CERN technology being applied to fighting cancer

[Orb]

This is interesting from both a medical and business perspective.
The company is Advanced Oncotherapy who look to be acquiring the ADAM spinoff from CERN.
Too early to invest in IMO unless a long term risk investor but great development opportunity, and hopefully another way forward in treating cancer in the future.

In April 2013, AVO announced it's potential acquisition of ADAM-Geneva, a CERN spin-off company based on the CERN campus, home of the LHC and the discovery of the 'God particle.'

AVO’s ADAM-Geneva physics team have created a compact linear accelerator that will be the next generation of targeted cancer treatment. The team‘s aim is to dramatically reduce the cost of delivering enhanced radiotherapy in the clinical setting. Thus, AVO makes radiotherapy more accessible to more patients with lower side effects and better outcomes. Currently, the cost and size of proton beam therapy machines and the necessary edifices to house them explain why there are only 32 centres in the world.

More information from AVO and CERN:
http://home.web.cern.ch/about/updates/2013/04/accelerators-medicine
http://www.advancedoncotherapy.com/

Cheers
Orb

 

[MylesBAstor]

This is interesting from both a medical and business perspective.
The company is Advanced Oncotherapy who look to be acquiring the ADAM spinoff from CERN.
Too early to invest in IMO unless a long term risk investor but great development opportunity, and hopefully another way forward in treating cancer in the future.



More information from AVO and CERN:
http://home.web.cern.ch/about/updates/2013/04/accelerators-medicine
http://www.advancedoncotherapy.com/



Cheers
Orb

p+ therapy is far from new modality and did work on it back in the early '80s up at Harvard/MGH. Here's the problem with any of these particle beams. They in theory can deliver a more precise dose of radiation to the tumor with a big caveat: as long as you're treating a small tumor. Once you have to spread the Bragg peak out over a tumor of realistic dimensions, you lose that precision. The one tumor that protons have proved effective in treating is however, choroidal melanomas.

This is basically a case of CERN trying to find other uses and sources of money for the program. The US tried the same tactic with negative pi-mesons out at Los Alamos in the 80s too. Problem is this physic facilities are often located far from patients (and remember many are very ill) and are far from a hospital environment (you'd know what I'm talking about if you been to one of these big accelerators ).

 

[Steve Williams]

choroidal melanomas.

how many of those have you seen?

Is that what Derek Fisher's young daughter had or did she have a retinoblastoma

 

[Orb]

p+ therapy is far from new modality and did work on it back in the early '80s up at Harvard/MGH. Here's the problem with any of these particle beams. They in theory can deliver a more precise dose of radiation to the tumor with a big caveat: as long as you're treating a small tumor. Once you have to spread the Bragg peak out over a tumor of realistic dimensions, you lose that precision. The one tumor that protons have proved effective in treating is however, choroidal melanomas.

This is basically a case of CERN trying to find other uses and sources of money for the program. The US tried the same tactic with negative pi-mesons out at Los Alamos in the 80s too. Problem is this physic facilities are often located far from patients (and remember many are very ill) and are far from a hospital environment (you'd know what I'm talking about if you been to one of these big accelerators ).

I think this is moving on from that Myles, last sentence says
Currently, the cost and size of proton beam therapy machines and the necessary edifices to house them explain why there are only 32 centres in the world.
As AVO shows at their site, they have a link relating to p+.
http://ptcog.web.psi.ch/ptcentres.html

Cheers
Orb

 

[Steve Williams]

I'm curious as to how proton beam therapy differs in results when compared to gamma knife therapy

 

[Steve Williams]

Found this........

Comparison of Charged ParticlesComparison of
Charged Particles (e. g. Protons) and Photons (Gamma particles)

Photons produced in Gamma Knife® and linear accelerator radiosurgery units do not produce a peak of interaction of a single beam with tissue as do charged particles such as protons. There is also no rapid fall off after the target is reached. Thus, with Gamma Knife and LINAC radiosurgical doses must be achieved by superimposing a large number of beams on the target while only a small number of beams reach other areas. The large number of different target paths required makes milling of individual collimators impractical, a limitation that will not be overcome until variably-gated (or dynamically-collimated) linear accelerators are widely available.
The circular collimators currently in use in photon radiosurgery units result in roughly spherical or elliptical target volumes. Most lesions can still be satisfactorily covered using multiple superimposed ellipsoids. However, this may significantly increase the dose inhomgeneity leading to the potential for side effects in regions recieving particularly high doses. This also suggetsts that proton radiosurgery will be particularly appealing in applications where dose fractionation is of benefit, since no portion of target in a proton field is expected to receive a complication producing dose because of superimposition of high dose areas. Fractionated particle beam radiosurgery is, therefore, an area of active current research.

The Proton Beam Unit was founded in 1962 and has the largest experience with stereotactic radiosurgery of any center in the United States. Proton beam offers certain theoretical advantages over other modalities of stereotactic radiosurgery (i.e. Gamma Knife® and linear accelerators) because it makes use of the quantum wave properites of protons to reduces doses to surrounding tissue beyond the target to a theoretical minimum of zero. In practice, the proton facility offers advantages for the treatment of unusually shaped brain tumors and arteriovenous malformations. The homogeneous doses delivered also makes fractionated therapy possible. Proton beam radiosurgery also has the ability to treat tumors outside of the cranial cavity. These properties make it the ideal post-resection therapy for many chordomas and certain chondrosarchomas of the spine and skull base as well as an excellent mode of therapy for many other types of tumors.

 

[Orb]

Here is the details relating to CERNs ADAM I am talking about:
http://adam-geneva.com/
Improving cost/scale/technology would mean this could be expanded from 32 centres worldwide today, to many 100s and with greater scope for various cancer types.
Cheers
Orb

 

[Steve Williams]

Orb

this could prove to be very exciting and innovational

 

[Orb]

Orb

this could prove to be very exciting and innovational

Very early days but yeah hopefully, as long as they can manage to achieve a viable cost/scale/usability with the new solutions, and critically without running out of cash while doing this from R&D-to-acceptable prototype.
Worth taking a look at the adam-geneva link as it explains in both summary web page (better for general interest and mugs like me hehe) and technical papers the subtle differences regarding the p+ centres/technology and potential (yeah emphasise this means could) improvements.
http://adam-geneva.com/protontherapy.html

Cheers
Orb

 

[MylesBAstor]

I think this is moving on from that Myles, last sentence says
Currently, the cost and size of proton beam therapy machines and the necessary edifices to house them explain why there are only 32 centres in the world.
As AVO shows at their site, they have a link relating to p+.
http://ptcog.web.psi.ch/ptcentres.html

Cheers
Orb

It still doesn't obviate the issues incurred when you spread the Bragg peak out. [Look it up] They now try to get around the issue using intensity modulated beams. See pdf under. BTW there are few hospital based proton machines in the US already.

 

[Steve Williams]

The cost of one must be staggering

 

[MylesBAstor]

Found this........

Comparison of Charged ParticlesComparison of
Charged Particles (e. g. Protons) and Photons (Gamma particles)

Photons produced in Gamma Knife® and linear accelerator radiosurgery units do not produce a peak of interaction of a single beam with tissue as do charged particles such as protons. There is also no rapid fall off after the target is reached. Thus, with Gamma Knife and LINAC radiosurgical doses must be achieved by superimposing a large number of beams on the target while only a small number of beams reach other areas. The large number of different target paths required makes milling of individual collimators impractical, a limitation that will not be overcome until variably-gated (or dynamically-collimated) linear accelerators are widely available.
The circular collimators currently in use in photon radiosurgery units result in roughly spherical or elliptical target volumes. Most lesions can still be satisfactorily covered using multiple superimposed ellipsoids. However, this may significantly increase the dose inhomgeneity leading to the potential for side effects in regions recieving particularly high doses. This also suggetsts that proton radiosurgery will be particularly appealing in applications where dose fractionation is of benefit, since no portion of target in a proton field is expected to receive a complication producing dose because of superimposition of high dose areas. Fractionated particle beam radiosurgery is, therefore, an area of active current research.

The Proton Beam Unit was founded in 1962 and has the largest experience with stereotactic radiosurgery of any center in the United States. Proton beam offers certain theoretical advantages over other modalities of stereotactic radiosurgery (i.e. Gamma Knife® and linear accelerators) because it makes use of the quantum wave properites of protons to reduces doses to surrounding tissue beyond the target to a theoretical minimum of zero. In practice, the proton facility offers advantages for the treatment of unusually shaped brain tumors and arteriovenous malformations. The homogeneous doses delivered also makes fractionated therapy possible. Proton beam radiosurgery also has the ability to treat tumors outside of the cranial cavity. These properties make it the ideal post-resection therapy for many chordomas and certain chondrosarchomas of the spine and skull base as well as an excellent mode of therapy for many other types of tumors.

This is also an issue (BTW Hall was my PHD advisor )

http://www.crr-cu.org/faculty/hall/ijrobp65-06.pdf

 

[Orb]

It still doesn't obviate the issues incurred when you spread the Bragg peak out. [Look it up] They now try to get around the issue using intensity modulated beams. See pdf under. BTW there are few hospital based proton machines in the US already.

You mean like as mentioned in: Recent applications of Synchrotrons in cancer therapy with Carbon Ions?
Paper is on the website of Adams with specifics of Braggs peak.
http://www.adam-geneva.com/docs_2009/Europhysics.pdf

And also very briefly mentions the Braggs peak on summary page: http://www.adam-geneva.com/protontherapy.html

Are you saying they (scientists related to CERN and also AVO) are ripping people off with an idea that either is pie in the sky or will be no better to the existing Synchrotron/Cyclotron systems?
Not my area of expertise but sounds like your pretty un-impressed with what they are doing.

Cheers
Orb

 

[Orb]

Myles I think we are moving away from the point (allowed myself to be dragged into a side of this that was not its intent).

CERN-AVO are looking to make the technology with their architecture:
1. More compact and flexible in terms of implementation and scalability.
2. Cheaper
3. Greater precision

The last point comes to their premise " the system has an active longitudinal modulation along the beam propagation axis (beam energy can be electronically varied during therapy and therefore the treatment depth), rather than using a passive modulation system (where the cyclotrons fixed initial energy is degraded through the interposition of variable thickness energy absorbers between the accelerator and the patient, causing a quality loss of the beam). Moreover, the LIGHT system has a dynamic transversal modulation that allows a precise 3D treatment of the tumours (spot scanning)".

If all 3 points are delivered then this does open the technology up for greater use (more hospitals/centres) and other tumours.
In what way do you feel this is no different to existing Synchrotron/Cyclotron solutions?
Asking as this seems to be something you know.

Cheers
Orb

 

[Orb]

Just to say their solution seems to be closer to that used for X-ray and Electron beam - they are using Linac linear accelerator rather than traditional p+ therapies that started our discussion going the wrong way Myles.
This would be improving upon traditional p+ done with Synchrotron/Cyclotron, and as they say on their site their proton beam linear accelerators would be similar in use to the conventional X-ray linear accelerators.

So Myles this went sideways very early as I think you jumped on it being identical to current p+ solutions, took me awhile to have this sink in as we ended up focusing on existing p+
As Steve mentions, comes back a bit to the Gamma Knife concept, but ADAM define their solution as Linac for Image Guided Hadron Therapy.
Their presentation as well: http://indico.cern.ch/getFile.py/access?resId=1&materialId=slides&confId=183874
Really interesting read as covers in summary much more IP than just their LIGHT technology (never realised the prototype was working already).
Cheers
Orb

 

[MylesBAstor]

You mean like as mentioned in: Recent applications of Synchrotrons in cancer therapy with Carbon Ions?
Paper is on the website of Adams with specifics of Braggs peak.
http://www.adam-geneva.com/docs_2009/Europhysics.pdf

And also very briefly mentions the Braggs peak on summary page: http://www.adam-geneva.com/protontherapy.html

Are you saying they (scientists related to CERN and also AVO) are ripping people off with an idea that either is pie in the sky or will be no better to the existing Synchrotron/Cyclotron systems?
Not my area of expertise but sounds like your pretty un-impressed with what they are doing.

Cheers
Orb

Here's some food for thought Do you think your organs sit still? That's why things like stereotactic radiosurgery was primarily used for treating brain tumors. On other tumors sites, the precision of stereotactic RS is lost (of course, we can also talk about actually how precisely the radiation is delivered to the tumor volume.)

Let's put it this way. Have seen a lot of money wasted on using charged particle and neutron therapy beams, etc. over the years with no return.

What I'm against is the *false* hope that too often happens in cancer therapy. In fact, there's so much hyping therapies to get funding, etc. lately that it's scary.

 

[Orb]

I guess it comes down to whether they can make their LIGHT design work as they say with "the LIGHT system has a dynamic transversal modulation that allows a precise 3D treatment of the tumours (spot scanning)".
Appreciate this comes back to what you say regarding p+, but then their system does not behave exactly as either a Synchrotron or Cyclotron.
I think the spot scanning capability has been created as well with regards to other hardware solutions they developed (working prototypes do exist and in testing), have the technical 'workshop session' presentation somewhere.

Cheers
Orb