Evohealth / Bench to bedside: the promise of radioligand therapy
Evohealth Report

Bench to bedside: the promise of RLT

Cancer is one of Australia’s biggest killers, touching almost every Australian directly, or their loved ones. [1]

Radioligand therapy advancements are set to support the next phase in cancer care with their precision medicine approach. Radioligand therapy (RLT) uses radioactive molecules to kill cancer cells, sparing healthy tissue and limiting patient side effects.
Figure 1 – Components of a radiopharmaceutical
Source: Adapted from What are Radiopharmaceuticals? | IAEA [4]
Although the use of radiopharmaceuticals in cancer treatment is not new, recent advancements have enhanced their specificity, bringing a new era of precision medicine. treating patients precisely with RLT is made possible by using targeted ligands that specifically bind to receptors or targets on cancerous cells, largely sparing normal cells from harm. [5-8]

Treatment with RLT can be:

  • personalised by selecting and interchanging radioisotopes or targeting compounds based on the patient’s disease characteristics. [6, 8-10]
  • customised for dosage and therapy duration based on the patient’s actual and predicted response.[8, 11, 12]
  • monitored for treatment response through visualisation with PET and SPECT scans. [6, 8-10]

With thousands of Australians touched by cancer each year there is an urgent need to provide equitable access to radioligand therapy advancements at scale. [1, 3]

Australia can propel RLT from bench to bedside

To embrace the potential of RLT and take it from bench to bedside we have developed three recommendations that leverage Australia’s robust reputation and expertise. These are:

Develop and promote an expert endorsed statement that clearly articulates Australia’s unique capability and capacity to deliver global RLT clinical trials.
Establish a national working group to develop and implement Australia’s nuclear medicine strategy. This strategy should include support for more RLT clinical trials, plans to provide equitable patient access to safe, efficacious and registered RLT, as well as enable sovereign manufacturing capability and capacity.
Develop a Government funded program ready to provide equitable patient access to safe, efficacious and regulated RLT.
References
  1. Australian Institute of Health and Welfare. Cancer data in Australia. 2023; Available from: https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview-of-cancer-in-australia-2023
  2. Cancer Australia. All cancers in Australia. 2022; Available from: https://www.canceraustralia.gov.au/impacted-cancer/what-cancer/cancer-australia-statistics
  3. Australian Institute of Health and Welfare. Health system expenditure on cancer and other neoplasms in Australia. 2021; Available from: https://www.aihw.gov.au/getmedia/6bff10f3-3ec8-43d7-a967-55c5168da174/aihw-can-142.pdf.aspx?inline=true#:~:text=In%202015%E2%80%9316%2C%20an%20estimated,national%20population%20cancer%20screening%20programs
  4. International Atomic Energy Agency. What are Radiopharmaceuticals? 2024; Available from: https://www.iaea.org/newscenter/news/what-are-radiopharmaceuticals
  5. Sgouros, G., Radiopharmaceutical Therapy. Health Phys, 2019. 116(2): p. 175-178.
  6. NeuroEndocrine Cancer Australia and the National Roundtable Steering Committee, The Future of Precision Oncology in Nuclear Medicine. 2022, NeuroEndocrine Cancer Australia: Australia.
  7. Australasian Association of Nuclear Medicine Specialists & Australian and New Zealand Society of Nuclear Medicine. ANZSNM and AANMS submission to House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into the approval processes for new drugs and novel medical technologies in Australia. 2020; Available from: https://www.anzsnm.org.au/news-item/5815/submission-to-house-of-representatives-standing-committee-on-health-aged-care-and-sport-inquiry
  8. The Health Policy Partnership, Radioligand therapy: realising the potential of targeted cancer care. 2020.
  9. Australasian Association of Nuclear Medicine Specialists. Theranostics. 2024; Available from: https://aanms.org.au/theranostics/
  10. UroToday. Alpha vs Beta Emitters in Prostate Cancer Radiopharmaceuticals: Energy, Range, and Cytotoxicity – Alan Bryce. 2024; Available from: https://www.urotoday.com/video-lectures/asco-gu-2024/video/3888-alpha-vs-beta-emitters-in-prostate-cancer-radiopharmaceuticals-energy-range-and-cytotoxicity-alan-bryce.html#:~:text=The%20impact%20of%20the%20much,to%20kill%20a%20cancer%20cell
  11. Shah, H.J., et al., Current and upcoming radionuclide therapies in the direction of precision oncology: A narrative review. Eur J Radiol Open, 2023. 10: p. 100477.
  12. Herrmann, K., et al., Radiotheranostics: a roadmap for future development. The Lancet Oncology, 2020. 21(3):
    p. e146-e156.
Renae Beardmore

Managing Director, Evohealth

Deanna
Mill

Advisor, Evohealth

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