Pluvicto’s Shift in Theranostics
In recent years, oncology has seen a major shift with the rise of Theranostics - a combination of therapy and diagnostics that enables personalized, targeted cancer treatment. Theranostics is no longer a niche innovation - it’s becoming a key part of how we approach cancer care. With Pluvicto’s recent approval for earlier use in the prostate cancer treatment pathway - specifically after ARPI therapy and before chemotherapy - it now offers a viable, less toxic intervention earlier in the patient’s treatment journey [1][2]. This advancement not only expands the eligible patient population but underscores the urgency for hospitals to incorporate Theranostics into their standard of care - not just as an add-on, but as a central pillar of cancer care.
For hospital leaders focused on advancing patient-centered, high-performance cancer programs, Theranostics is not only a clinical innovation - but a strategic priority.
Pluvicto’s Expanded Role in Prostate Cancer
With Pluvicto moving earlier in the treatment cycle, hospitals must take a thoughtful approach - updating clinical pathways to bring radioligand therapy earlier in the treatment cycle, training multidisciplinary teams, and investing in infrastructure for dosimetry, radiopharmacy, and therapy response monitoring. Establishing streamlined referral workflows and robust radiation safety protocols are also essential to improve patient access and minimize delays [3][4]. Without these steps, hospitals risk delayed adoption, reduced treatment efficacy, and falling behind in delivering precision oncology. This isn’t just a clinical challenge - it’s an operational one that requires flexibility and coordination across the system.
Updating Clinical Protocols and Pathways
Hospitals must proactively update clinical protocols to identify Theranostics-eligible patients sooner. Early integration allows for timely intervention, which can reduce patient toxicity and improve long-term outcomes. This shift requires re-evaluating existing pathways to ensure Pluvicto is considered at the appropriate decision points, particularly for patients with PSMA-positive disease who may benefit before exhausting other therapies. Aligning protocols with emerging clinical trial data and evolving guidelines ensures institutions remain at the forefront of innovation, offering patients access to the most advanced care available.
The Importance of Dosimetry and Therapy Response Monitoring
Dosimetry is becoming a critical tool in helping clinicians understand how well a patient is responding to radioligand therapy. It gives real-time data on how much radiation is reaching the tumor and healthy tissues, allowing clinicians to quickly adjust their treatment approach depending on patient response. This means patients can get the most benefit from treatment while avoiding unnecessary radiation exposure or continuing ineffective therapies.
Dosimetry also lays an exciting foundation for the future of RLT administration that could involve personalized dosing optimized for their individual response to therapy. Currently, Pluvicto is administered on a standardized schedule based on manufacturer’s guidelines (6 doses of 200mCi every 6 weeks) with only minimal dosing adjustments based on patient adverse reactions. As dosimetry advances, it will enable more tailored treatment plans, improving outcomes and reducing waste. Investing in these capabilities now creates the foundation for a more precise approach to care.
Interdisciplinary Collaboration: A New Standard
The future of cancer care is not just about new therapies; it’s about new ways of working together. Pluvicto’s move earlier in the patient’s treatment journey means care teams need to work more collaboratively to sequence available treatments and monitor therapeutic success.
Effective Theranostics treatment requires an interdisciplinary team - from nuclear medicine and oncology to radiology, urology, and beyond [6]. However, many hospitals still operate in silos, which can hinder communication and delay care.
To overcome this, Theranostics must be approached as a coordinated service line, with clear communication across specialties to create a patient-centered model. This approach offers a more seamless experience from diagnosis through post-treatment.
Without this kind of collaboration, hospitals risk delayed diagnoses, suboptimal treatment plans, and missed opportunities for early intervention. By contrast, a well-integrated team can deliver faster, more accurate, and more personalized care.
REFERENCES
- https://www.fda.gov/drugs/resources-information-approved-drugs/fda-expands-pluvictos-metastatic-castration-resistant-prostate-cancer-indication
- https://pubmed.ncbi.nlm.nih.gov/40441170/
- https://pubmed.ncbi.nlm.nih.gov/36933329/
- https://pubmed.ncbi.nlm.nih.gov/39362764/
- https://www.rltinstitute.novartis.com/pdfs/FA-11376822_U%20Pluvicto%20Dosing%20and%20Administration%20Guide_0325.pdf
- https://pubmed.ncbi.nlm.nih.gov/36321986/
