Also known as PRnT™, the treatment uses highly localized radiation to destroy cancerous tumors by placing a radioactive isotope directly inside the treatment area, delivering therapeutic radiation from within the tumor. Vivos Inc. has developed a Yttrium-90 based injectable device to treat tumors in animals (IsoPet® Division) and humans (RadioGel™ Division, not currently approved for human use).

Radionuclide therapy, also known as nuclear medicine therapy or radiopharmaceutical therapy, involves the use of radioactive substances to treat diseases, most commonly cancer. The therapy utilizes radionuclides, which are radioactive isotopes, attached to molecules that can specifically target cancer cells. This allows the radionuclides to deliver targeted radiation directly to the tumor or diseased area, minimizing damage to surrounding healthy tissue.

In this treatment, the radioactive isotopes emit radiation that damages the DNA of the targeted cells, leading to cell death or a significant reduction in the cell's ability to multiply. The most familiar forms of radionuclide therapy include treatments for thyroid cancer using iodine-131, pain relief from bone metastases with strontium-89 or samarium-153, and peptide receptor radionuclide therapy (PRRT) for treating neuroendocrine tumors using radionuclide peptides. Vivos Inc. and their patented Precision Radionuclide Therapy™ uses Yttrium-90 to kill tumors and is revolutionizing the treatment of cancer.

Yttrium-90’s Role In Cancer Treatment

Yttrium-90 (Y-90) is a radioactive isotope commonly used in radionuclide therapy, particularly for cancer treatment. Y-90 emits beta radiation, which is effective for treating certain types of cancers because of its ability to deliver high doses of radiation to localized areas with minimal impact on surrounding healthy tissue. Here are some key applications of Yttrium-90 in cancer therapy:

• Radioembolization: Also known as selective internal radiation therapy (SIRT), it involves delivering Y-90 microspheres directly into the arteries feeding a tumor, typically in the liver. This is commonly used for treating hepatocellular carcinoma (primary liver cancer) and metastatic colorectal cancer in the liver when surgery is not an option.
• Radiosynovectomy: Y-90 is used to treat inflammation in the synovial joints (such as in rheumatoid arthritis) by injecting it directly into the joint. Although not a cancer treatment, it's worth mentioning for its therapeutic use in joint disease using radiation.
• Non-Hodgkin Lymphoma: Y-90 is conjugated to monoclonal antibodies that target specific cancer cells in some types of non-Hodgkin lymphoma. The antibodies deliver Y-90 directly to the cancer cells, where it can destroy them with localized radiation.

The use of Y-90 allows for high precision in targeting tumors, reducing the risk of side effects typically associated with external beam radiation. The treatment planning involves sophisticated imaging techniques to ensure accurate delivery of the radioactive material.

Y-90 therapy is effective in extending survival and improving the quality of life for patients with specific types of cancer, making it a valuable option in the oncological toolkit.

Radionuclide therapy has several advantages, including its ability to treat cells systematically throughout the body, which makes it particularly useful for conditions where cancer cells have spread to multiple locations. It is typically considered for use when other treatments have failed or as an adjunct to other therapies to enhance their effectiveness.

The Radionuclide Market 

The market for radionuclide therapy is expected to experience steady growth in the coming years, driven by several factors:

• Rising Cancer Burden: The increasing prevalence of cancer globally creates a larger patient pool for this treatment approach.
• Targeted Therapy Advantages: Radionuclide therapy offers a targeted approach with potentially fewer side effects compared to traditional radiation therapy.
• Technological Advancements: Developments in radiopharmaceuticals and targeted isotopes are improving the effectiveness and specificity of the treatment.
• Focus on Minimally Invasive Procedures: Radionuclide therapy can sometimes be administered with minimal invasiveness, leading to faster recovery and potentially lower costs.

Market segments - The radionuclide therapy market can be segmented based on various factors, including:

• Type of Radionuclide: Different isotopes with varying properties are used for specific applications.
• Cancer Type: The market can be further segmented by the types of cancers treated with radionuclide therapy (e.g., prostate cancer, neuroendocrine tumors).
• Delivery Method: The market can be segmented based on how the radiopharmaceuticals are administered (e.g., oral, intravenous, injection).

Market Research - While a single definitive market size for the global radionuclide therapy market might be elusive, some market research firms provide reports on related segments:

• Radioligand Therapy Market: This segment focuses on radiopharmaceuticals that use antibodies or peptides to target cancer cells. 
• Radionuclide Therapy Market: Considering the growth drivers and targeted therapy advantages, the radionuclide therapy market is expected to be a promising area within nuclear medicine.
• Reports suggest this market could reach USD 13 billion by 2030

The global radiation therapy market size was estimated at $7.47 billion in 2023 and is expected to reach $10.4 billion to $16.3 billion by 2033 at a CAGR of 8.58% from 2024 to 2033. Major companies like Pfizer (NYSE: PFE) are returning to their emphasis on cancer treatment after focusing on COVID-19 for the past few years. 

Other major pharmaceutical companies like AstraZeneca(NASDAQ: AZN) and Eli Lilly (NYSE: LLY) are also going nuclear with radiation to tackle cancer, and Big Pharma’s billions of dollars in investments in nuclear medicine highlight how cancer treatment is shifting to targeted approaches.

Vivos Inc. has made significant developments in both their human and animal divisions. The company has achieved milestones announcing that the FDA granted RadioGel™ Precision Radionuclide Therapy™ the designation of a Breakthrough Device and will use this designation to accelerate clinical trial approvals. 

The IsoPet® division is treating animal cancer in eight clinics across the United States and is expanding quickly. Vista Veterinary Hospital in Kennewick, WA, University of Missouri in Columbia, MO, Johns Hopkins University Veterinary Clinical Trials Network in Baltimore, MD, New England Equine Practice in Patterson, NY, Myhre Equine Clinic in Rochester, NH, Hopkinton Animal Hospital in Hopkinton, NH, Indian Creek Veterinary Hospital in Fort Wayne, IN and the most recently certified University of Wisconsin in Madison, WI for Equine cancer treatment. 

The RadioGel™ Division is working closely with the Mayo Clinic for the initial indication for delivering therapeutic radiation to solid metastatic tumors in lymph nodes associated with papillary thyroid cancer. Currently RadioGel™ is not approved for treating cancer in humans and is scheduled to submit an IDE Application in 2024.

ADVANCED RADIATION THERAPIES FOR PET CANCER

Radiation therapy has emerged as a superior option for treating solid tumors in animals thanks to its precision, safety, and effectiveness. This blog explores targeted radiation such as IsoPet®’s Precision Radionuclide Therapy™ over traditional external beam radiation therapy (EBRT) in managing pet cancer. 

Cancer is a leading cause of death in pets, with various types affecting both cats, dogs, horses and exotic animals. As veterinary medicine advances, the options for treating cancer in pets have expanded significantly, providing hope and better outcomes for many animals. Among these options, radiation therapy has become a cornerstone for managing solid tumors. Let’s explore why targeted radiation therapy is considered safer and more effective than traditional external beam radiation for treating solid tumors in pets.

How Does Radiation Help Treat Cancer?

Radiation therapy is a common treatment for cancer in pets, similar to its use in human cancer treatment. Here are some reasons why radiation may be used for treating cancer in pets:

1. Targeted Radiation Treatment

Radiation can be precisely targeted to cancerous tumors, minimizing damage to surrounding healthy tissues. This precision makes it an effective option for tumors that are inoperable or located in sensitive areas. IsoPet®’s patented Precision Radionuclide Therapy™ is a targeted treatment for solid tumors, often only requiring one treatment to effectively kill the tumor. Targeted radiation is safer for pets because it precisely directs the radiation to cancerous tissues, minimizing exposure and potential damage to surrounding healthy cells. This approach reduces the risk of severe side effects and improves the overall quality of life for pets undergoing treatment.

2. Pain Relief

In addition to shrinking tumors, radiation therapy can help alleviate pain associated with cancer. This is particularly important for improving the quality of life in pets with advanced cancer.

3. External Beam Radiation

For some pets, surgery may not be a viable option due to the location of the tumor, the pet’s overall health, or other factors. Radiation such as external beam radiation (EBRT) provides an alternative that can still be effective in controlling the disease but external beam radiation can cause significant side effects, including severe skin burns, inflammation, and damage to healthy tissues surrounding the treatment area. Additionally, pets may experience fatigue, decreased appetite, and potential long-term organ damage with EBRT depending on the radiation's location and dosage.

4. Combination Therapy

Radiation is often used in conjunction with other treatments such as surgery and chemotherapy. This multimodal approach can enhance the effectiveness of treatment by attacking the cancer from multiple angles.

5. Control of Local Disease

Radiation therapy is particularly useful for controlling local disease, preventing tumors from growing or spreading further. This can be crucial for managing the progression of cancer and prolonging the pet’s life.

6. Palliative Care

Even when a cure is not possible, radiation can be used palliatively to shrink tumors and reduce symptoms, thereby improving the pet’s comfort and quality of life.

Veterinarians are trained to carefully evaluate each case to determine if radiation therapy, and which type of radiation is appropriate based on the type of cancer, its location, the overall health of the pet, and other individual factors.

The Two Types of Radiation Therapy EBRT & PRnT™

External Beam Radiation Therapy (EBRT)

External Beam Radiation delivers radiation from outside the body using high-energy beams, such as X-rays or protons, to target and destroy cancer cells. It involves directing radiation from an external machine towards the tumor. Despite advancements of image guided radiation, some side effects related to tissue damage may still occur.

Benefits of EBRT

- Can treat large areas.

- Can shrink a tumor before surgical removal.

Limitations of EBRT

- Difficulty targeting only the tumor without affecting surrounding tissues

- Requires multiple sessions.

- Challenging for equine cancer treatment due to the size and anatomy of horses.

- Side effects such as skin irritation, fatigue, and damage to nearby organs.

Targeted Radiation Therapy -  IsoPet®’s PRnT™

Targeted Radiation Therapy includes advanced techniques such as IsoPet®’s patented Precision Radionuclide Therapy™ which provides a more precise treatment by injecting a radioactive isotope, Y-90, directly into the tumor without harm to surrounding tissues. Targeted radiation is deemed safer because it delivers precise doses of higher levels of radiation (up to 400Gy) to the tumor while sparing surrounding healthy tissue. This precision reduces the risk of side effects and damage to non-cancerous areas, enhancing overall treatment safety and effectiveness.

Benefits of Targeted Radiation such as PRnT™

-PRnT™ is an advanced treatment that delivers higher doses of radiation with pinpoint accuracy often in one session.

- PRnT™ places radioactive material (Y-90) directly inside or near the tumor, effectively killing the tumor from the inside out with minimal, if any, side effects.

Limitations of Targeted Radiation

-can be less effective for treating large, diffuse tumors or cancers that have metastasized

Veterinary oncologists advocate for targeted radiation therapy in certain cases of solid cancerous tumors where minimizing the damage to surrounding tissues is critical. 

Why Targeted Radionuclide Radiation Therapy and PRnT™ is Safer than EBRT

These five factors demonstrate that targeted radionuclide radiation therapy is safer and more effective when compared to external beam radiation therapy.

1. Precision and Localization

• Precision Radionuclide Therapy™ PRnT™: Uses the radioactive isotope Y-90 that specifically targets cancer cells, minimizing exposure to healthy tissue.
• EBRT: Directs beams of radiation from outside the body, which can be challenging to avoid irradiating nearby healthy tissues completely.

2. Reduced Side Effects

• Precision Radionuclide Therapy™ PRnT™: More localized radiation results in fewer side effects, which is crucial in sensitive areas.
• EBRT:Can cause widespread side effects due to its impact on both the tumor and surrounding tissues.

3. Effectiveness for Specific Cancers

• Precision Radionuclide Therapy™ PRnT™: Effective for cancers with specific markers or receptors.
• EBRT: Used for a wider range of cancers but may be limited by the risk of damaging healthy tissue.

4. Potential for Combination Therapy

• Precision Radionuclide Therapy™ PRnT™: Can be combined with other treatments, such as chemotherapy or surgery, to enhance effectiveness without significantly increasing toxicity.
• EBRT: Also used in combination therapies, but the added radiation burden can limit the extent of additional treatments.

5. Radiation Dose Control

• Precision Radionuclide Therapy™ PRnT™: Allows for controlled delivery of higher doses of radiation directly to the tumor, tailored to specific treatment needs.
• EBRT: Dose modulation is possible but involves complex planning and advanced technology to ensure concentration on the tumor while sparing healthy tissue.

In conclusion, targeted radiation therapy has four main advantages over external beam radiation.

1. Precision: Can focus on the tumor with millimeter accuracy, sparing healthy tissue.

2. Reduced Side Effects: Limits radiation exposure to healthy areas, minimizing side effects.

3. Efficiency: Delivers higher doses in often one session, reducing stress for pets and owners.

4. Accessibility: Targeted Radiation Therapy is a better option for equine cancer over External Beam Radiation which is challenging for equine cancer due to the size and anatomy of horses 

Targeted radiation therapy represents a significant advancement in veterinary oncology, offering a safer and more effective option for treating solid tumors in pets. By focusing on the tumor with high precision, it reduces side effects and improves outcomes, providing a better quality of life for our beloved animal companions.