Carilion Clinic and FBRI Expand Theranostics Clinical Trials, Positioning Southwest Virginia as a Hub for Targeted Radiopharmaceutical Cancer Therapies
核心洞察
Carilion Clinic and Virginia Tech's Fralin Biomedical Research Institute are expanding clinical trials for theranostics, a precision medicine approach using radioactive isotopes for both imaging and therapy.
New trials will target brain and urologic cancers including glioblastoma (搜索) and renal cell carcinoma (搜索), building on prior research that led to FDA-approved therapies Pluvicto and Lutathera.
The initiative aims to bring cutting-edge radiopharmaceutical treatments to underserved rural communities in Southwest Virginia, expanding access beyond major academic health centers.
Carilion Clinic, in partnership with Virginia Tech's Fralin Biomedical Research Institute (FBRI) at VTC, is significantly expanding its clinical trials portfolio for theranostics — a rapidly growing field of precision oncology that uses radioactive isotopes for both diagnostic imaging and targeted therapy. The expansion positions Southwest Virginia as an emerging hub for advanced cancer medicine, with new trials targeting brain and urologic cancers, including glioblastoma (搜索) and renal cell carcinoma (搜索).
The initiative was highlighted during a recent workshop hosted on the FBRI campus, which drew researchers from as far away as Japan. The gathering was part of the Appalachian Radiotheranostics Coalition (ARC) workshop series, the second of four sponsored as part of the Society of Nuclear Medicine and Molecular Imaging's (SNMMI) Mars Shot initiative — a national effort to accelerate access to radiotheranostic therapies.
A Field in Transformation
Theranostics, also referred to as radiopharmaceuticals, represents a paradigm shift in cancer treatment by enabling more targeted, less aggressive interventions compared to conventional chemotherapy. The approach can be customized for each patient, according to James Crowley, imaging services manager at Carilion Clinic.
Bill Kiser, medical director of molecular imaging at Carilion Clinic, described the dramatic evolution of the field. "This is probably the most growthful area right now — what we're seeing," Kiser said. "It used to be what we called nuclear medicine was kind of put in the basement in the dark, nobody cared about it, the pictures were ugly, and now all of a sudden it's on the forefront of imaging and treatment. So it's a very exciting time to be in this."
Kiser, a 27-year veteran of the field, noted that the past five years have been transformative. "We started out doing three PET scans a day and now we're doing about 25-30 a day. So, it's really exploded. We went from one scanner to two scanners, and we have two shifts now," he said. A third scanner is expected to be added when the Carilion Taubman Cancer Center opens in 2028.
Building on Proven Success
The new theranostic treatment trials for cancer pain, renal cell carcinoma (搜索), and glioblastoma (搜索) build on Carilion's earlier research conducted in partnership with Blue Ridge Cancer Care (搜索). That collaboration has already attracted patients from across the country and contributed to the FDA approval of therapies in use today, including Pluvicto (Lu177PSMA) (搜索) and Lutathera (dotatate) (搜索).
David Buck, president of Blue Ridge Cancer Care (搜索), emphasized the significance of the partnership. "Our longstanding partnership with Carilion Clinic has allowed us to be early adopters of theranostics," Buck said. "Through our shared collaboration with industry partners and the SCRI research network, we're excited to continue to offer these novel, cutting-edge therapies to the patients here in their communities."
Expanding Access to Underserved Communities
A central goal of the expansion is to bring theranostics beyond the major academic health centers where they have traditionally been concentrated and into rural areas. Southwest Virginia, a largely rural region with historically limited access to cutting-edge treatments, stands to benefit significantly.
"Our overarching goal is to expand access to theranostics beyond larger academic health centers where they have traditionally been offered and into rural areas to benefit Carilion patients in Southwest Virginia," Crowley said.
Cheng-Chia "Fred" Wu, M.D., Ph.D., an assistant professor involved in the research, underscored the human impact. "This type of research and these types of opportunities are really not available for everyone, and so for this area, for patients who have devastating cancers where radiation medicines can help, it creates new hope and new possibilities," Wu said.
Lana Wahid, M.D., vice chair for research in Carilion Clinic's Department of Medicine, framed the effort in terms of both access and ambition. "The opportunity to expand access to these much-needed, innovative therapies for patients is exciting, and we are aggressively seeking clinical trials that will make Roanoke a destination for cancer research and leading-edge care," Wahid said.
A Growing Research Enterprise
The theranostics expansion is part of Carilion's rapidly growing research enterprise, which has prioritized novel therapies as the health system prepares to open the Carilion Taubman Cancer Center in 2028. In total, Carilion now has approximately 150 clinical trials underway across more than 20 specialties, broadening access to innovative therapies and strengthening care quality for patients throughout Southwest Virginia.
Crowley, along with Dustin Osborne, Ph.D., of the University of Tennessee, Knoxville, were awarded SNMMI's $100,000 Mars Shot grant in 2025 to support these efforts. The recent ARC workshop featured researchers presenting findings on astatine, a promising isotope for use in brain, prostate, and other cancers.
Carilion's expanding research portfolio, alongside a new regional biotech incubator and other developments, is contributing to continued biotechnology growth in the region and state, both of which have targeted the sector for economic development.