Open Access
CC BY 4.0 · World J Nucl Med
DOI: 10.1055/s-0045-1812309
Review Article

ARTnet Perspectives and Contributions to Theranostics

Autoren

  • Roslyn J. Francis

    1   Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
    2   Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, Australia
    3   Medical School, University of Western Australia and Sir Charles Gairdner Hospital, Perth, Australia
  • Dale L. Bailey

    4   Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia
    5   The Institute of Medical Physics, University of Sydney, Sydney, Australia
    6   Faculty of Medicine and Health at University of Sydney, Sydney, Australia
  • Kathy Willowson

    4   Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia
  • Melissa J. Latter

    1   Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
  • Bridget Chappell

    7   Department of Molecular Imaging and Therapy at Austin Health, Melbourne, Australia
  • George McGill

    8   Department of Molecular Imaging, Princess Alexandra Hospital, Brisbane, Australia
  • Michael S. Hofman

    9   Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Centre, Melbourne, Australia
    10   Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
  • Louise Emmett

    11   Department of Nuclear Medicine, St Vincent's Hospital, Sydney and Faculty of Medicine, UNSW Sydney, NSW, Australia
  • Andrew M. Scott

    7   Department of Molecular Imaging and Therapy at Austin Health, Melbourne, Australia
    12   Olivia Newton-John Cancer Research Institute, School of Cancer Medicine at La Trobe University, Melbourne, Australia
    13   Faculty of Medicine, University of Melbourne, Melbourne, Australia

Abstract

Theranostics is a rapidly growing field, providing new therapeutic options for cancer patients. Clinical trials have a key role in establishing the efficacy and safety of new treatments and determining impact on patient care. Multicenter clinical trials with radiopharmaceuticals provide robust data to support clinical implementation; however, there are important considerations to ensure high-quality and reliable clinical data.

Australasian Radiopharmaceutical Trials Network (ARTnet) is a multidisciplinary clinical trials network established in 2014 to facilitate multicenter clinical trials with radiopharmaceuticals in Australia. Over the last decade, ARTnet has supported impactful, prospective clinical trials through quality activities and engagement. In theranostics, Australia has had a key role in clinical translation and generating evidence for safety and efficacy, resulting in regulatory approval and health care funding internationally. This report describes the development of ARTnet as a clinical trials network, highlighting the intent, current status, and operations of ARTnet, with a particular focus on theranostics.



Publikationsverlauf

Artikel online veröffentlicht:
14. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Bodei L, Herrmann K, Schöder H, Scott AM, Lewis JS. Radiotheranostics in oncology: current challenges and emerging opportunities. Nat Rev Clin Oncol 2022; 19 (08) 534-550
  • 2 Al-Ibraheem A, Zimmermann R, Abdlkadir AS, Herrmann K. Radiotheranostics global market and future developments. Semin Nucl Med 2024; 54 (04) 622-633
  • 3 Giammarile F, Paez D, Zimmermann R. et al. Production and regulatory issues for theranostics. Lancet Oncol 2024; 25 (06) e260-e269
  • 4 Hofman MS. ProPSMA: a callout to the nuclear medicine community to change practices with prospective, high-quality data. J Nucl Med 2020; 61 (05) 676-677
  • 5 Francis RJ, Bailey DL, Hofman MS, Scott AM. The Australasian Radiopharmaceutical Trials Network: clinical trials, evidence, and opportunity. J Nucl Med 2021; 62 (06) 755-756
  • 6 Pascual TNB, Paez D, Iagaru A. et al. Guiding principles on the education and practice of theranostics. Eur J Nucl Med Mol Imaging 2024; 51 (08) 2320-2331
  • 7 Hofman MS, Lawrentschuk N, Francis RJ. et al; proPSMA Study Group Collaborators. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 2020; 395 (10231): 1208-1216
  • 8 Bailey DL, Hofman MS, Forwood NJ. et al; ARTnet, the ProPSMA Trial Investigators. Accuracy of dose calibrators for 68Ga PET imaging: unexpected findings in a multicenter clinical pretrial assessment. J Nucl Med 2018; 59 (04) 636-638
  • 9 John N, Pathmanandavel S, Crumbaker M. et al. 177Lu-PSMA SPECT quantitation at 6 weeks (dose 2) predicts short progression-free survival for patients undergoing 177Lu-PSMA-I&T therapy. J Nucl Med 2023; 64 (03) 410-415
  • 10 Yadav S, Lowery B, Tuchayi AM. et al. Impact of posttreatment SPECT/CT on patient management during 177Lu-PSMA-617 radiopharmaceutical therapy. J Nucl Med 2024; 65 (09) 1395-1401
  • 11 Bailey DL, Willowson KP, Muñoz-Ferrada C. A practical method for assessing quantitative scanner accuracy with long-lived radionuclides: the ARTnet insert. Asia Ocean J Nucl Med Biol 2024; 12 (01) 27-34
  • 12 Bailey DL, Willowson KP, O'Keefe G. et al; I-FIRST investigators and ARTnet. A method for validating PET and SPECT cameras for quantitative clinical imaging trials using novel radionuclides. J Nucl Med 2025; 66 (02) 315-322
  • 13 Hofman MS, Emmett L, Violet J. et al; ANZUP TheraP team. TheraP: a randomized phase 2 trial of 177Lu-PSMA-617 theranostic treatment vs cabazitaxel in progressive metastatic castration-resistant prostate cancer (Clinical Trial Protocol ANZUP 1603). BJU Int 2019; 124 (Suppl. 01) 5-13
  • 14 Hofman MS, Emmett L, Sandhu S. et al; TheraP Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. [177Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial. Lancet 2021; 397 (10276): 797-804
  • 15 Hendrikse H, Kiss O, Kunikowska J, Wadsak W, Decristoforo C, Patt M. EANM position on the in-house preparation of radiopharmaceuticals. Eur J Nucl Med Mol Imaging 2022; 49 (04) 1095-1098
  • 16 Buteau JP, Martin AJ, Emmett L. et al; TheraP Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. PSMA and FDG-PET as predictive and prognostic biomarkers in patients given [177Lu]Lu-PSMA-617 versus cabazitaxel for metastatic castration-resistant prostate cancer (TheraP): a biomarker analysis from a randomised, open-label, phase 2 trial. Lancet Oncol 2022; 23 (11) 1389-1397
  • 17 Roach PJ, Francis R, Emmett L. et al. The impact of 68Ga-PSMA PET/CT on management intent in prostate cancer: results of an Australian prospective multicenter study. J Nucl Med 2018; 59 (01) 82-88
  • 18 de Feria Cardet RE, Hofman MS, Segard T. et al. Is Prostate-specific membrane antigen positron emission tomography/computed tomography imaging cost-effective in prostate cancer: an analysis informed by the proPSMA trial. Eur Urol 2021; 79 (03) 413-418
  • 19 Cornford P, van den Bergh RCN, Briers E. et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: screening, diagnosis, and local treatment with curative intent. Eur Urol 2024; 86 (02) 148-163
  • 20 Jadvar H, Calais J, Fanti S. et al. Appropriate use criteria for prostate-specific membrane antigen PET imaging. J Nucl Med 2022; 63 (01) 59-68
  • 21 Hofman MS, Emmett L, Sandhu S. et al; TheraP Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. Overall survival with [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer (TheraP): secondary outcomes of a randomised, open-label, phase 2 trial. Lancet Oncol 2024; 25 (01) 99-107
  • 22 Emmett L, Subramaniam S, Joshua AM. et al; Australian, New Zealand Urogenital, Prostate Cancer Trials Group (ANZUP), the ENZA-p investigators. ENZA-p trial protocol: a randomized phase II trial using prostate-specific membrane antigen as a therapeutic target and prognostic indicator in men with metastatic castration-resistant prostate cancer treated with enzalutamide (ANZUP 1901). BJU Int 2021; 128 (05) 642-651
  • 23 Emmett L, Subramaniam S, Crumbaker M. et al; ENZA-p Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. [177Lu]Lu-PSMA-617 plus enzalutamide in patients with metastatic castration-resistant prostate cancer (ENZA-p): an open-label, multicentre, randomised, phase 2 trial. Lancet Oncol 2024; 25 (05) 563-571
  • 24 Dhiantravan N, Emmett L, Joshua AM. et al. UpFrontPSMA: a randomized phase 2 study of sequential 177Lu-PSMA-617 and docetaxel vs docetaxel in metastatic hormone-naïve prostate cancer (clinical trial protocol). BJU Int 2021; 128 (03) 331-342
  • 25 Azad AA, Bressel M, Tan H. et al; UpFrontPSMA Study Team. Sequential [177Lu]Lu-PSMA-617 and docetaxel versus docetaxel in patients with metastatic hormone-sensitive prostate cancer (UpFrontPSMA): a multicentre, open-label, randomised, phase 2 study. Lancet Oncol 2024; 25 (10) 1267-1276
  • 26 Emmett L, Subramaniam S, Crumbaker M. et al; ENZA-p Trial Investigators, Australian and New Zealand Urogenital and Prostate Cancer Trials Group. Overall survival and quality of life with [177Lu]Lu-PSMA-617 plus enzalutamide versus enzalutamide alone in metastatic castration-resistant prostate cancer (ENZA-p): secondary outcomes from a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol 2025; 26 (03) 291-299
  • 27 Lee ST, Emmett LM, Pattison DA. et al. The importance of training, accreditation, and guidelines for the practice of theranostics: the Australian perspective. J Nucl Med 2022; 63 (06) 819-822