Oncologists rarely resort to injecting the body with radioactive components to directly destroy cancer cells, as this therapeutic technique has not yet gained a large place in their arsenal, but this treatment appears more and more promising, and the pharmaceutical industry is investing billions of dollars in it.
Jamila Al-Boqrini, a financial analyst specializing in pharmaceutical manufacturing, noted in a statement to Agence France-Presse that these radioactive drugs “are in line with the spirit of the times.”
This is no clearer than the announcement in mid-October of a partnership between two giant French companies: the Sanofi pharmaceutical group and the Orano company (formerly Areva), which specializes in the nuclear field.
This announcement raised eyebrows and questions about what could combine medicine boxes and nuclear power plants in Orano.
The answer lies in the concept of nuclear medicine itself, and more specifically in unique medicines, one of which Orano is developing through its subsidiary, of which Sanofi will acquire a small share for 300 million euros.
These drugs use radioactive components to destroy tumors. To do this, a molecule is attached to it that identifies typical markers of the cancer cell, thus acting as a “carrier” to take the radioactive element directly into the cell.
The general principle is well known because it is the principle of radiotherapy, by which the majority of cancer patients are already treated. But instead of shooting radiation at a person, these radioactive components seek to directly hit cancer cells with very high precision.
These are “targeted” radiation treatments. This concept has been widely used for decades in oncology, where radioactive iodine is regularly used to treat some types of thyroid cancer.
But iodine is a special case because it is naturally attracted to the thyroid gland and therefore does not need a “carrier” attached to it. On the other hand, in recent years, drugs have achieved positive results thanks to the combination of a radioactive component and a biological carrier.
The major turning point was the purchase by the Swiss company Novartis in 2018 of the radioactive drug Lutathera for about $4 billion.
“No one was previously interested in our specialty,” Françoise Craber-Bauderé, a nuclear medicine specialist at Nantes University Hospital in western France, told Agence France-Presse.
Corporate rush
However, the drug “Lutathera” is intended exclusively for rare gastrointestinal cancers. Shortly after, Novartis bought the rights to another radioactive drug, Pluvicto, for $2 billion, which is used to treat some types of prostate cancer, and published positive data about it at the beginning of this decade.
Since then, giant pharmaceutical companies have flocked to this option. In recent months, AstraZeneca, Bristol-Myers Squibb, Eli Lilly and again Novartis have paid billions of dollars to buy biotech companies specializing in targeted radiation therapies.
The merger between Sanofi and Orano is the latest example of this movement.
Al-Bouqrini stressed that this deal “places Sanofi among the most advanced entities in radiotherapy.”
The drug developed by “Urano”, which is based on lead 212, belongs to a new generation of radiation treatments that rely on particles called alpha.
These particles release more radiation energy than beta particles, and are the basis of most existing treatments, but over a shorter distance. This therefore gives hope for a more selective working style.
It must be confirmed whether this hope will actually translate into convincing clinical results. Large-scale trials have not yet been conducted on most alpha treatments, but “Urano” is preparing to take this step.
Although specialists are cautious, they are optimistic. “The first clinical results make me expect that these treatments will be effective,” Crapper-Baudrier said. She added, “If someone had asked me five years ago, I would have said that it was still a bit risky. But now I think we have to move forward.”