一种精准医学的经典设置，治疗诊断一体化(theranostics)是一个快速发展的医学领域，其先诊断疾病，然后使用与诊断工具相同或类似的治疗工具治疗疾病阳性患者。在仅在可视化时进行治疗的背景下，目标是高治疗指数，其疗效明显超过毒性。肿瘤学在治疗诊断一体化创新方面处于领导地位，该方法已成为可能，因为肿瘤与健康组织具有选择性表达独特蛋白质和其他因子，成像技术的进展可以报告这些组织因素，以及有关针对化学物质和纳米装置的重要理解，以及将标签或武器头附加到成像和治疗的方法。放射治疗技术-使用放射性药物-正在成为前列腺癌和神经内分泌肿瘤患者例行操作，他们分别在他们的癌症上表达PSMA（前列腺特异性膜抗原）和SSTR2（生长抑素受体2）。该领域的显著进展源于这样一个发现，即一部分具有大型转移负担的患者呈现出完全和部分反应，这一结果正在推动寻找更多放射治疗技术方法。并非每个患者都能从放射治疗技术中获益，但对于那些跨越目标检测线的患者来说，反应的可能性非常高。©2023年作者。由Wiley Periodicals LLC代表美国癌症协会出版的《临床医师癌症杂志》(CA: A Cancer Journal for Clinicians)。

A quintessential setting for precision medicine, theranostics refers to a rapidly evolving field of medicine in which disease is diagnosed followed by treatment of disease-positive patients using tools for the therapy identical or similar to those used for the diagnosis. Against the backdrop of only-treat-when-visualized, the goal is a high therapeutic index with efficacy markedly surpassing toxicity. Oncology leads the way in theranostics innovation, where the approach has become possible with the identification of unique proteins and other factors selectively expressed in cancer versus healthy tissue, advances in imaging technology able to report these tissue factors, and major understanding of targeting chemicals and nanodevices together with methods to attach labels or warheads for imaging and therapy. Radiotheranostics-using radiopharmaceuticals-is becoming routine in patients with prostate cancer and neuroendocrine tumors who express the proteins PSMA (prostate-specific membrane antigen) and SSTR2 (somatostatin receptor 2), respectively, on their cancer. The palpable excitement in the field stems from the finding that a proportion of patients with large metastatic burden show complete and partial responses, and this outcome is catalyzing the search for more radiotheranostics approaches. Not every patient will benefit from radiotheranostics; but, for those who cross the target-detected line, the likelihood of response is very high.© 2023 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.