(AFP) – Inject radioactive components into the body which will directly destroy cancer cells. The avenue still only has a small place in the arsenal of oncologists, but it appears more and more promising and the pharmaceutical industry is now investing billions of euros in it.
These radioactive drugs are “in the spirit of the times”, summarizes financial analyst Jamila El Bougrini, a specialist in the pharmaceutical sector, to AFP.
A recent operation between two French giants bears witness to this. Announced in mid-October, a partnership will bring together the pharmaceutical group Sanofi and the nuclear specialist Orano, the former Areva.
Having gone largely unnoticed, in a context where Sanofi is at the heart of a controversy in France surrounding the sale of its subsidiary manufacturing Doliprane to an American fund, the announcement is surprising. What do boxes of medicine and the nuclear power plants of Orano have in common?
The answer lies in the very concept of nuclear medicine and, more specifically, unique drugs. Orano is developing one of them via a subsidiary in which Sanofi will take a small share for 300 million euros.
These drugs use radioactive components to destroy tumors. To do this, they are associated with a molecule capable of identifying markers typical of a cancer cell and, therefore, of serving as a “vector” to take the radioactive element straight to it.
The general principle is well known since it is that of radiotherapy, by which the majority of cancer patients are already treated. But, instead of emitting rays on the person, we seek here to directly hit the cancer cells, with the promise of very high precision.
We therefore speak of “targeted” radiotherapies. In the broad sense, the concept has already been used for decades in oncology since radioactive iodine is regularly used to treat certain thyroid cancers.
But the case of iodine is special, because it is naturally attracted to the thyroid and therefore does not require an associated “vector”. On the other hand, in recent years, therapies have produced results by successfully combining a radioactive component and a biological vector.
And the pharmaceutical industry follows. The big turning point was the purchase in 2018 by the Swiss Novartis, for almost four billion dollars, of a radioactive treatment, Lutathera.
“Before, no one was interested in our discipline,” Françoise Kraeber-Bodéré, a specialist in nuclear medicine at Nantes University Hospital, in western France, told AFP.
– The industry is rushing –
However, Lutathera is limited to rare cancers of the digestive system. It was shortly after that Novartis opened a “mass market”, in the words of Ms. Kraeber-Bodéré, with the purchase for two billion dollars of another radiotherapy, Pluvicto, against certain prostate cancers, and the publication of positive data in the early 2020s.
Since then, the pharmaceutical giants have been rushing. In recent months, AstraZeneca, Bristol-Myers Squib (BMS), Eli Lilly and, again, Novartis have all paid billions of dollars to buy biotechs specializing in targeted radiotherapies.
The merger between Sanofi and Orano is the latest example of this ferment. Has the French giant, which has also been the subject of criticism over its capacity for innovation since its slowness in developing an anti-Covid vaccine, simply followed suit?
“Sanofi’s operation is not pioneering, but it places the group among the most advanced players in radiotherapy,” explains Ms. El Bougrini.
Indeed, the drug developed by Orano, based on lead 212, belongs to a new generation of radiotherapies, based on so-called alpha particles.
These release more radioactive energy than beta particles, the basis of most existing therapies, but over a shorter distance. This therefore gives hope for an even more selective mode of action.
It remains to be seen whether this promise will really translate into convincing clinical results. Most alpha therapies have not yet led to large-scale trials, a step that Orano is preparing to take.
While remaining cautious, the specialists are optimistic: “the first clinical results make me say that it will be effective,” says Ms. Kraeber-Bodéré. “If you had asked me five years ago, I would have said that it was still a bit risky. Now I think we have to go for it.”
