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See the target, then test the treatment: the promise of antibody-guided cancer imaging
Cancer imaging • The science behind theranostics
GRAYMEDY EXPLAINER · Reviewed October 17, 2026
A cancer scan can show where a suspicious mass sits. A more ambitious question is whether imaging can reveal the biology that makes a treatment worth trying—and show where that treatment travels after it enters the body. Antibody-guided imaging sits at that intersection of molecular biology, measurement and clinical decision-making.
This explainer was prompted by City of Hope’s March 10, 2026 interview with Anna Wu, Ph.D., hosted by Monty Pal, M.D. In the conversation, Wu describes engineered antibody fragments, CEA-directed research, a planned copper-64 PSCA imaging study in pancreatic cancer, and imaging of CD8 immune cells. Those program descriptions reflect the interview’s date; they are not presented here as confirmed October recruitment updates. Read City of Hope’s episode and transcript.
The key distinction: seeing a biological target, delivering radiation to it and improving a patient’s outcome are separate achievements. Each needs its own evidence.
1. Turning a targeting molecule into a measurable signal
Antibodies recognize particular molecular features. Researchers can adapt them into probes that carry a detectable label. The broader field includes radioactive, optical, magnetic-resonance and ultrasound approaches; antibody fragments give researchers additional formats to optimize for a particular imaging task. The scientific challenge is to preserve useful binding while producing a signal that can be distinguished from background. Freise and Wu’s review of antibody imaging explains this engineering framework.
For a reader, the practical question is: what does this particular probe measure? A signal associated with a tumor target answers a different question from a probe associated with immune cells. Neither should be interpreted simply as a universal picture of “how much cancer” is present.
2. What theranostics adds
Theranostics links a diagnostic approach with a treatment directed at the same biological target. A radiopharmaceutical can combine a targeting molecule, a radioactive component and the chemistry connecting them. Imaging can help establish whether an agent reaches a lesion; a related therapeutic version can carry radiation intended to damage cancer cells. The National Cancer Institute describes how imaging compounds have provided starting points for treatment development. NCI’s molecular radiation therapy explainer.
This approach offers a way to ask about delivery before relying on a treatment’s presumed selectivity. But a useful image is not itself proof of a safe therapeutic dose. Researchers still need to determine exposure in normal organs, how long the compound remains in the body and whether the balance of benefit and harm is acceptable.
Graymedy’s reading: the most valuable promise is better-informed testing. A visible target can narrow a hypothesis; clinical trials must establish whether acting on it helps.
3. A concrete example: imaging CEA-positive cancers
A City of Hope study registered as NCT02293954 evaluates copper-64-labeled anti-CEA antibody M5A for PET imaging. One listed aim is to determine its ability to localize CEA-positive cancers, including several gastrointestinal and other tumor types. This illustrates an imaging question: does a labeled antibody find the intended disease sites in people? Read the clinical trial record.
A registry entry describes a study’s objectives and design. It should not be read as a positive result. Likewise, evidence for one antibody, radioactive label or cancer population does not automatically transfer to another. Readers considering a research study should use its current record and the study team to establish eligibility and availability.
4. Imaging the immune response: what the 2026 evidence says
CD8 PET takes a different angle: it measures a signal associated with CD8 immune cells rather than simply targeting a tumor-associated protein. The prospective, multicenter phase II iCorrelate study examined the relationship between PET measurements using zirconium-89 berdoxam-crefmirlimab and CD8 cells measured in core-needle biopsies in people with solid tumors receiving immune checkpoint blockade.
Published March 27, 2026, the study reported 49 patients and 70 biopsies used for correlation. Mean uptake in the biopsied tumor, normalized to the aorta, correlated with biopsy immunohistochemistry at 0.49 (95% confidence interval 0.26–0.59). That is a moderate association rather than a perfect match. Read the phase II iCorrelate paper.
What this establishes: evidence that the imaging measurement relates to a tissue-based CD8 measurement. What this statistic does not establish: that using the scan to choose or change therapy improves survival, quality of life or treatment safety. An association with a biological marker and clinical utility are different endpoints.
Earlier first-in-human work included an initial six-patient dose-escalation cohort and assessed pharmacokinetics, distribution and lesion targeting. That sequence shows why development proceeds through measurement and safety questions before broader claims. Read the early anti-CD8 minibody study.
5. An established treatment category, with investigational branches
Targeted radionuclide therapy is already used for selected patients with advanced prostate cancer and gastroenteropancreatic neuroendocrine tumors, as described in NCI’s radiation therapy overview. That clinical footing should be distinguished from experimental antibody platforms discussed in research interviews.
The phrase “theranostics” therefore needs a second question: which agent, for which disease and under which evidence or authorization? A broad technology category cannot tell a patient whether a particular option is appropriate or available.
Questions to bring to the next breakthrough headline
- What is being measured? Tumor-associated target, immune-cell distribution or another process?
- What was actually tested? Laboratory feasibility, human safety, agreement with biopsy or a treatment outcome?
- What is the comparison? A new measurement needs a defined reference and an explanation of disagreement.
- What decision would change? Ask whether evidence supports using the result to guide care.
- What is the date? A planned study in an interview is not a current enrollment announcement.
Sources, attribution and image credit
Originating source: City of Hope, How engineered antibodies and next-generation imaging tools are reshaping cancer care with Anna Wu, Ph.D., March 10, 2026; host Monty Pal, M.D. Watch the original video. This is independently structured Graymedy explanatory writing, supported by the linked primary research, registry and NCI resources. No interview was conducted by Graymedy.
Photo: Jens Maus / Wikimedia Commons, public domain.
Scope: educational reporting reviewed October 17, 2026. This article explains research and evidence; it does not establish individual treatment suitability or confirm current trial recruitment.
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