New Medical Breakthroughs Discussed at Hawaii Nuclear Conference
4/8/2009
This week scientists from around the world representing the American Nuclear Society are meeting in Hawaii to present research and advances that impact our ability to grapple with difficult diseases such as Cancer, Arthrits, Alzheimer's, HIV/AIDS, Heart Disease, Pain and many more.
One company that is deeply committed to these advances is Advanced Medical Isotope Corporation, (AMIC). Today in Washington, they are being HONORED by ROTARIANS for their entrepreneurial leadership. This company is working very hard on making the nuclear isotopes available to our country for all of our nuclear diagnostic procedures and up and coming therapeutic treatments.
We currently have to import 90% of our medical isotope needs from a handful of aging reactors that are breaking down and interrupting our ability to do research and provide medical care. Since there is a moratorium on building nuclear reactors, medicine has been dependent on this foreign supply. AMIC is working hard to make sure that we can meet our own needs.
In addition AMIC is trying to overcome the hurdles of supply that will allow our research and implementation of therapies to move forward more quickly. As a physician and patient, I can see that my struggle with cancer has been long, difficult and there is still the uncertainty of recurrence. I had to face poor survival odds of 8-10%, 5 year survival statistics and am definitely not looking forward to the traditional chemotherapies that I had to endure.. Most other stage IV cancer patients just don't make it because of the side effects, limitations in tolerating traditional chemotherapy, age, and immune suppression.
One other concept is the difference between survival and cure. In the U.S. we talk about 5 year survival. This in no way addresses what happens to patients after 5 years and does not mean that the patient is "cured." So typically we will think that we have a certain chance of being cured but the truth of the matter is that we are given a certain statistical chance of surviving five years. Another important figure is what is the average survival time for a particular disease with a certain stage level (the amount of spread).
For example, here in the U.S., our doctors tell us that we may have a 80% 5 year survival. In Europe they look at the same patients over the lifetime of the patient and may only come out with an actual 10-20% cure rate. They view survival over the long term, not just whether you make it 5 years.
It is important that we have access to our medical care and that the medicine and medical isotopes are made available to us. Most of us are paying or have earned our right to medical care and it should not subject to the political football game.
We generally take what we have for granted and don't realize what we are at risk of losing. At the same time, we should be aware of what is not available to us and make sure that we are afforded every opportunity to battle these deadly and disabling diseases.
AMIC website: http://www.isotopeworld.com/:
Dr. Darrell Fisher who is in charge of DOE's National Isotope Program at Pacific Northwest National Laboratories, which are run by Battelle, has provided me with the below summary of medical isotope therapies.
FDA-approved therapeutics
I-131 sodium iodide for thyroid cancer, hyperthyroidism P-32 orthophosphate for polycythemia vera P-32 chromic phosphate (Phosphocol™): intercavitary malignancies, and peritoneal and pleural effusions from metastatic diseaseSr-89 chloride (Metastron®) for painful bone metastasesSm-153 EDTMP (Quadramet® Lexidronam) for painful bone metastasesI-131-B1-anti-CD-20 monoclonal antibody, tositumomab, Bexxar™) for non-Hodgkin’s lymphomaY-90-Y2B8-anti-CD-20 monoclonal antibody, ibritumomab, Zevalin®) for non-Hodgkin’s lymphoma
Therapy agents
Thyroid disease (benign and malignant)Iodine-131 sodium iodide, oral Targets thyroid (hormone-secreting) tissues, salivary glands, cancer metastasesI-131 scan of normal thyroid
Myeloproliferative diseases (bone marrow)P-32 sodium phosphate (targets trabecular bone surfaces)P-32 orthophosphate for polycythemia veraHo-166-DOTMP plus melphalan for multiple myelomaMalignant ascites (intraperitoneal cavity)P-32 chromic phosphate colloidY-90 silicate, colloidal suspensionsY-90-labeled anti-ovarian-cell antibodiesTargets cell-surface antigensProblem achieving sufficiently high, uniform radiation doses
Neuroendocrine tumors
I-131-meta-iodobenzylguanidine (mIBG)Targets the neurosecretory granules of catecholamine-producing cells in neuroblastomaBladder cancer Experimental only in the US, in combination with high-dose chemotherapy therapy agents
Radiolabeled somatostatin analog peptides (peptide receptor radionuclide therapy, PRRT) Target somatostatin receptors overexpressed on hormone-secreting tumors, internalizingSomatostatin, gastrin, bombesin, calcitonin, VIP, PACAP, GRP, oxytocin, a-MSH, GLP-1Conjugated with In-111, Y-90, Lu-177Y-90-DOTA-Tyr3-Octreotides, octreotates Problem with high kidney uptake, renal failure
Liver cancer
P-32 albumin colloids (1970s)I-131-or Re-188-HDD-lipiodol fatty acid ester for treating nonresectable hepatocellular carcinoma by endocytosis (not effective for metastases, diffuse disease)Y-90 silicate microspheres (Theraspheres, SIR-spheres) administered intra-arterially with lung shunt (classified as devices)
Therapy of Benign Diseases
rheumatoid arthritis Y-90 silicates, colloids P-32-colloid Dy-165-FHMA, Ho-166-FHMA* Sm-153-hydroxyapatite synovitis Au-198-colloid
Bone Pain Agents
P-32-chromic phosphate ankylosing spondylitis Ra-224 chloride hyperthyroidism I-131-sodium iodideP-32-orthophosphateSr-89 chloride (Metastron)Sm-153-EDTMP phosphonate (Quadramet)Ho-166-EDTMP phosphonateSn-117m(stannic 4+)-DTPA Lu-177 DOTMP/EDTMPRe-188-hydroxyethylidene diphosphonate (HEDP)Re-186, -188-HEDP hydroxyethylidene diphosphonate Re-188 dimercaptosuccinic acidI-131--amino(4-hydroxybenzylidene)-disphosphonateY-90-chlorideRa-223-chloride (AlphaRadin)
Radiolabeled antibodies, antibody constructs, engineered antibodies, diabodies, hormones, peptides)
Hodgkin’s disease Y-90-antiferritin, Y-90 mAb
Acute leukemia I-131-mAb, Bi-213 mAb
Colorectal cancer Y-90-mAb, I-131-mAb
Brain glioma, astrocytomaAt-211-anti-tenascin Ab
MelanomaPb-212/Bi-212 peptide
Many others (Cu-67, Lu-177,
Bi-213, Ac-225, At-211, Bi-212)
Recent advances in radionuclide therapy
Very-high-dose radioimmunotherapyUniversity of Washington, Johns Hopkins Univ., others Pretargeting strategies to achieve higher tumor uptakes Radiogels for direct intra-tumoral injection Advanced brachytherapy seeds Nanoparticles
Hawaii Reporter
Freedom to Report Real News
By Glen C. Farkas, M.D., 4/8/2009
Glen C. Farkas, M.D. is a Board Certified Ophthalmologist who trained at USC, Stanford, and University of Arizona. He also trained in Internal Medicine at Los Angeles County USC Medical Center, serving the poor, uninsured, most ill and desperate faction of society. He can be reached at mailto:glenfarkas@att.net
See presentation on Medical Isotope Production and Use by Darrell Fischer, PhD of PNNL
