Day 4

Thursday, July 4

• Introduction to nuclear medicine and regulatory aspects
• Radiopharmacy lecture with a focus on the case of astatine-211
• Lecture on theranostic approaches

• Of mice and men
  Mickaël Bourgeois
  Radiopharmacist and professor assistant at nuclear medicine department, University Hospital of Nantes, and GIP ARRONAX

The ultimate goal of our work around the nuclear medicine applications is to inject a radiopharmaceutical drug into a human patient. To fulfill this objective and to bridge the gap between mice preclinical works to first-in-human clinical trials, radiopharmacy practices are positioned at the interface between nuclear physics, radiochemistry and radiobiology. This multidisciplinary approach from bench to bedside falls within a very strict regulatory framework to ensure the quality and safety of the drug to the patient. In accordance with this interdisciplinary school in nuclear medicine program, this presentation will focus on the possible ways to develop a human injectable product with regulatory approvals. We shall describe the specific case of small-scale “in-house” healthcare establishment production for mono- or multicentric clinical trials.

• Radiopharmacy of Astatine-211: from bench to bedside
  Emma Aneheim
  Associate professor in radiochemistry at the department of Medical Radiation Sciences, Sahlgrenska Academy at the University of Gothenburg, Gotheburg, Sweden

In this lecture we will explore most aspects of using astatine-211 in nuclear medicine, from the irradiated target to the production of an astatine based radiopharmaceutical ready for patient treatment. Targeted alpha therapy is an emerging technique utilizing the large linear energy transfer and destructive power of the alpha particle, directed to the cancer cells by a tumor specific targeting vector. Only very few alpha particle emitting nuclides fulfill the requirements for nuclear medicine applications, such as suitable half-life and decay properties, feasible production route, etc. Among the proposed candidates, astatine-211 is often considered to be the most promising choice for treatments with a curative intent. Astatine-211 is produced by cyclotron bombardment of natural bismuth with high energy alpha particles. In theory limitless amounts of astatine can therefore be produced, but in reality production sites are scarce. The second heaviest halogen in the periodic table, astatine, do not have any stable isotopes and the longest half-life is only 8.1 hours. Because of this, contrary to most other elements, many basic chemical and physical properties of astatine are still not known. These are things that naturally pose some challenge in working towards producing radiopharmaceuticals with astatine but all challenges are meant to be overcome…

• Personalized medicine in nuclear medicine
  Clément Bailly
  Physician at the nuclear medicine department, University Hospital of Nantes

Over the past few years, nuclear medicine has undergone impressive growth with the development of positron emission tomography (PET) and new approaches in targeted radionuclide therapy. These developments pave the way for personalized medicine by offering practical solutions, especially in oncology, well beyond the well-known radioiodine therapy in patients with thyroid cancer. Novel radiopharmaceuticals targeting relevant biomarkers are powerful patient selection tools for patients who may benefit from targeted therapies, and for early therapeutic response assessment. Moreover, once labeled with beta- or alpha-emitters, radiopharmaceuticals targeting relevant molecular markers expressed by different solid tumors and hemopathies, can be used for radionuclide therapy. PET imaging and targeted radionuclide therapy then come together in the context of the theranostic approach to adapt injected activity for personalized therapy.

• Back to ISI NucMed program 2024