Theranostics in the Arab World; Achievements & Challenges

Abstract

In nuclear medicine, theranostics (combining therapy and diagnostics in one platform) is made possible
through the utilization of radiopharmaceuticals for both therapeutic and diagnostic purposes by targeting one
specific tumor receptor or certain molecular pathway.
To make radiopharmaceuticals biologically relevant compounds, receptor ligands must be labeled with
radionuclides. The possible applications are multifold and include: in vivo visualization of tumor biology;
diagnosis and tumor staging; therapy planning and treatment of specific tumors.
The application of theranostics results in giving the right treatment to the right patient at the right time, which
is expected to improve therapeutic efficacy and increase overall compliance to therapy. For example,
theranostics can be used to determine the heterogeneity of cancer lesions, which is one of the most difficult
aspects of therapeutic success, allow the identification of patients who will benefit from therapy, avoid
unnecessary conventional therapies, and implement salvage treatments for those who need them.
The use of theranostics has seen unprecedented value for cancer patients in the last decade. Several
radiopharmaceuticals are currently in use in clinical practice (e.g., [68Ga/177Lu] DOTATATE), while
dozens more are still in the preclinical stages.
The goal of this review article is to cover the current and future status of nuclear theranostics, particularly in
the Arab world, with a focus on expanding the discipline beyond neuroendocrine tumors, castration-resistant
prostate cancers, and differentiated thyroid cancers. Furthermore, representatives from different Arab
countries were invited to describe their recent understanding and contributions to drive innovation in this
evolving field.