War in Ukraine blocks supply of rare cancer treatment molecule

 – Gudstory

War in Ukraine blocks supply of rare cancer treatment molecule – Gudstory

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New Delhi: The war in Ukraine has halted imports of key radioactive isotopes used in advanced cancer treatments, prompting the country’s top medical institutions to look for less effective alternatives.

Dr CS Bal, head of the department of nuclear medicine at the All India Institute of Medical Sciences (AIIMS), New Delhi, said there has been no import of actinium-225 for more than a year, which used to come from Russia via Germany. Although actinium-225 is found in nature, separating it from other isotopes and obtaining a large pure quantity requires nuclear facilities and technology.

“Actinium has not been available for the last one year since the war between Russia and Ukraine started. Russia is the center of the world’s radionuclides. Unfortunately, Russia got the raw materials, but not the final product. It is bought by Germany and from there it is sent to all other countries including India.” Radionuclides, also called radioactive materials, emit radiation because they have extra neutrons or protons in their atomic nuclei.

In the pediatric department, actinium-225 is used in theranostics, a radioactive drug used to diagnose and provide therapy to treat tumors. The word is a combination of therapeutic and diagnostic.

Since actinium is not available in India, AIIMS Delhi is using other, less effective molecules. The institute has a heavy burden of patients requiring theranostics, and the department selects patients with the highest priority.

The disappearance of actinium-225 is significant given that the cancer burden in India is the third highest in the world after China and the US, and the unavailability of the molecule could impact treatment strategies. Earlier this year, the Indian Council of Medical Research had said the number of cancer cases in the country could rise from 1.46 million in 2022 to 1.57 million in 2025. In India, common cancer cases are lung, breast, cervical, colon and prostate.

Many private hospitals in India also provide theranostics for cancer treatment. One of them is Indraprastha Apollo of New Delhi.

“Actinium-225 is an alpha particle emitter. Currently, we are using lutetium-177 which is a beta emitter. An alpha emitter has both mass and charge and can dissipate a lot of energy in a small area. “They have good potential but they are expensive,” said Dr Dipanjan Panda, senior consultant and medical oncologist, Indraprastha Apollo.

Questions emailed to the health ministry spokesperson on December 18 remained unanswered.

Dr Bal said, AIIMS will have to treat patients with “whatever is available”. “We cannot send patients back. There is huge demand for theranostics. It was introduced in India much before it was introduced in the US. We have also received requests from US residents to get treated at AIIMS as it has not yet been introduced in the US. has not been approved by the FDA. The currently available option is from Bhabha Atomic Research Center (BARC), which is of lower quality, only 20% effective than ours. Getting it from Germany was 100% effective,” said Dr. Baal said.

“The therapy dosage includes lutetium and actinium which are radionuclides that target a specific area of ​​the tumor cell and attach and serve their purpose. There is no additional effect on the body. What we are importing from other countries is in very small quantity, which is not as per the requirement of India. The therapy has to be given in four doses every eight weeks and the entire course costs approximately 23 lakhs. Dr Bal said, poor patients at AIIMS are provided free treatment with the funds received as part of research grants from ICMR.

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Published: Dec 19, 2023, 11:12 pm IST

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