Key takeaways:
- The Division of Nuclear Medicine within radiology has been at the forefront of using radioactive drugs (known as radiopharmaceuticals) for the diagnosis and treatment of several types of cancer for more than 70 years.
- One of the most recent advancements involve theranostics for the treatment of neuroendocrine tumors and prostate cancer.
- The addition of these treatment options at University Hospital and the Brighton Center for Specialty Care are helping patients gain access to world-class cancer care close to their homes.
U-M Radiology is ranked No. 6 in the nation among radiology programs according to U.S. News & World Report.
The Division of Nuclear Medicine within radiology was founded in 1952 and has been at the forefront of using radioactive drugs (known as radiopharmaceuticals) for the diagnosis and treatment of several types of cancer for more than 70 years. The program has been a leader in the use of radioactive substances to treat disease for over 75 years.
When a drug is tagged with both a diagnostic and a therapeutic radionuclide, the result is what is called a “theranostic” pair of radiopharmaceuticals that can be used in cancer treatment.
Within the last few years, nuclear medicine has added to its cutting-edge treatment options, including theranostics developed by Novartis for the treatment of neuroendocrine tumors (Lutathera) and, more recently, prostate cancer (Pluvicto) at University Hospital and the Brighton Center for Specialty Care.
The diagnostic radiopharmaceutical is used in conjunction with radiology’s state-of-the-art Positron Emission Tomography (PET) Imaging Center to identify and stage the cancer and confirm suitability of the patient for subsequent treatment.
If the PET scan confirms a targeting of cancer, patients receive intravenous infusions of the therapeutic radiopharmaceutical, up to six cycles of treatment, and additional imaging is used to confirm response to therapy.
“It’s an exciting time for the field of nuclear medicine as we focus on the vision of precision theranostics for personalized cancer care,” said Peter J. H. Scott, Ph.D., professor of radiology and director of the Division of Nuclear Medicine and Radiology’s Cyclotron and Radiochemistry Facility.
“Our multidisciplinary committee of physicians, radiochemists, physicists, technologists, nurses, administration and operations staff have worked extremely hard to introduce these new theranostics agents for cancer patients that are referred to our clinics from across U-M Health and beyond.”
Improving patient access
Since the FDA approved Pluvicto in March 2022, U-M has received a large number of referrals for treatment of patients with Stage 4 metastatic prostate cancer who have experienced disease progression after chemotherapy and other treatments.
“Patients that are responsive to Pluvicto are expected to have longer times before development of new metastases and modest improvement in cancer outcomes, with several of our patients showing a decline in their PSA levels during treatment, an important biomarker for prostate cancer,” said Ka Kit Wong, M.D., clinical associate professor and director of the Nuclear Medicine Therapy Clinic. “Improving patient access to these treatments is foremost in our agenda.”
Given today’s unprecedented demand and the expected growth of theranostics in the coming years, the nuclear medicine team has been working closely with David Miller, M.D., M.P.H.,, president of U-M Health and executive vice dean for clinical affairs, and Vikas Gulani, M.D. Ph.D., chair of radiology, to grow both the clinical service and U-M’s Research and Development capabilities in this area.
It’s all part of the BASE strategic priority of improving Access.
The first step of this access expansion was to begin offering Pluvicto treatment for prostate cancer at the Brighton Center for Specialty Care (BCSC) in addition to University Hospital (UH).
It is the goal of the theranostics team to take a multidisciplinary approach to the use of these theranostic pairs.
“We believe that in the long term, U-M’s tradition of collaborating across diverse disciplines such as radiology, urology, oncology and radiation oncology, will be important for patients as the use cases for theranostic approaches expand greatly in the coming years,” said Charlie Reuland, M.D., chief operations integration officer for U-M Health.
“Offering Pluvicto treatment at BCSC makes sense,” said Benjamin L. Viglianti, M.D., Ph.D, clinical associate professor and nuclear medicine’s clinical service chief. “Not only is it convenient for the many patients that travel to our therapy clinic from the north and west parts of the state, but it has also allowed us to rapidly increase capacity with the support of the U-M Medical Group for a high demand cancer treatment. This benefits our entire prostate cancer patient population within the state.”
Looking ahead
The team began offering Pluvicto treatment for prostate cancer patients at BCSC in July and continues to work with both radiology and U-M Health leadership on further expansion of FDA-approved theranostics agents in Ann Arbor and throughout the state.
Not only has Lutathera and Pluvicto have been available at University Hospital since their FDA approval in 2018 and 2022, respectively, the Nuclear Medicine Division has been also involved in multiple clinical trials with new theranostic agents for treating other types of cancer.
For more information on Pluvicto and Lutathera treatment, contact Nuclear Medicine Therapy Clinic at 734-232-6072 or send an email or inbasket message to the Clinic Care Coordinator, Meghan Doyle, R.N.
Further information on U-M's theranostic clinical trials can be found here.
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