Effect of Will Rogers Phenomenon: Expanding Theranostics Beyond Oncology and Improving Outcomes with Multimodality Therapies

Saturday, April 13, 2024

10:00 AM - 10:00 PM ET

Location: Foyer Kiosk

First Author(s)

ES

Easton Sheffield, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Flowood, Mississippi, United States

Co-Author(s)

JY

Johnny Yang, BS, BA

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
CC

Chanukya Cherukuri, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
BB

Bryson Brister, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Brandon, Mississippi, United States
JT

John Hollis Tackett, BS

Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Flowood, Mississippi, United States
JS

John D. Salvemini, MS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
ML

Marjorie Lam, BA

Medical Student
University of Mississippi Medical Center, United States
LR

Logan Ryals, BS

Medical Student
University of Mississippi Medical Center, United States
JR

Jeffrey A. Roux, BA

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
VV

Vani Vijayakumar, MD

Professor
University of Mississippi Medical Center, United States

Purpose: Referred to as the Will Rogers phenomenon, stage migration was first described by Feinstein et al. in 1985. New diagnostic imaging technologies have served a permissive role in identifying previously silent metastases. Patients who were shifted to a higher stage due to new diagnostic imaging technologies experienced better outcomes compared to patients who were stage defined by the older imaging technologies. The purpose of this presentation is to educate professionals in radiology on the impact of stage migration in patient outcomes with the advent of new technologies.

Methods/Materials: A literature review was performed to investigate possible associations of imaging modality advancements and theranostics with stage migration. Through the utilization of ScienceDirect, Google Scholar, and PubMed, articles and cases found using combinations of the key words “Will Rogers Phenomenon,” “theranostics,” and “stage migration” were included in the literature review. Patients from an academic tertiary hospital were included in the discussion.

Results: Theranostics has gained greater importance in personalized medicine, including oncology. In addition to targeting PSMA for prostate cancer and DOTA for NET, 18F-fluoroestradiol has been approved to select estrogen receptor-positive patients for estrogen receptor–targeted therapies. Rapidly evolving beyond oncologic imaging and therapy, Theronostic applications can be found in neurology, specifically β-amyloid imaging and lecanemab antibody therapy. Additionally, Theranostics has contributed to other fields including immunology as well as neuropsychology with dopamine transporter imaging and dopaminergic therapeutics being investigated for the treatment of Parkinsonian syndromes. Patients from an academic tertiary hospital were included in the discussion.

Conclusions: The diagnostic and therapeutic applications of Theranostics are rapidly expanding beyond radioligand therapies to include external-beam radiotherapy, medical therapy, and cellular immune therapy. As new Theranostic technologies provide earlier detection and treatment of oncologic and non-oncologic diseases, the Will Rogers Phenomenon will grow more applicable.