Theranostics

Theranostics is a case word consisting of the two terms Thera pie and Diag nostik is formed.

Theranostics is understood to mean the increasingly closer interlinking of diagnostics and therapy. The aim of theranostics is to enable the right therapy for the right patient at the right time.

Theranostics is the diagnosis accompanying therapy with the aim of a patient-specific therapy. The main elements of diagnosis in theranostics include the determination of the genetic predisposition, the characterization of the stage of the disease and the monitoring of the healing progress. Theranostics are used to determine, among other things, the suitability and effectiveness of a drug for a specific disease in an individual patient.

In the English-speaking world, the terms personalized medicine and predictive medicine are very often used in connection with theranostics .

The "classic" approach

In the previously usual procedure, the attending physician makes the diagnosis based on the patient's symptoms . On this he builds the subsequent therapy. He is partially supported by results from laboratory tests and imaging procedures . The success of the initiated therapy is usually determined by the disappearance of the symptoms. In principle, this is only possible at a later point in the treatment.

The theranostic concept

Proponents of the concept theranostics say a change in the health system from a sickness service to a health service forward. The focus here is on maintaining health ( wellness ).

In order to be able to realize this concept, a comprehensive diagnosis is required, which recognizes the predispositions and can record changes in the health status in as presymptomatic a stage as possible, i.e. before the patient himself perceives the symptoms of his illness.

Essentially, in-vitro diagnostic methods such as DNA chip technologies are used here. Imaging methods, especially molecular imaging , will continue to gain in importance for early diagnosis. This allows diagnoses to be made at a very early point in the course of the disease, even before the molecular changes show up in anatomical restructuring. For example, tumor diseases could be diagnosed up to 7 years earlier than with today's techniques.

Examples of theranostics

Some initial approaches to theranostics have already been implemented. An example of this is the individualized chemotherapy by in vitro chemosensitivity determination.

Some authors see September 25, 1998 as the “birth” of theranostics when the FDA approved trastuzumab (Herceptin ^® , Genentech ) for the treatment of stage IV breast cancer and HercepTest ^® (Dako) for the diagnosis of overexpression of Her2 granted.

Both examples, however, are only the first approaches in theranostics, which are still a long way from the actual concept - the early detection of diseases at the molecular level.