Theranostic Approaches in Nuclear Medicine as a Strategy to Overcome Cancer Treatment Resistance

Prof Mariza Vorster is an associate Professor and Head of Department at the University of Kwa-Zulu Natal’s Department of Nuclear Medicine, which currently includes three hospital sites in Durban. She has significant experience in the use of alpha and beta targeted radionuclide therapies and started treatment with Ac-225-PSMA and DOTATATE in KZN in Jan of 2023. In 2023 she was awarded the Maurits W Geerlings award by the ICPO for her significant contributions with regards to Ac225 therapy. Prof Vorster is an IAEA expert and collaborator, who has authored and co-authored over 120 peer-reviewed publications (including several book chapters). Her research interests include the use of novel Ga-68 based tracer applications and theranostics aimed at solving important clinical problems. She is the President of the College of Nuclear Physicians and serves as an examiner, convenor and senator for the Colleges of Medicine of South Africa Dr Mike Sathekge is at the forefront of specialist training and was elected President of the Colleges of Medicine of South Africa, the national specialist examining body for all medical disciplines. He is Professor and Head of the Nuclear Medicine Department at University of Pretoria. Previously, he was President of the International Society of Radiolabeled Blood Elements (ISORBE) and past Secretary General of the World Federation of Nuclear Medicine and Biology (WFNMB). Sathekge is Chairman of the Medical Research Council of South Africa. He has performed several first-in-human studies and introduced peptide receptor radionuclide therapy and peptide radioligand therapy in Africa, as well as 225AcPSMA for prostate cancer. He is a recipient of several key awards for research and service, including being rated as an internationally acclaimed researcher by the National Research Foundation. His publication and presentation record earned him editorial roles on peer-reviewed journals. He is Co?Editor in Chief of the Seminars of Nuclear Medicine and member of the Academy of Science of South Africa (ASSAf)

• 1. Introduction2. Mechanisms of Treatment Resistance3. Principles of Theranostics in Nuclear Medicine4. Theranostic Agents, Development and Novel Delivery Approaches5. Applications in Oncology6. Emerging Applications Beyond Oncology7. Combination Strategies, Tandem Approaches and Place in Treatment Landscape8. Dosimetry and Personalized Treatment Planning9. Challenges and Limitations in Theranostic Applications10. Conclusions and Future Directions