“Nuclear medicine has a great unexplored potential”

Interview with Anthony Waked, PhD Fellow  at SCK CEN – Belgian Nuclear Research Centre and the University of Liège, Belgium

In the past decade, research has made tremendous progress and medical isotopes are expected to become a vital tool in the treatment of many types of cancers in the near future. Some of them are particularly aggressive and prognosis for survival are still quite poor, like for glioblastoma. Anthony Waked, PhD Fellow at SCK CEN – Belgian Nuclear Research Centre and the University of Liège, focuses his research on the development and preclinical evaluation of targeted radiopharmaceuticals for the treatment of this malignant brain tumour. Anthony is also an Ambassador for the Oncidium Foundation, which focuses on raising awareness about radiotheranostics as alternatives for cancer care and providing support to accelerate global access.

Dear Anthony,
What are the main passions and interests that inspire your work? Why did you choose to focus on this field of research?

I chose to do my PhD in this area because it has a lot of potential in improving patients’ lives if we develop effective treatments. I think the clinical experiences of targeted radionuclide therapy with prostate cancers and neuroendocrine tumours clearly demonstrate this.

I remember when I first learnt about targeted radionuclide therapy (TRNT) during my studies, it sounded like science fiction to me: there’s something a bit magical in harnessing the “power of the atom” to treat cancer in a targeted way. Today, what I enjoy the most in this field is that it’s truly interdisciplinary. There’s always a lot to learn and discover from different areas of fundamental and applied sciences.

Could you please tell us more about your project? And what are its main benefits in relation to nuclear medicine?

I am currently working on two preclinical projects within my PhD, both ultimately aimed at exploring the potential of TRNT for the treatment of an aggressive form of brain cancer, glioblastoma. Worldwide, there is not a lot of research being done on TRNT for this disease, and I hope my research contributes a little in filling this gap.

Anthony Waked at SCK CEN – Belgian Nuclear Research Centre.

In one project, our research sheds light on the underlying radiobiology of TRNT in glioblastoma, while evaluating different ¹⁷⁷Lu-radiolabelled peptides as potential radiopharmaceuticals. These peptides carry the Lu-177 radionuclide directly to a marker that’s highly expressed on the surface of cancer stem cells. Most of our understanding on the radiobiology of such treatments is derived from research done on conventional radiotherapy, which does not always translate well to TRNT.

In another project, we are evaluating novel, radiolabelled, single-domain antibodies (sdAbs, also known as nanobodies^®) targeted against another promising molecular target in glioblastoma recurrences. These sdAbs, developed in a collaboration with the University of Liège, are genetically engineered from special antibodies found in animals like llamas and alpacas. They bind very strongly to their target on cancer cells. And due to their smaller size, they are better at reaching tumours than antibodies, and are eliminated faster from the body – which usually means less toxicity to healthy organs. It’s also great that they’re easier and cheaper to produce than antibodies.

What are the main developments that you expect from your research?

Of course, the ultimate aim is always to find new effective therapies and to improve existing ones. The path to doing that is not always straightforward, though, and a lot more fundamental questions need to be addressed to improve our understanding of TRNT.

That is what my colleagues and I at SCK CEN are working on, and it helps that we have scientists working all across the spectrum of radiopharmaceutical development and research. They cover everything from the production of radionuclides at the BR2 reactor and the design of new chelators (the “glue” that binds the radionuclide to the targeting molecule), to the discovery of new cancer biomarkers and dosimetry investigations.

Beyond your research, you are involved in many other projects and volunteering activities. What does being an “ambassador of radiotheranostics” mean to you?

I think one common thread that runs across most of my volunteering activities is a desire to help improve access to healthcare, whether that is by providing first aid services through the Red Cross, or by lobbying EU policymakers to increase funding for programmes that fight preventable diseases, as I have done through my activism with the anti-poverty organisation ONE Campaign.

And it’s also important that people have access to the newest effective therapies, too. That is why I’m involved as an ambassador for the Oncidium Foundation, along with a brilliant network of nuclear medicine professionals from across the globe. The foundation focuses on supporting and accelerating the development of radiotheranostics for cancer care, worldwide. A great deal of work is dedicated to raising awareness among patients and doctors alike, in view of increasing access to these therapies to as many patients as possible, providing hope for those who could potentially benefit from this option.

As medical and nuclear technologies advance, and new effective cancer therapies become available, we must make sure that where you live does not affect your ability to access those treatments.

Why do you think nuclear medicine is so important? In your opinion, what are the main challenges nuclear medicine will have to face in the future?

I think nuclear medicine holds a great deal of unexplored potential in improving patient outcomes and quality of life. It has the potential to bring true a personalized medicine approach to cancer patients, something that the biomedical community has been working on for decades.

Funnily enough, sometimes seemingly simple tasks, like agreeing on a standard name, prove to be challenging: targeted radionuclide therapy? molecular radiotherapy? radiopharmaceutical therapy? Or a handful of other names, too?

On a more serious note, I think the main challenges lie across different levels: research, clinics, and supply chains.

• Research-wise, we still need to figure out what are the best approaches to maximize the tumour dose while minimizing doses to other organs? How can we accurately estimate these doses for each patient? How does the immune system and tumour microenvironment impact the effectiveness of TRNT? And a lot more…
• At the clinical level, such treatments require highly trained and specialised teams of doctors, (radio)pharmacists, nurses, technologists, medical physicists, radiation protection personnel, and other professionals. The international community has already pointed out that we need to pull our efforts to satisfy the high training and staffing requirements needed to administer such therapies[1] [1].
• Finally, as more and more treatments become clinically approved and adopted, we need to ensure a reliable supply of radionuclides and radiopharmaceuticals to clinics worldwide. SCK CEN, like other actors in the field, is already preparing for that future by expanding their nuclear medicine activities and facilities.

[1] Cutler, C.S., et al., Global Issues of Radiopharmaceutical Access and Availability: A Nuclear Medicine Global Initiative Project. Journal of Nuclear Medicine, 2021. 62(3): p. 422-430.

ENS Event – “Beating Cancer – Turning the tide with medical isotopes”

Every year 10 million patients in Europe benefit from nuclear medicine. In the past decade, research has made tremendous progress and medical isotopes are expected to become an even more vital tool in the treatment of many types of cancers.

By focusing on these topics, ENS and Euratom Supply Agency organise the informative session “Beating Cancer – Turning the tide with medical isotopes“, on 17th April in Antwerp and Online.

Register here: https://www.eventbrite.it/e/beating-cancer-turning-the-tide-with-medical-isotopes-tickets-531909243867

You can attend the event on-site or via live streaming. It is free of charge, but registration is mandatory.

In this session, we will learn about the use of medical isotopes for diagnosis and treatment. Our experts will give an update on increasingly effective therapeutics and the expected growth in medical nuclear procedures in line with these dynamic developments.

More details are available here: https://www.eventbrite.it/e/beating-cancer-turning-the-tide-with-medical-isotopes-tickets-531909243867