Like every cancer treatment, radiotherapy is also designed, essentially, to be harmful. The damage is supposed to focus on the tumor, but there are limitations to the extent to which it can focus. The knowledge that the body will barely survive the event, but that the cancer won't survive it all, is all that is needed to pronounce the treatment effective. The next stage is to try and ensure the body suffers as little harm as possible, although there is no question that it will be affected.
X-Ray radiotherapy is currently the radiotherapy used in most cancer treatments, but it is fraught with problems. The therapy loses most of its energy (meaning it produces the most damage) en-route to the growth rather than at the site itself. Even after hitting the growth, it continues to move, harming the organs behind it as well. Although the damage to surrounding organs can be limited by training the radiation on the growth from different directions, they are nevertheless likely to be harmed.
Recent years have seen a growth in the popularity of a method of radiation using heavy particles - protons, for example. Dr. Michael Marash, CEO of Netanya-based biotech start-up pCure Ltd. explains, "A heavy particle, with boosted acceleration, moves through the body with hardly any interaction with it, but also stops abruptly, so it can be directed in a manner that causes its energy to erupt and run out right on the location of the growth. That's where it stops, so it is there that the interaction with the body tissue takes place, causing the damage."
Proton-based therapies were invented as far back as the 1940s, but they have been gaining momentum since the 1990s. "All the big companies have woken up and they now want to buy radiation devices based on protons or on even heavier particles," says Marash. However, one thing is stopping the method from becoming the leader the price. "Setting up a proton therapy center costs more than $100 million," Marash explains, "so there are only 25 treatment centers worldwide.
"The proton radiotherapy system consists of a booster, which costs $10 million, and several devices that train the radiation on the patient, costing $12 million each," Marash continues. "Each radiation device is fitted with powerful magnets that are supposed to train the radiation on the patient. The radiation device, which weighs 150 tons and is eleven meters in diameter, is stored in a massive 2,000 square meter treatment room, with walls three to five meters thick. To enable simultaneous treatment, between two and four boosters radiation devices are connected to the booster, and these are ultimately what make these centers so expensive."
pCure has founded a way to significantly reduce the cost of such centers. On the face of it, its idea is simple but it runs counter to one of the field's underlying precepts - that during therapy the patient must not be moved, so that doctors can pinpoint the precise location of the growth, on the basis of the diagnostic imaging carried out beforehand.
pCure examined what would happen if this constraint were removed, and instead of, or in addition to, moving the proton beam using the massive magnet, the patient were moved slightly. To ensure the radiation is still targeting the right spot, the patient is scanned at x-ray level resolution, and the images are then merged with the three-dimensional imaging carried out earlier to create an up-to-date three dimensional image of the location of the growth after moving the patient to a different spot.
One of the reasons that no one ever thought of this idea until now was that the usual practice was to carry out the treatment by moving the beam only. The idea of moving the patient, while using advanced imaging eliminates the need for massive and expensive radiation machines, makes room for the introduction of highly advanced imaging methods, and adds an additional element of precision to the treatment.
pCure's product will cost a few million dollars for every radiation unit and a further $1.5 million for the building of one treatment room. The shared booster for all the units will cost $10 million - adding up to less than $30 million for a center with two to four radiation devices. "It's a bargain for any hospital, even in Israel," says Marash.
Building on the 510k
pCure was founded by Marash, a Ph.D. graduate of the Weizmann Institute of Science in cell biology, who previously served as head of biology at gastroenterological research company Vecta Ltd.. "Because I'm not from the radiology field, I could ask questions that others didn't ask," he says. The company was founded under the auspices of the Targetech Innovation Center, and received several hundred thousand dollars in seed investment from Targetech's controlling shareholder, Starvest.
"We're currently in talks with several medical centers in the US," says Marash, "and we believe that by the end of year we will have built the first center and obtained marketing approval from the US Food and Drug Administration (FDA)." Marash believes the regulation will be fairly straightforward, since the radiation is the same. "We haven't touched the booster," he explains, "so we'll probably be able to get approval under a 510K abbreviated procedure, but with some documentation of the clinical results from the pilot."
Published by Globes [online], Israel business news - www.globes-online.com - on July 30, 2008
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