Friday, July 12, 2019

Proton Therapy

There are more than 200 different types of cancers. According to the US National Cancer Institute, nearly 40% of Americans will be diagnosed with cancer during their lives. The World Health Organization names cancer as the second leading cause of death globally, causing nearly one in six deaths. In case anyone needs reminding, cancer is a big deal. Lung cancer is the leading cause of cancer deaths around the world, causing more deaths than prostate, breast and colon cancers combined. Only 18.5% of patients will survive five or more years after being diagnosed with lung cancer. So smokers, take note! Alongside chemotherapy and surgery to remove tumors, about 40% of cancer patients are treated with radiotherapy, which fires ionizing radiation into the body, killing malignant cells with X-ray photons. Roughly 17,000 clinics worldwide deliver X-ray radiotherapy treatment today.

The rise in popularity of proton therapy (vs X-ray) is continuing across the globe. It is estimated that more than 165,000 patients suffering from a variety of cancers, such as prostate cancer, brain tumors, etc. have already been successfully treated using this method. In fact, the proton therapy market is on track to become a multibillion-dollar industry by 2024. The number of proton therapy centers is increasing globally. Still, industry experts believe that players will miss out on a majority of cancer patients who can benefit with proton therapy, overlooking a huge multi-Billion-dollar potential market.

The proton therapy market is likely to almost double by 2024 from its current market value.  Globally, the numbers of patients treated with proton therapy is very low whereas the potential candidates for it are in the Millions.

Shortly before 1975, I had started promoting Varian’s Clinacs throughout the Middle East (back then it was not yet proton beams but x-ray and electron beams) and Linacs (for inspecting fully loaded shipping containers). Unfortunately, the effort died in its track because of the Lebanese civil war and by October 4, 1976 I reported to work in Zug, Switzerland, not for the Medical group but for the Industrial Product Operation which was mainly semiconductor equipment and instruments based around high or ultra-high vacuum technology.

While I never got to sell any Clinacs or Linacs, at least I was for a very short period exposed to the technology (including a visit to Palo Alto where they were manufactured). The technology had been pioneered years earlier at the then 2-mile long SLAC (now 3-mile accelerator) of Stanford University, by Dr. Edward Ginzton, a Ukrainian-American engineer and Bill Hansen. As a student at Stanford, Ginzton worked with William (Bill) Hansen and brothers Russell + Sigurd Varian. In 1941 he became a member of the Varian-Hansen group at the Sperry Gyroscope Company and some years later joined the Varian brothers on their board of directors at Varian Inc. in Palo Alto, California. 

Actually, the first clinical Van de Graaff generator treatment was done at Harvard’s Medical School in 1937. 

In 1972, a Dr. Peter Fessenden joined Stanford and began developing a linear accelerator that combats tumor cells using two types of radiation. Working with Varian Medical group, Fessenden’s team creates the first linear accelerator that combined both X-ray and electron treatment.  So, Varian holds the claim to fame for developing the first medical linear accelerator in cooperation with Fessenden and his team. Since then, the company has developed a portfolio of technologies to treat and manage cancer, including equipment for radiotherapy, radiosurgery, brachytherapy, and proton therapy. Seems their Linac line for shipping containers either didn’t fly or got sold off; I lost track of that line long ago though I’m partly back in that fold with gamma ray detectors mainly as a tool to counter potential radiation terrorism (homeland security type equipment).

But post-WW2, cobalt therapy was the medical use of gamma rays from the radioisotope cobalt-60 to treat cancer. It was then widely used in external beam radiotherapy machines, which produced a beam of gamma rays which was directed into the patient's body to kill tumor tissue. Radiotherapy doctors were not yet hot on clinical linac technology; it was not yet the tool of choice. Indeed, when I started peddling Clinacs to any medical center with a semblance of serious oncology department, my main technology competitor was Cobalt-60 systems which back then were fairly well established in most Western nations.     

Philips introduced their SL25 in 1985, it was the “first fully digitally controlled” medical linear accelerator. They continue to be in many other medical equipment but no longer in proton therapy systems.

In proton therapy, the proton beam is generated through use of a particle accelerator, which uses electromagnetic fields to accelerate protons to very high energies. The use of protons to deliver radiation therapy allows physicians to maximize the radiation dose to the treatment target, while minimizing the adverse effects of radiation on the surrounding healthy tissue. (For those of you who no longer remember kindergarten physics, protons and neutrons makeup the nucleus of atoms. And if you have extreme dexterity in your fingers, you might even manage to catch one of the spinning electrons! 😊)

Similar to traditional X-ray therapy, proton therapy is an external beam radiation therapy technique. High-energy protons deposit radiation dose in a more targeted manner than X-rays. When protons enter the body, they only leave a small amount of radiation along their path as they pass through the tissue. Upon reaching a specific depth, protons deposit a large focused amount of radiation and then stop, leaving virtually no radiation beyond that depth.

Today, while clinical linear accelerators are available in approximately 65 facilities worldwide. A few very poor nations in Africa and Latin America also have such capabilities, though probably far too few for the size of some of their populations. Not only do they need the therapy machine but also the imaging techniques as well as the sophisticated software programs dedicated to that type of intervention. It amounts to millions and millions in investments. The dominant players in proton therapy are IBA, Mitsubishi, Optivus, Hitachi, Mevion, Varian, ProNova, Sumitomo.

One inherent shortcoming of stand-alone proton machines as seen below is they suffer from the same inherent issues that all cyclotrons and synchrotrons do, such as slow beam-energy modulation that’s problematic for accurate targeting. It can be overcome by adding a therapy station on a beamline, but this can mean systems with the footprint of a sports field, impossible for most hospitals. So, many accelerator labs worldwide have extended their beamline capabilities to include a “home-made” radiation therapy ward. It’s the case for South Africa, near the Stellenbosch wine country, iThemba have a therapy ward. In Switzerland, at the Paul Scherrer Institute, they rank among the most advanced for ophthalmology cancer therapy. In Geneva, Proton Beam Therapy and CERN hadron technology are fighting cancer with LIGHT; this accelerator produces a proton beam of 230 megaelectron volts traveling at 60 percent of the speed of light, almost 181 million m/s !


Tuesday, January 31, 2017

Swiss Society for Biomaterials & Regenerative Medicine Annual Conference

Advances in Antimicrobial Biomaterials science, industry, physicians

The SSB+RM meetings are devoted to all aspects of biomaterials science including basic research, engineering, and medical applications. The 2017 conference is dedicated to Advances in Antimicrobial Materials. This conference will include keynote speakers who will give an overview of clinical and commercial translations of biomaterials. Selected sessions are devoted to the design, preparation, characterization, quality control and application of all types of antimicrobial materials from the viewpoints of academia, industry and the clinics.
 
Both oral and poster presentations are welcome. Those wishing to present are asked to submit an extended abstract (1 page maximum) by March 17th, 2017. Abstracts must be submitted as an electronic file in MS Word and must adhere to the abstract guidelines. The abstract template can soon be obtained from the conference website.
 
 
Contact
Dr Katharina Maniura
EMPA, Biointerfaces
Phone: +41 58 765 74 47
e-mail

Thursday, November 3, 2016

Alzheimer's, a dementia disease of the past?

The BACE1 inhibitor verubecestat (MK-8931) reduces CNS β-amyloid in animal models and in Alzheimer’s disease patients

The discovery of BACE1 inhibitors that reduce β-amyloid peptides in Alzheimer’s disease (AD) patients has been an encouraging development in the quest for a disease-modifying therapy. Kennedy and colleagues now report the discovery of verubecestat, a structurally unique, orally bioavailable small molecule that potently inhibits brain BACE1 activity resulting in a reduction in Aβ peptides in the cerebrospinal fluid of animals, healthy volunteers, and AD patients. No dose-limiting toxicities were observed in chronic animal toxicology studies or in phase 1 human studies, thus reducing safety concerns raised by previous reports of BACE inhibitors and BACE1 knockout mice.
 
According to the World Health Organization over 36 million people world-wide are affected by dementia, of which the majority have Alzheimer’s. This number is forecast to double by 2030 and triple by 2050 if no treatment is discovered. So great hopes are placed on verubecestat. 
 

Monday, August 15, 2016

Nanoparticles to Break Up Plaque and Prevent Cavities

Philadelphia, PA (Scicasts) — The bacteria that live in dental plaque and contribute to tooth decay often resist traditional antimicrobial treatment, as they can "hide" within a sticky biofilm matrix, a glue-like polymer scaffold.
 
A new strategy conceived by University of Pennsylvania researchers took a more sophisticated approach. Instead of simply applying an antibiotic to the teeth, they took advantage of the pH-sensitive and enzyme-like properties of iron-containing nanoparticles to catalyze the activity of hydrogen peroxide, a commonly used natural antiseptic. The activated hydrogen peroxide produced free radicals that were able to simultaneously degrade the biofilm matrix and kill the bacteria within, significantly reducing plaque and preventing the tooth decay, or cavities, in an animal model.
 
"Even using a very low concentration of hydrogen peroxide, the process was incredibly effective at disrupting the biofilm," said Hyun (Michel) Koo, a professor in the Penn School of Dental Medicine's Department of Orthodontics and divisions of Pediatric Dentistry and Community and Oral Health and the senior author of the study, which was published in the journal Biomaterials. "Adding nanoparticles increased the efficiency of bacterial killing more than 5,000-fold."
 

Research Shows Gentle Cancer Treatment Using Nanoparticles Works

Copenhagen, Denmark (Scicasts) — Cancer treatments based on laser irradiation of tiny nanoparticles that are injected directly into the cancer tumour are working and can destroy the cancer from within.
 
Researchers from the Niels Bohr Institute and the Faculty of Health Sciences at the University of Copenhagen have developed a method that kills cancer cells using nanoparticles and lasers. The treatment has been tested on mice and it has been demonstrated that the cancer tumours are considerably damaged. The results are published in the scientific journal, Scientific Reports.
 
Traditional cancer treatments like radiation and chemotherapy have major side affects, because they not only affect the cancer tumours, but also the healthy parts of the body. A large interdisciplinary research project between physicists at the Niels Bohr Institute and doctors and human biologists at the Panum Institute and Rigshospitalet has developed a new treatment that only affects cancer tumours locally, therefore, much more gentle on the body. The project is called Laser Activated Nanoparticles for Tumor Elimination (LANTERN). The head of the project is Professor Lene Oddershede, a biophysicist and head of the research group Optical Tweezers at the Niels Bohr Institute at the University of Copenhagen in collaboration with Professor Andreas Kjær, head of the Cluster for Molecular Imaging, Panum Institute.

Click for complete article

Monday, May 9, 2016

Latest Advances in Nano-Oncology

Unique characteristics of nanoparticles make them highly attractive for various applications in oncology. They are able to function as carriers for chemotherapeutic drugs to increase their therapeutic index and lower their toxicity, as therapeutic agents in photodynamic, gene, and thermal therapy, as well as molecular imaging agents to detect and monitor cancer progression. Several nanoparticle-based agents for cancer therapy and diagnostics have been approved by FDA, more are in clinical trials, and even more are in the discovery and early development stages in academic and industry laboratories. Cambridge Healthtech Institute’s Latest Advances in Nano-Oncology symposium is designed to encourage open discussion and knowledge exchange in this exiting and rapidly developing area at the junction of nanobiotechnology and oncology.
 

Thursday, April 21, 2016

Hitting cancer from the inside

Most cancer cells carry unique receptors on their surface. Because the receptors extend into the cell's interior, they act as intermediaries between the outside and the inside. Chemotherapeutic drugs that dock on the exterior trigger a cascade of biochemical reactions inside the cell. At the end of this process, the cancer cells should die off. Researchers at the Paul Scherrer Institute PSI are now investigating a new method that would not only attach radioactive substances to the outside of a cancer cell, but also would channel them right into the cell's nucleus. Thus the radiation source would remain inside the cell and work in a more targeted way, by getting closer to the genetic information. If the suitable radioactive compounds can be found, this method has the potential to help with several kinds of cancer in the future.

One of the most important goals in cancer therapy is to strike at the heart of the camouflaged cancer cells – that is, in the nucleus. In cancer cells, pathologically mutated DNA ensures that cell division occurs more rapidly and more frequently than in normal cells. Many cytotoxins used in chemotherapy against cancer manage to penetrate to the cell nucleus and attack precisely those processes that are important for cell division. Others interfere with the metabolism of tumour cells, thereby impeding their growth. Thus they all operate within the cell, and particularly at the time when it is dividing. Many cytotoxins, however, are non-specific and also attack other tissues of the body that renew themselves frequently, such as hair or mucous membranes.
 
 

Tuesday, April 5, 2016

New frontiers in bioscience

In laboratories around the world, some of the brightest scientists—well-established and those early in their careers—are conceiving novel theories at the very forefront of knowledge. In tissue regeneration, multilevel function, multiscale modeling, longevity, and other cutting-edge fields, breakthrough research will soon enable us to improve human health and perhaps even reveal the deepest mechanisms of life itself.

Paul G. Allen is the cofounder of Microsoft, the chief executive officer of Vulcan Inc., a recipient of the 2015 Carnegie Medal of Philanthropy, and the founder of the Allen Institute for Brain Science, Institute for Cell Science, and Institute for Artificial Intelligence.
 
In his article Allen explains how "...the complexity of biology is a fascinating challenge, and I am keen to see the field deconstruct its mysteries, establish reliable and predictive models, and put that knowledge to work."

Allen further believes ".....we should also be working more aggressively to break down scientific silos by backing more collaborative, interdisciplinary teams that include experts in bioscience, mathematics, computer science, medicine, engineering, and other fields. For example, the Human Genome Project succeeded because of the convergence of massive computing power, new algorithms, expertise in laboratory biology, and broad support from the public and private sectors."

Thursday, March 31, 2016

Human Brain Project's Research Platforms Released

Public Release of Platforms Will Help Advance Collaborative Research in Neuroscience, Medicine, and Computing
 
The Human Brain Project (HBP) is pleased to announce the release of initial versions of its six Information and Communications Technology (ICT) Platforms to users outside the Project. These Platforms are designed to help the scientific community to accelerate progress in neuroscience, medicine, and computing.
 
The Platforms released today consist of prototype hardware, software tools, databases and programming interfaces, which will be refined and expanded in a collaborative approach with users, and integrated within the framework of a European Research Infrastructure. The public release of the Platforms represents the end of the Ramp-Up Phase of the HBP and the beginning of the Operational Phase.
 
Karlheinz Meier, Co-leader of the Neuromorphic Platform, said, “The HBP invites scientists everywhere to work with our prototype Platforms and give us their feedback. This will help us improve their functionality and ease of use, and hence their value to society”.
 

Wednesday, March 30, 2016

Neuronal Feedback Could Change What We "See"

Study from Carnegie Mellon Neuroscientists Could Explain Mechanism Behind Optical Illusions

By Jocelyn Duffy / 412-268-9982 / jhduffy@andrew.cmu.edu

Ever see something that isn't really there? Could your mind be playing tricks on you? The "tricks" might be your brain reacting to feedback between neurons in different parts of the visual system, according to a study published in The Journal of Neuroscience by Carnegie Mellon University Assistant Professor of Biological Sciences Sandra J. Kuhlman and colleagues.
 

Optical Illusion
 
Understanding this feedback system could provide new insight into the visual system's neuronal circuitry and could have further implications for understanding how the brain interprets and understands sensory stimuli.
 
Many optical illusions make you see something that's not there. Take the Kanizsa triangle: when you place three Pac-Man-like wedges in the right spot, you see a triangle, even though the edges of the triangle aren't drawn. 
 
"We see with both our brain and our eyes. Your brain is making inferences that allow you to see the triangle. It's connecting the dots between the corners of the wedges," said Kuhlman, who is a member of Carnegie Mellon's BrainHub neuroscience initiative and the joint Carnegie Mellon/University of Pittsburgh Center for the Neural Basis of Cognition (CNBC). "Optical illusions illustrate some of the amazing things our visual system can do."

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