Nuclear medicine: Belgium takes the lead

2019-05-10

Thanks to an excellent network of academics, industry and hospitals, where multidisciplinarity and the complementary nature of the research, the implementation and the clinical applications are combined, Belgium has unique know-how in terms of radioisotopes. It therefore comes as no surprise that the only European symposium that aims to valorise all actors of a chain dedicated to medical applications of radioisotopes is organised in Belgium.

On Thursday, 9 May, about a hundred international experts have come together in Liege on the Val Benoit site to share their knowledge about the prospects concerning the global production of radioisotopes, current breakthroughs in the field of research and new Belgian initiatives. Here is a short survey of what the future nuclear medicine has in stall for us.

Production of new medical radioisotopes for the targeted treatment of several cancers, including prostate cancer (SCK•CEN / IRE)

Targeted radiation for the production of medical radioisotopes is the first phase of the supply of isotopes to hospitals and patients. In Belgium, global leader in this field, this is done by SCK•CEN in Mol. Belgium produces every year over 25% of the global demand, a percentage that may rise to 65%. The innovation in nuclear medicine is an essential element in the development of the research centre and its activities in this field and the close cooperation with IRE have led to the development of a new generation of radioisotopes.

Prostate cancer results in almost 90,000 deaths every year in Europe. One of the most promising treatment methods is the use of Lutetium-177 (Lu-177), a radioisotope that is produced within SCK•CEN by the research reactor BR2. In 2018, the production capacity was increased considerably to anticipate the strong increase of the global demand, which within the next decade could well triple or even quintuple.

As from mid-2019, SCK•CEN will deliver the so-called new-generation medical radioisotope Lutetium-177 “non-carrier added” or Lu-177 nca, as a result of which the dose in the body can be reduced and the patient will have to spend less time in hospital. It will also produce a second innovative medical isotope, actinium-225, which will release alpha particles that destroy cancer cells in a highly effective manner and thus provide new treatment options depending on the type of tumour, its size and its location.

Launch of a Radiotheranostics Platform (VUB / Bordet)

Personalised medicine, which offers every patient an adapted therapy, has become the fundamental goal of modern oncology. Nuclear medicine makes a radiotheranostic approach possible: one and the same molecule that is used simultaneously for diagnosis and treatment.

The Jules Bordet Institute, which plays a major role in the development and clinical introduction of radiotheranostics, and the Vrije Universiteit Brussel (VUB), a pioneer in the field of innovative vectors, have jointly created the Brussels Radiotheranostics Platform. Through this platform, they want to generate innovative radiotheranostics, continue fundamental applied research in radiobiology, set up a network of scientists and clinicians in the Brussels Region and promote the mutual exchange between universities and businesses so as to give radiotheranostics a prominent place in cancer research.

Two innovative applications for patients: total body PET (UGent) and new-generation biomarkers (UZ Brussels)

  • The PET technology (positron emission tomography of the entire body) has recently been applied to humans. UGent set a project to develop clinical PET technology and in this way obtain the best possible spatial resolution. The Total Body PET ensures that both the dose that is applied to the patient and the time required for the examinations are reduced and also that a series of so-called "dynamic" images, which are essential for developing new radiopharmaceuticals, can be collected within a short time frame.
  • The selection of patients according to an increasingly precise molecular definition of the subcategory of the disease is becoming increasingly important to avoid unnecessary toxicity, improve patient outcomes and reduce the cost of clinical trials. The use of these new-generation biomarkers highlights the potential of nuclear medicine for a personalised image-guided therapy. Its impact is currently being studied by UZ Brussels through the follow-up of patients with breast cancer.

What may be the impact of the Brexit in this area?

In the past two years, there have been several changes concerning the actors for the transport of radioisotopes. If, following the Brexit, the United Kingdom leaves the European Union, it will also leave EURATOM, which manages certain matters related to the use of medical radioisotopes. It can therefore not be excluded that, in the future, the United Kingdom will face a shortage in this area.