PRISMAP – The European medical radionuclides programme sets out to transform the European landscape for novel and emerging medical radionuclides
Nuclear therapy and molecular imaging, which are widely used in hospitals for promising new medical procedures, can drastically improve outcomes for many medical conditions, making it possible to treat disseminated cancer in particular. However, the effective development of these techniques has long been limited by the difficulty of obtaining access to radionuclides, which are not yet commercially available. With PRISMAP – The European medical radionuclides programme, this is about to change.
In nuclear medicine, a radioactive substance is introduced into a patient and finds its way to specific biological targets in the body. Depending on the radioactive properties of the radioisotope used, it may emit radiation that can be seen with external detectors to visualise the distribution of the isotopes (SPECT, PET imaging); alternatively, it may emit charged particles such as α or β- particles, which deposit their energy locally (within a radius of a few μm, i.e. from the size of a cell to the size of a metastasis), thereby only destroying cells located nearby, e.g. to treat a cancer using targeted radionuclide therapy (TRNT).
Out of the more than 3,000 different radioisotopes that scientists have synthesised in the laboratory, only a handful are regularly used for medical procedures, mostly for imaging, although interest in TRNT has been growing in the recent years, as demonstrated by the marketing of Lutathera®. One of the main limits to the development of novel radio-medicinal products is access to radionuclides during the development and early biomedical research phases. Within PRISMAP – The European medical radionuclides programme, we aim to facilitate this development phase by providing access to novel radioisotopes of high purity grade for medical research.
Production of radioisotopes
The radioactive elements that are used in nuclear medicine are not available naturally and must be synthesised in the laboratory. There are two main ways of doing this: neutron irradiation in a nuclear research reactor or proton or alpha irradiation using a particle accelerator. The size and energy of the particle accelerator determines which radioisotopes can be produced. Small compact machines are found in many hospitals, providing access to the radioisotopes used today. However, higher-energy machines are needed to produce novel radioisotopes that are currently not available.
Purification of radioisotopes
When producing these novel radioisotopes, new challenges emerge: the co-production of unwanted radioactivity, which affects the quality of the medicinal product, may cause adverse effects in a patient and can also create serious waste management challenges in a hospital environment. As a result, novel purification techniques are required. Within PRISMAP – The European medical radionuclides programme, we aim to develop techniques based on physical mass separation and radiochemistry to achieve high purity radioisotope production that is suitable for medicinal products.
Access and translational research
In order to support the ongoing research across Europe and beyond, immediate access to novel radioisotopes will be provided by PRISMAP. A single-access platform has been set up via our website where the production and support capabilities are presented.
A network of world-leading European facilities, including nuclear reactors, medium- and high-energy accelerators, and radiochemical laboratories, has been established to offer the broadest catalogue of radioisotopes for medical research. Mass separation is available at the CERN MEDICIS facility to provide the physical separation of the isotopes of an element. This is supported by a network of biomedical research facilities which can host external researchers, allowing them to perform their research close to the production facility in situations where the isotopes are not suitable for long haul transport to their institution, or when the European licence for the novel radioisotopes has not yet been obtained.
Access to radioisotopes and the associated support facilities will be granted based on excellence, with applicants applying for access to radioisotopes and, if necessary, to the associated biomedical facilities, via our online access platform. A selection panel consisting of experts in the fields of radioisotope production, molecular imaging and radionuclide therapy will select the best projects from among the applicants. The first call for proposals will be launched by the end of 2021 for applications in the first quarter of 2022.
Looking to the future
In the fast-evolving landscape of nuclear medicine, PRISMAP – The European medical radionuclides programme, is also focused on the future. The European Commission has expressed its commitment to tackling cancer through the Europe’s Beating Cancer Plan, and in particular the SAMIRA Action Plan unveiled earlier this year, which includes the establishment of a European Radioisotope Valley Initiative. Through the PRISMAP consortium of 23 academic and research institutions across Europe, the possibility of upscaling of the production of these novel radioisotopes will be investigated. PRISMAP will address novel production technologies, new purification methods, and proof-of-concept investigations demonstrating the development of new treatments from test bench to patient care, thus directly feeding into this European-wide plan.
As a consortium serving an emerging community of researchers, we are looking to the future, towards becoming a more established community and welcoming new facilities to enhance our capabilities. New facilities are on the horizon, such as the Jules Horowitz Reactor at the CEA in Cadarache (France) and the ISOL@MYRRHA mass separator facility at SCK CEN (Belgium), the new SPES accelerator complex in Legnaro (Italy) and the European Spallation Source in Lund (Sweden), and finally both the new SPIRAL2 facility at GANIL (France), which recently accelerated its first beams, and the FAIR facility at GSI (Germany), which is currently under construction. These new facilities will directly benefit from the findings of the PRISMAP project and help to increase production capacity across Europe.
The Institut Laue-Langevin in Grenoble (France), which for the last 50 years has operated the world’s most intense neutron source for neutron scattering applications, has recently expanded its activities by exploiting its research reactor for the production of emerging radionuclides. Together with its research partners in radiochemistry and nuclear medicine, the ILL has successfully pioneered the production of novel radionuclides, such as terbium-161. The PRISMAP project will make this combined expertise available for a wider user community.
Nuclear medicine research is a truly multidisciplinary approach, and to move forward, we must build bridges between, among others, physicists, radiochemists, inorganic chemists, structural biologists, clinicians, medical physicists, dosimetrists, pharmacologists and oncologists. To this end, the PRISMAP project will drive the practical implementation of an interdisciplinary approach that will transform the production of and access to novel radionuclides.