Kidney and prostate cancer, two new radiopharmaceuticals under study to improve diagnosis

A phase 1 clinical trial for two new radiopharmaceuticals is about to start at the San Raffaele Hospital in Milan (one of the centers of excellence for urology): OncoAcp3 and OncoCaix. The two molecules are designed to improve the diagnostic specificity and characterization of prostate cancer and renal lesions suspicious for clear cell carcinoma, respectively. It will be a multicenter study, which will also see the participation of the National Cancer Institute of Milan and the Asst Papa Giovanni XXIII of Bergamo (also one of the centers of excellence for urology).

What is a radiopharmaceutical?

But what exactly are radiopharmaceuticals? They are molecules that contain a radioactive atom, also called a radionuclide, used mainly in the oncology field, both for diagnostic and therapeutic purposes.

In general, radiopharmaceuticals have two components: a part that serves to direct them towards the organ or tissue of interest, and then the radioactive part. The latter emits a certain type of radiation (alpha, beta or gamma), which allows to determine their position inside the organism with the use of specific instruments. In the case of diagnostics, therefore, radiopharmaceuticals essentially serve to precisely locate the tumor or lesion of interest.

When used for therapeutic purposes, however, the so-called carrier component serves to transport the radiopharmaceutical into or near the tumor, so that the radiation emitted by the radionuclide can specifically target the cancer cells.

Clear cell renal cell carcinoma

As anticipated, the two molecules are designed to “recognize” clear cell renal cell carcinoma and prostate cancer. The first is the most common form of renal cancer, representing approximately 70-80% of cases. This type of neoplasia generally originates silently, without symptoms in the initial stages, and is often discovered by chance during investigations carried out for other reasons.

In the case of suspicious renal lesions, the current diagnostic process is often complicated: renal biopsy, although theoretically useful, is rarely performed due to the risk of bleeding and the difficulty of histological interpretation. For this reason, surgery is frequently resorted to as a precaution, with nephrectomy interventions even in cases where the lesion may not be malignant.

“The introduction of a highly specific radiopharmaceutical such as OncoCaix could offer a valid non-invasive alternative in the diagnosis of renal lesions. This approach would allow us to distinguish benign lesions from malignant ones with greater precision, significantly reducing the need for surgery, especially in cases where it is not strictly necessary,” explains Arturo Chiti , director of the Nuclear Medicine Unit at San Raffaele and professor of Diagnostic Imaging and Radiotherapy at the Vita-Salute San Raffaele University.

Prostate cancer

As for prostate cancer, which is the most common neoplasm among men in Italy, in most cases it is a slow-growing and localized form, but a significant portion evolves into metastatic forms, an advanced stage in which the disease progresses despite hormone therapy. According to Chiti, OncoAcp3 could improve the precision of diagnostic images, potentially allowing for more targeted and personalized treatments.

“We expect these molecules to be more efficient than standard ones, not only for diagnostic precision, but also for a possible therapeutic approach - adds the expert - In line with other clinical applications, in fact, it is possible to adopt a theranostic approach, which allows to modify the radioactivity of the molecule used for the diagnosis, transforming it into a therapeutic tool. This would mean not only a better diagnosis, with a better characterization, but also a more effective and customizable therapy, with a significant direct impact on the quality of life of patients”.

How to participate in the study

The study is currently enrolling at San Raffaele. Eligible patients, with suspected renal lesions or a diagnosis of prostate cancer, may undergo the diagnostic test (Pet/Tc) with standard radiopharmaceuticals, which may be followed, on a voluntary basis, by the administration of the new experimental molecule. San Raffaele emphasizes that the trial is expected to last slightly longer in the Pet/Tc machine. To receive more information or express your interest in participating, you can write to the e-mail address: [email protected]