An NCI-designated Comprehensive Cancer Center
By City of Hope | December 4, 2019
Anna Wu Anna Wu, Ph.D., co-director of the Center for Theranostic Studies
When Anna Wu, Ph.D., co-director of the Center for Theranostic Studies, returned to City of Hope last year, she came with the goal of making the institution the leader in one of the most exciting fields in science and medicine today: theranostics and targeted pharmaceuticals.
 
“It’s the right time now,” said Wu, who is also a professor in the departments of Radiation Oncology and Molecular Imaging & Therapy. “The need has always been there, but the field of theranostics is really maturing. We’re right in the thick of it.”

Finding and killing Tumor cells

Theranostics, a term that combines “therapeutic” and "diagnostic,” is a personalized, highly targeted approach to treatment that combines diagnosis and therapy used to target specific tumors and diseases. For diagnosis, tumor-specific antibodies are tagged with a radionuclide and intravenously administered into the body. These tagged antibodies identify specific tumor cells by binding to their receptors. An imaging technique such as PET (positron emission tomography) is used to detect the location and concentration of the tagged antibodies.
 
“What we do is complementary to personalized medicine. We can image individual patients and see exactly where the therapies go in the individual,” said Wu. “This is important in oncology because you can’t biopsy everything. And a biopsy is only a snapshot. It doesn’t say anything about how heterogenous it [the tumor] is. It can’t assess the whole body, which is what we can do with imaging.”
 
Once the location of the tumor cells is known, a different radionuclide is used to target and kill the cells. The development of this approach — using targeted radiolabeled therapeutics — has progressed to the point where there are Food and Drug Administration-approved targeted radiotherapeutics on the market, providing patients with new treatment options. A recent example is Lutathera, which was approved last year for the treatment of advanced neuroendocrine tumors affecting the pancreas or gastrointestinal tract. Neuroendocrine tumor cells are known to express receptors for the hormone somatostatin. Lutathera consists of a radioactive isotope, Lu-177, attached to dotatate, a molecule that specifically binds to tumor cells expressing the somatostatin receptor on the cell surface. The drug enters the tumor cells, and radiation emitted by Lu-177 kills the cells.
 
“It’s a very exciting time for the field because we’re at the forefront of approvals for these agents,” said Wu. “At City of Hope, we have the history and the infrastructure in place, as well as a strong team, so we have a unique capability to identify and develop novel ideas and agents in-house.”
 
When Wu joined City of Hope in 1984 as an assistant research scientist in the Department of Molecular Biochemistry at Beckman Research Institute of City of Hope, the radioimmunotherapy program was still in its infancy. For the next 18 years, Wu and her colleagues made great strides in expanding the field, focusing on the role of targeted therapies in treating cancer. She continued her work at UCLA and, in 2007, co-founded ImaginAb, a startup company that develops and commercializes engineered antibodies for clinical imaging in cancer and other diseases. In 2018, she returned to City of Hope as the basic science lead, joining Jeffrey Wong, M.D., and Eileen Smith, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation, both clinical leads, to build a comprehensive, leading-edge theranostics program.

A MultiDisciplinary Approach

Wu and Wong are co-directors of the Center for Theranostic Studies within Beckman Research Institute of City of Hope. This cross-disciplinary program brings together basic science and clinical investigators, as well as molecular imaging and therapy, surgery, medical oncology, hematology/bone-marrow transplant, nuclear medicine, radiology/radiation oncology, pathology, molecular biology and biostatistics. City of Hope is one of the few institutions to have built all of the required specialized facilities needed to conduct these studies, including small animal imaging, cGMP process development and biologics manufacturing, clinical radiopharmacy and a highly specialized clinical research team.
 
The theranostics team is focused on developing targeted radiopharmaceuticals with antibodies, small molecules and peptides. Currently, there are 12 active and pending industry- and City of Hope-sponsored clinical trials in many different cancer types, including breast, colorectal, gastric, gastrointestinal, leukemia, lung, lymphoma, melanoma, multiple myeloma, ovarian and prostate. The team is also exploring opportunities for theranostics beyond cancer, including its potential in diabetes.
 
“I love that City of Hope hasn’t lost that personal feeling — that we’re all here because the patients are waiting,” said Wu. “This is why I came back. I know that here, there is a strong sense of purpose and a singular focus on what we can do to make life better for patients.”

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