Theranostics expands from radiolabelled peptides to multiscale cancer care

Theranostics, the inseparable pairing of disease diagnosis and therapy, is moving beyond its traditional radiopharmaceutical roots, according to a review published in Nature Reviews Cancer on 22 October 2026.

Written by Alexandros Marios Sofias, Yvonne Derks, Twan Lammers and colleagues, the article defines oncological theranostics as the use of diagnostic information to guide the selection, application and outcome of treatment. In its classic form, this involves radiolabelled peptides that image receptor expression on cancer cells in vivo, followed by treatment with the same peptides carrying beta-emitting radioisotopes.

The review’s central argument is that the term should now be broadened. The authors propose extending the terminology to include locally and systemically applied nanotheranostics and microtheranostics, as well as imaging-guided surgical interventions, placing these approaches alongside established radiotheranostic practice.

According to the abstract, this expansion builds on solid progress in three areas: target identification, probe design and hardware development. The authors also cite promising recent results achieved in clinical trials as grounds for optimism about the field’s direction.

Three accompanying figures illustrate the scope of the framework. The first shows the application of radiotheranostics in oncology, the second depicts nanotheranostics and microtheranostics, and the third covers image-guided therapy and surgical theranostics, reflecting the multiscale character of the proposed terminology.

The review is a perspective piece rather than a clinical study, and the publicly available abstract does not report new trial data, patient outcomes or quantitative results. Its contribution lies in synthesising current clinical practice and outlining where the authors expect the field to develop.

On that basis, the authors foresee a bright and broad future for multiscale theranostics, both for the treatment of oncological pathologies and beyond the cancer setting. The full analysis, including the evidence behind that outlook, is available only behind the journal’s subscription access.

For readers following precision oncology, the review signals that the diagnostic-therapy pairing long associated with radioligand therapy is being reframed as a unifying concept spanning nanoparticles, microscale agents and surgery, with diagnosis remaining the critical guide to treatment at every scale.

Subject of Research: Expanding the theranostics concept in oncology to include nanotheranostics, microtheranostics and imaging-guided surgery

Article Title: Cancer theranostics

Article References: Sofias, A. M., Derks, Y., Bradbury, M. S., Chen, X., Kiessling, F., van Dam, G. M., Weber, W. A., & Lammers, T. (2026). Cancer theranostics. Nature Reviews Cancer. https://doi.org/10.1038/s41568-026-00983-3

Image Credits: AI Generated

DOI: 10.1038/s41568-026-00983-3

Keywords: theranostics, radiopharmaceuticals, nanotheranostics, microtheranostics, image-guided surgery, precision oncology, radionuclide therapy, molecular imaging, Nature Reviews Cancer, cancer treatment, diagnostic imaging, review article