Targeted radionuclide therapy (TRT) has become increasingly prominent in nuclear medicine. Radiopharmaceuticals based on beta-emitters, such as Lu-177, have proven highly efficient in treating patients with metastatic neuroendocrine tumors or advanced prostate cancer. Furthermore, alpha-emitters have also been adopted into clinical practice. Currently, the demand for both established and emerging radionuclides for TRT is increasing rapidly. However, this is not equally matched by increased radionuclide availability or by addressing related technical gaps. These include emerging beta-emitters like Tb-161, alpha-emitting radionuclides, such as Ac-225 and Pb-212/Bi-212, for Targeted Alpha Therapy (TAT). Therefore, the SECURE consortium has teamed up to strengthen the EU supply network and enhance the availability and sustainability of radionuclides in the EU.
Selected radionuclides: Ag-111, Tb-161, Lu-177, Re-188, and Au-199 as beta-emitters, and Ac-225 and Pb-212 as alpha-emitters, with high potential for TRT, were in focus of the SECURE project, in their entire life cycle assessment, starting from the resourcing, available irradiation facilities, target preparation and handling, target encapsulation, processing, and their use in the preparation of radiopharmaceuticals. Alternative solutions were investigated, such as the use of legacy materials. Mitigating the limited availability of enriched target materials was addressed by the example of Cu-64. The objective of SECURE was to address gaps and challenges in securing their future availability, including:
- Developments in innovative routes of production of selected radionuclides, involving research reactors and other neutron sources as well as charged-particle accelerators, separation/purification methods, legacy materials, generators, and transportation concerns,
- Developments in irradiation targets, target requirements, preparation and recycling procedures, and infrastructural needs, as well as target material sourcing and target enrichment concerns,
- Assessment of radiation risks for the workers, patients, and caregivers related to the novel radionuclides and recommendations for their safe handling. Recommendations for implementing clinical trials involving radiopharmaceuticals, including the development of individual/specific organ dosimetry for therapeutic applications.
Meeting these objectives was demonstrated by the project results and supported by scientific publications. Proving the scalability of the results is underway.