostics space to elicit positive outcomes in patients undergoing treatment for cancer. Contrasting his current work with external beam radiation therapy and brachytherapy, he further explained that radiopharmaceuticals as well as theranostics were unique due to their radiation biology, physics, and novelty in the US, particularly in the prostate cancer field.

Emphasizing anticipation for change surrounding theranostics and radiopharmaceuticals, Mancini remarked that radiopharmaceutical use in conjunction with external beam palliation would enable the effective treatment of patients experiencing stage IV malignancies or metastatic disease. To this end, patients could experience greater survival length and quality of life following treatment.

Further displaying an appreciation for increased patient longevity due to survival-extending developments in the field, Mancini highlighted the ability of a treating oncologist to play a larger role in a patient’s treatment and recovery thereafter. Mancini concluded by expressing excitement about radiation oncology’s inclusion among other innovative developments in cancer care.

Transcript:

At this time, I am more biased because of that transition into the theranostics space, but it is incredibly exciting. Most of what we do is external beam radiation therapy, or brachytherapy, so something that we plan from the outside in, radiation beams crossing tissues and getting to where they need to go to create positive outcomes or physically implanting brachytherapy seeds or catheters to get radiation where it needs to go.

Theranostics and radiopharmaceutical therapy are exciting because of the unique attributes of radiation biology, the physics that go into it, the image review of patient-specific PET scans and [ensuring] qualification, and the fact that this is something brand-new for the US, specifically in the prostate cancer space, which is just 3 years old here in the [US]. The prospects and anticipation for change in the years and decades ahead are enormous, and that should make [many] radiation oncologists excited to participate in that.

Where patients have stage IV malignancies or metastatic disease, we can still play a role with our thorough oncologic training and our knowledge of radiation biology and physics. We can still [play a] role not only in external beam palliation of symptomatic lesions but [also in creating] meaningful quality and quantity of time for patients by using these targeted radiopharmaceuticals as a part of our practice. One of the most valuable aspects of that is the longevity that you have with the patient from a relationship perspective; you [can] play that bigger role for longer.

There is so much research within that space. There are endless clinical trials. There is disease site expansion to [many] different tumors. It is incredibly exciting because it is not frequent that something new and innovative [suddenly] hits a home run, in the sense of an offering in oncologic care, and radiation oncologists are part of that. It is something with a ton of potential opportunities within the space, and we should all be excited about that.