A Revolution in cancer Treatment: Gustave Roussy Pioneers “See and Treat” Approach with Vectorized Internal Radiotherapy
Gustave Roussy Institute is at the forefront of a transformative shift in cancer care, driven by advancements in nuclear medicine and a strategy Désirée Deandreis, head of the Nuclear Medicine Service, describes as “see and treat - treat and see.” This approach centers on Vectorized Internal Radiotherapy (RIV), a technique rapidly expanding beyond its initial applications in prostate cancer and endocrine tumors.
RIV utilizes radiopharmaceuticals – molecules designed too deliver radioactive isotopes directly to tumor cells,minimizing damage to healthy tissue. “We discover more and more molecules that will be able to convey the radioactive isotope in the tumor while sparing healthy fabrics,” explains Deandreis, “and imagery helps us to understand the journey of therapeutic radiopharmaceutical, and to check its distribution in tumor areas.”
This “see and treat” ideology is embodied by theranostics, a process combining therapy and diagnostics. The same molecular target is used to both identify and treat the tumor, offering a highly personalized approach. As Frédéric Hubert, a health executive in the nuclear medicine department, illustrates, “It’s a bit like introducing a key into a lock, with a bomb hanging on the key.”
Significant progress has been made in prostate cancer treatment utilizing radioligands that target Prostate-Specific Membrane Antigen (PSMA).These ligands are paired with radioactive isotopes, either alpha or beta emitters, to deliver targeted radiation. researchers are now exploring the potential of PSMA targeting for other cancers, including kidney cancer, due to the protein’s role in tumor vascularization.
The potential of alpha-emitting isotopes is particularly promising. “The transmitters-alpha has a fabulous interest, thanks to their high energy which breaks the DNA of the cell, and their very short route in the tissues. The radiation is hyperculy,” notes the service head.”Besides, we believe that they are more effective than bêta transmitters.” Radium 223 is currently in use, with Actinium 225 slated for testing in an upcoming clinical trial.
Supporting this innovative work is Gustave Roussy’s state-of-the-art radiopharmacy.This facility,operating under strict sterile and radioactive drug handling standards,is responsible for the preparation,quality control,and dispensing of all radiopharmaceuticals used in diagnostic,therapeutic,and research applications. Equipped with automated and shielded preparation units, the radiopharmacy ensures optimal safety and quality.
Patients are responding positively to this personalized treatment approach. ”They are very open to receive this type of personalized treatments. They know they will receive the right molecule in the right dose,” observes Hubert.
Gustave Roussy aims to become a leading European reference center for RIV and theranostics, continuing to investigate new targets in cancers of the digestive, pancreatic, pulmonary, and other systems. The impact of this work is already evident: RIV treatments increased by 88% from 2022 to 2023, rising from 250 injections to 470. With 13 clinical trials underway or planned for 2025, compared to 9 in the previous five years, the institute is poised to further expand the reach of this groundbreaking approach to cancer care.
