Understanding theranostics: a pairing of therapy and diagnostic test
In theranostics, a diagnostic test and therapy that both bind to the same target are paired up. For example, a molecule targeting a specific protein on a cancer cell could carry a radioactive isotope that shows up on a scan to diagnose the disease, and then another radioactive isotope designed to destroy cancer cells.
The aim of new IHI project ACCELERATE.EU is to improve the future of cancer care by pioneering the development of novel radiotheranostic pairs in which the therapy part features the radioactive isotope astatine-211 (211At). What sets 211At apart from other similar treatments is the fact that it emits alpha particles, and so could prove effective at treating cancers that are resistant to beta and gamma particles as well as chemotherapy.
A focus on pancreatic, breast and brain cancer
The project will focus its efforts on three highly aggressive cancers: pancreatic, breast and brain cancer, all of which are characterised by rapid progression, resistance to conventional therapies, and high mortality rates. For each cancer, the project will use a molecule that targets a protein found on the tumour cells to carry a diagnostic marker that shows up on PET (positron emission tomography) or SPECT (single photon emission computed tomography) scans. The same molecule will then be used to carry the 211At to the tumour.
“By integrating the entire value chain - from bench to bedside - ACCELERATE.EU aims to streamline the supply of 211At across Europe, ensuring that patients have timely access to this innovative treatment,” said project lead coordinator Hugo Levillain of the Institute Jules Bordet. “The project will also explore co-clinical approaches, where clinical studies run in parallel with preclinical studies, enhancing the ability to identify patients who are most likely to benefit from 211At therapy. The Accelerate.EU project is a significant step forward in cancer research.”
Boosting production of 211At
In parallel, the project aims to facilitate 211At production and access by developing a new generation cyclotron. A cyclotron is a particle accelerator and so can be used to generate isotopes like 211At. The ACCELERATE.EU cyclotron would be more compact and easy to use, meaning trained medical staff would be able to use it in hospitals to generate 211At as and when it is needed – an important issue given its short half-life of around 7 hours.
"As a global leader in particle accelerators, IBA is proud to bring its expertise and advanced technology to this transformative project. Accelerate.EU presents a unique opportunity to push the boundaries of cancer treatment by developing 211At theranostics and accelerating the production and clinical development,” said Charles Kumps, President at IBA RadioPharma Solutions. “With the support of EU funding, we will equip our partners with dedicated state-of-the-art production solutions, offering hope to cancer patients with very limited treatment options."
In the long term, ACCELERATE.EU hopes its efforts will result in the establishment of a stable, cross-EU supply chain for 211At which will in turn enable a wider availability/access of theranostic pairs using 211At, and a greater ability to identify the patients who are most likely to benefit from them.
The IHI theranostics portfolio
ACCELERATE.EU is one of three theranostics projects launched under IHI call 5, the other two being ILLUMINATE and Thera4Care.