Latest / BioSpace / How radioligand therapy is rewriting cancer care
Transcript
- speaker-0: Hi, my name is Jennifer Smith Parker, Director of Insights at Biospace, and you're listening to The Natured. In this episode, sponsored by Curium, I speak to Mike Patterson, Curium CEO North America, and Sabine Brookman May, VP and Head of Global Clinical Development. We look at the momentum behind radioligand therapy and how its diagnostic and therapeutic capabilities are improving care for more than 14 million patients worldwide. We also discuss Curium's push. To expand US capacity and scale up a pace, and critically, what success could mean for patients with cancer in the years ahead. Sabine and Michael, thank you so much for joining this episode of Denatured. I look forward to this conversation. So tell me about Curium and the work you're doing. speaker-1: Thanks, Jennifer. Kering's a Boston, Massachusetts headquartered company, and we're the largest nuclear medicine supplier in the world, which means we've developed some pretty unique skill sets in terms of vertical integration, from isotopes supplied to manufacturing the dose to distributing it around the world. We serve patients in a number of conditions from cardiology, neurology, nephrology, urology, even oncology. So yeah, maybe you want to spend a minute talking about our focus on cancer. speaker-2: Yeah, thank you, Mike. I think one important aspect I would like to mention is that we are currently also at Quarium transitioning from the diagnostics part to the theragnostics part. And cancer is the main focus here. But what I would like to outline is that traditionally nuclear medicine has mainly focused on the diagnostics part, which means looking where the disease is when you think about metastatic disease and cancer. Now we are looking more for the theragnostics part, which means we are combining both diagnostic and treatment. And this is an ideal setting also for nuclear medicine, considering that we might have a biological target that we can identify and we can see, and that we can also then treat what we see. So an ideal approach to treat ⁓ cancer patients. And this is something unique and something where we would like to focus more on with our work at Corium. speaker-0: Brilliant. Well that's a great introduction, both of you. Thank you. So speaking of nuclear medicine, it seems to be getting more attention than ever. We're hearing about it constantly in the media. So what is it that's driving that momentum? speaker-2: It's really an exciting time right now. And I think the momentum is mainly driven by the fact that nuclear medicine is moving now from a highly specialized field into a more central role in precision oncology. And this is where we are focusing on what we just mentioned with theronostics. We are targeting cancer and we are working in precision oncology. And the key shift here again is the thernostics part, which means we are using a targeted radio pharmaceutical. to target and identify the disease and then to treat the disease where appropriate and with that deliver a high precision ⁓ medicine to our patients. And this approach, what I mentioned already when you asked me the first question, to see what you treat and to treat what you see, this model can help clinicians and patients also to make a more informed treatment decision. And that may also support a more targeted treatment approach beyond what we have with systemic therapies, like for example, chemotherapy. speaker-1: Yeah, I I think to add what Sidney was saying, the science is is just overwhelmingly exciting right now. And when you take and combine that with what people are seeing is critically important, which is a resilient supply chain. So a company like Carrion, which brings such unique skill sets to this space, if we're able to fulfill on our promise of reliably supplying patients to ensure that their treatment is not disrupted, then we can start to see that nuclear medicine can be a vital contributor to treatment of cancer across a number of conditions, not just for five or ten years, but for the next twenty years of evolution of great data coming forward. speaker-0: Yeah, that makes a lot of sense. And I and I do wonder for our listeners who may be less familiar with this therapeutic area or generally with this field, can you explain what makes radioligand therapy different from other cancer treatments? speaker-2: Yeah, very happy to explain that a little bit more in detail. So radioligand therapy represents potentially one of the most advanced forms of precision medicine in oncology. And when you look at the radio pharmaceutical overall, it combines a radioactive isotope that delivers radiation to a cancer cell and it combines it with a ligand that is designed to bind to a specific biological target. So for example, we think about prostate cancer, then we target PSMA, which is prostate specific. membrane antigen and this is expressed by prostate cancer cells and it has the benefit then that we have a very specific biological target. The medicine after it is delivered to the patient travels through the bloodstream. And on the one hand it is delivered through the entire bloodstream to the entire body, but as it is very specific, then it targets tumor cells and delivers the localized radiation to these tumor cells. So on the one hand we can deliver therapy But still a very specific, precise and a very targeted precision medicine. This is especially important when we think about metastatic disease, where the cancer has spread to different parts of the body and where you have metastatic lesions that might be not so easy to target with focal and localized treatments. So overall the goal is precision medicine. And of course it always depends also on ⁓ whether patient fits to that therapy, whether it's an appropriate therapy, considering How the patient has been treated before, at which disease stage the patient is, or whether comorbidities are existing, and the overall health status. And this is what ultimately the patient and the treating physician is deciding. But overall in in a nutshell and to summarize, a radioligand therapy is ⁓ a therapy that has the potential to change how we currently treat cancer in a very precise way. speaker-0: incredibly exciting when you think about that, and especially as you're saying about the precision medicine aspect, because we know it really depends upon the person. So why is curium well positioned to lead the next phase of nuclear medicine? speaker-1: You know, Jennifer, that's a really great question. I think if you look at our heritage, right? So if you look at the Kiram companies, we have more than a hundred years of experience in the Wow. So no one has the experience we have in terms of manufacturing isotopes, radio labeling those isotopes, and distributing them out to the end user. It's a very difficult process and it requires precision. And that's something that we've done better than anyone else for the last fifty years. So as we think through this, that Excellence has allowed us to treat fifteen million patients a year worldwide. And now that we're investing more money back into this space. So we've committed one hundred percent of our ⁓ profits back into expanding ⁓ the field of nuclear medicine. So if you look at our US sites right now, so we have onshore all of our Lutetian production therapies ⁓ in Noblesville, Indiana. In St. Louis, we've expanded our Copper Sixty Four diagnostic platform from No endocrine to now hopefully in the future pending at AA approval to include prostate cancer. It's it's this commitment though, financially and emotionally across the organization to focus on new therapies and finding new therapies that positions us to drive growth across nuclear medicine, not for five years, ten years, but for twenty years and beyond, so that we can get to hopefully achieving targeting eighty percent of cancers with radioligand. speaker-0: That's fantastic. And actually the operational aspects that you're talked about building and growing here, that's perfect segue to the next question of why is operational infrastructure so important in radiologian therapy? speaker-1: You know, it's a challenging product as I was mentioning, right? So it's precision. We're manufacturing products for just in time manufacturing and we're using materials that are decaying away as you're making the dose. So isotopes have a certain shelf life. So unlike traditional pharma that manufactures a dose and it has eighteen or twenty-four months it can sit on a pharmacy shelf, we're manufacturing a dose overnight. We're shipping it to the end user during the day so that they can You've been with their patients the next morning. And supply disruptions here disrupts a cancer patient's treatment. That's something that they just can't tap, right? Their entire focus is on attacking the cancer. And to be honest, their family's entire focus is on attacking the cancer. Our job to ensure that from an operational perspective, we do everything possible to not disrupt their care and to be reliable and get that dose there on time. That's why being vertically integrated is so critical. Because we control our isotope production, we control our manufacturing of the dose, and we control our distribution to the hospital or the end user, which is critically important. speaker-0: So you really need to have that tight fit all around from what you're saying here, from start to finish. speaker-1: It has to be completely tight and cohesive across development process and also critically important that we coordinate well with our own customers so that they know when the dose is coming and and have their patients prepared. speaker-0: Yeah. ⁓ but and that's such a good contrast you're saying, for example, to small molecules and the shelf life you can have there where you cannot have that for radioligand therapies as an example. So you've both talked a bit about prostate cancer, which is obviously a very highly a met need right now. So since radioly gent therapy is increasingly being used to treat prostate cancer, and with curium advancing an investigational radioligand therapy for prostate cancer through phase two clinical development, why does expanding the number of US suppliers matter? speaker-1: Maybe I can start here Sabina just thinking about the supply chain resiliency. So today, if one ⁓ one manufacturer has an issue with their manufacturing, the patients are without another option. And we've seen this happen in twenty twenty two and twenty twenty three. Patients were left without therapy options when there was a supply chain disruption. So we're looking to find ways to have a more resilient supply chain and having somebody like curium. who has our own vertically integrated supply chain, expertise in distributing these products, we think we can add that resiliency needed and help patients in need. Sabina, your thoughts? speaker-2: I think these aspects are so important, Mike, that you ⁓ just mentioned, right? And on the one hand, when I think about where I am working on in clinical development, of course, my focus is also on development, on research, on evidence and science. But this is not the most important aspect. So everything, ⁓ including also all these operational aspects and especially the supply, needs to be managed in a clinical trial setting, but also when a product then is commercialized. To make sure that we get it to the patient and don't have any interruptions in the treatment that these patients need. And I think one important aspect to consider as well is also that, ⁓ and you mentioned it already, it's different than other types of drugs, right? When we talk about chemotherapy, when we talk about other treatments, specific pills, for example, that can be stored, right? But we cannot just stockpile the radioligand therapy because they have a short half life and this means everything needs to be perfect and work one hundred percent. to have all the supply chain managed. And I think here at Corium we have the best setting to implement that from the beginning in the entire life cycle until the patient receives the treatment. speaker-0: And then on that point, so let's talk a bit more on what curium is doing to help address that need because as you're both mentioned, the supply chain aspect is so crucial. speaker-2: And this is an important aspect where we are currently working on ⁓ prostate cancer development. This is where ⁓ most of my ⁓ team members in clinical development are currently focusing on. And we are evaluating ⁓ a treatment developed for prostate cancer. This is the reason why we are doing the phase three registrational trial to evaluate those aspects and in parallel, then also preparing all these operational details ⁓ if we get the treatment approved and if we can commercialize it later. speaker-0: You're addressing a very unmet medical need here. So wishing the best for your program going forward. And then the final question, which is always like I said, called the crystal ball question looking forward. So what would success look like for curium and for patients over the next several years? speaker-1: Then from my side, it means a couple of things. So it means expanded access for patients. I think that's critically important. So Sabina is talking about all of the tremendous clinical work that her team is doing. It's about taking that data and getting it submitted into the agency and getting it approved to provide physicians and their patients with another treatment option. I think it also goes to what we were talking about with that supply chain resiliency. That opportunity allows cure AM. ⁓ to bring these products to patients on a regular basis and ⁓ provide that strength so that if there is a disruption from either supplier there is another option out there and then allowing us to reinvest back into other forms of cancer treatment and I think that's where Sabina can talk a little bit about what her team is focused on to the future of of curium. speaker-2: Yeah. And as it concerns the future of Curium and ⁓ and what it means to have success in that setting, I think above all, advancing the science on the one hand through appropriate clinical trials and our clinical development, but then also working constructively, for example, with regulators to find the best ways how to develop drugs, how to bring them to the patient in the end. Also working closely together with patient advocacy groups, with clinical research groups, with academic networks. to identify where the highest unmet need is, because this is what we actually want to do. We want to develop new ways to treat cancer and we want to develop effective treatments that are needed and bring benefit to the patient. And then as Mike already also ⁓ mentioned, again in parallel, building the manufacturing and the delivery capabilities also to serve the patients ⁓ at scale. And the promise of nuclear medicine finally is substantial. So ⁓ Mike mentioned it already. ⁓ eighty percent of tumors have specific targets that could be targeted with nuclear medicine. And this is such a great promise and such a great potential we have. And Curium's role is now also to help to bring and translate that promise into a reliable and real world patient benefit. speaker-0: Well, the future looks really exciting when you both lay it out that way. So thank you so much for this great discussion about radio ligand therapy and what Curium is doing to advance this field as well. There's ⁓ a lot of exciting news, I think, going ahead for for you. So thank you so much for joining this episode of Denatured. If you'd like to listen to more episodes, please turn to biospace.com or shoot me a pitch at jennifer.smith hyphenparker at biospace.com. Thank you.