Targeted
therapy and
immunotherapy have become mainstream in
cancer treatment. However, only patient subsets benefit from these expensive
therapies, and often responses are short-lived or coincide with side effects. A growing modality in precision oncology is the development of
theranostics, as this enables patient selection, treatment and monitoring. In this approach, labeled compounds and an imaging technology are used to diagnose patients and select the best treatment option, whereas for
therapy, related compounds are used to target
cancer cells or the
tumor stroma. In this context,
nanobodies and nanobody-directed
therapeutics have gained interest. This interest stems from their high
antigen specificity, small size, ease of labeling and engineering, allowing specific imaging and design of
therapies targeting
antigens on
tumor cells, immune cells as well as
proteins in the
tumor environment. This review provides a comprehensive overview on the state-of-the-art regarding the use of
nanobodies as
theranostics, and their importance in the emerging field of
personalized medicine.