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A South African researcher believes a new precision medicine approach could dramatically improve breast cancer survival rates by detecting the disease earlier and delivering highly targeted treatment.

The approach, known as theranostics, combines diagnosis and treatment to help doctors identify tumours sooner, personalise treatment plans and monitor how patients respond over time.

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Researchers believe it could shift breast cancer from being a life-threatening disease to one that can be managed more effectively.

The research is being led by Professor Mike Sathekge, head of Nuclear Medicine at the University of Pretoria and Steve Biko Academic Hospital, and president and CEO of the South African Nuclear Medicine Research Infrastructure (NuMeRI).

Sathekge has been awarded the 2025 Harry Oppenheimer Fellowship Award, including a R3 million grant from the Oppenheimer Memorial Trust, to complete the research and develop a system that could eventually be made widely available.

“Theranostics, brings diagnosis and treatment together, is a combination of early diagnosis with treatment that is personalised and precise down to mere cells, which allows us to exactly detect and assess tumours, devise specific treatment regimens and assessment of treatment response over time,” said Sathekge.

The earlier the breast cancer is detected, the more accurately it is assessed and the more precise the treatment, the exponentially better the patient’s prognosis.

Breast cancer remains the most common cancer affecting women in South Africa and worldwide.

Research published in the South African Medical Journal found that 67% of patients in South Africa are diagnosed only after the disease has reached an advanced stage, when it has already spread to other parts of the body, significantly reducing their chances of survival.

The study also warned that South Africa is expected to see a substantial increase in cancer cases over the coming decades because of population growth, ageing and changing disease patterns.

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Sathekge’s research focuses on a protein called Trop2, which is found in high concentrations in breast cancer and several other cancers, including cervical, pancreatic and lung cancers.

Working with researchers from KU Leuven in Belgium, his team is developing tiny engineered antibody fragments known as nanobodies, which can attach to Trop2-positive cancer cells.

The first stage involves using a PET/CT scan with a radioactive tracer to identify where Trop2 is present throughout the body, allowing doctors to build a far more complete picture of a patient’s cancer than is possible through a single biopsy.

If sufficient Trop2 is detected, the same targeting method could then be used to deliver treatment using the radioactive isotope actinium-225, which emits highly localised radiation designed to destroy cancer cells while limiting damage to surrounding healthy tissue.

Researchers hope the technique will allow doctors to select patients more accurately for treatment and monitor how tumours respond over time.

Rebecca Oppenheimer, chairperson of the Oppenheimer Memorial Trust, said the project stood out among 80 fellowship applications.

“There were so many excellent applicants for this year’s award, touching on vital issues impacting the world we live in, and worthy of further research and development,” she said.

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“This made our selection panel’s final decision all the more challenging, but I believe we have made an exciting choice that will have far-reaching, positive ramifications for South Africa’s public healthcare system and the people who use it.”

“In developing a technology that makes diagnosing and treating cancers more effective, affordable and available, Prof Sathekge and his colleagues hold in their hands the potential for a quantum leap forward in improving South African patients’ health outcomes and human dignity, as well as for beating breast cancer globally. OMT is proud to support his endeavours.”

University of Pretoria vice-chancellor Professor Francis Petersen said the research places South Africa at the forefront of efforts to improve cancer care.

“South Africa urgently needs better ways to detect, understand and treat aggressive breast cancer. Too many patients still present late, when the disease is more difficult to manage and treatment options are limited.”

Prof Sathekge’s work at NuMeRI brings together advanced imaging, radiopharmaceutical science and targeted treatment in a way that could help doctors make more informed, patient-specific decisions.

“It also demonstrates the depth of scientific talent, innovation and academic rigour in South Africa. Through work of this calibre, African researchers are not only responding to local health challenges, but helping to shape the global future of cancer care,” Petersen said.

“We look forward to seeing this research strengthen South African capacity and contribute to better outcomes for patients here and internationally.”

Sathekge said the ultimate goal is to improve patients’ quality of life through more personalised care.

“Our goal is not simply to find cancer earlier. It is to understand each patient’s cancer better, select treatment more intelligently, and reduce the uncertainty that patients face when standard treatment no longer works,” he said.

“This award supports a South African-led effort to see the biology of aggressive breast cancer more clearly, select patients more accurately and lay the foundation for targeted treatment.”