The growing implementation of radioligand therapies is causing a profound change in the profile of the nuclear physician and consolidating their clinical weight within the multidisciplinary approach to cancer. This was made clear in the plenary session "Theragnosis: Are We Ready?", held at the 42nd National Congress of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM), where various specialists analyzed how these therapies are repositioning Nuclear Medicine in the context of precision oncology.
In this scenario, Dr. Stefan Prado Wohlwend, from the La Fe University and Polytechnic Hospital in Valencia, defended the figure of the "nuclear oncologist" as a response to the greater clinical complexity of patients opting for these treatments. Experts emphasized that the nuclear physician is no longer limited to selecting candidates and administering radiopharmaceuticals: they now assume key roles in clinical follow-up, response assessment, toxicity control, and the design of future therapeutic lines.
"The challenge is no longer solely to administer a radiopharmaceutical therapy, but to understand what the best therapeutic sequence is for each patient throughout the entire disease," explained Prado Wohlwend.
According to the speakers, the introduction of these therapies in earlier stages of oncological treatment is accelerating the transformation of the specialist and consolidating the need for profiles with a broader and more integrated clinical vision. Furthermore, they indicated that, beyond the already established indications, research is opening new avenues for applying theragnosis in brain tumors, one of the fields with the greatest scientific dynamism today.
They recalled that, although some strategies have shown encouraging results in certain meningiomas, gliomas remain one of the major challenges for translational and clinical research. The identification of new molecular targets, the development of alpha emitters, intra-arterial administration routes, and combination with other oncological treatments are among the main lines of work that could significantly expand the role of Nuclear Medicine in neuro-oncology in the coming years.
Theragnosis, the axis of precision oncology
Specialists highlighted that theranostics has experienced especially rapid progress in the last decade. The approval of new therapeutic radiopharmaceuticals and the improvement of molecular imaging techniques have allowed for more precise patient selection, adaptation of treatments to each case, and improvement of clinical outcomes.
During the session, Dr. Noelia Álvarez Mena, from the University Clinical Hospital of Valladolid, recalled that "we are witnessing a transition from standardized therapeutic models towards increasingly individualized strategies, adapted to the biological characteristics of each tumor and each patient."