NEW PATHS TO PROTON THERAPY

Advanced Oncotherapy CEO Nicolas Serandour provides an update on the development of the LIGHT proton therapy system

1 An artist's impression of the LIGHT proton therapy treatment room (IMAGE: ADVANCED ONCOTHERAPY)

For those who are not yet aware, what is proton therapy and the LIGHT system?

In the treatment of cancer with radiotherapy, radiation is largely delivered through X-rays, using photons. However, patients can often experience side e ects, as this method doesn’t discriminate between cells at di erent depths. This limits the ability of physicians to deliver enough radiation and kill the tumour. In contrast, proton therapy deposits most of the radiation at a particular depth within the body, which can be tuned to the tumour itself to preserve healthy tissue.

The development of the LIGHT system deals with one of the main problems historically in delivering proton therapy – the need for expensive and large infrastructure to house proton accelerators. The design of LIGHT avoids the large space and cost required, making proton therapy more accessible to patients.

Advanced Oncotherapy has grown tremendously over the past year, with more than 100 employees across three sites. How close is the company to obtaining regulatory approval for LIGHT?

Currently, we are in the process of assembling the di erent components of the machine at our assembly site in Daresbury, on the campus of a UK Government organisation called the Science and Technology Facilities Council (STFC). We are very much in the latter stages of completing the project, and our aim is to fi nalise the fi rst system by the beginning of 2021 for subsequent approval. This involves a rigorous regulatory process of

“Proton therapy doesn’t have to be reserved for a few ‘elite’ patients; it can be democratised and made much more widely available”

2 The facade of the Harley Street building that has been transformed internally to house the LIGHT system | 3 Part of the assembly site in Daresbury, on the campus of the Science and Technology Facilities Council (PHOTOS: ADVANCED ONCOTHERAPY)

verification and validation, and we are very fortunate to have a strong and experienced team to assist with this.

Advanced Oncotherapy unveiled significant partnerships recently. Could you tell us more about these?

We’re very proud and excited to install a LIGHT system at three di‹erent sites, two in the UK and one in Cyprus. These operators are outstanding institutions with superb track records across a range of therapies. These are the London Clinic in London, the University Hospitals Birmingham NHS Foundation Trust (UHB) in Birmingham and the Mediterranean Hospital of Limassol in Cyprus.

Beyond these installation projects, we have also established scientific partnerships with UHB and the Cleveland Clinic. Our research collaboration with the Cleveland Clinic will essentially assess the extent to which the much smaller proton beam of the LIGHT system benefits patients receiving treatment. Clear medical benefits of the system include the ability to adjust, at a very fast rate, the depth in the body at which radiation is deposited,

up to 200 times per second, as well as the significantly smaller size of the proton pulses that are damaging cancer cells. This o‹ers physicians many benefits, as it becomes easier to deliver a treatment that conforms better to the irregular shape of a tumour, and a lot more healthy tissue can be spared. This can be achieved if the size of the beam is much smaller – something called Mini Beam, which is 10 times smaller than those produced by legacy systems.

These collaborations further establish our network of scientific partners, positioning Advanced Oncotherapy at the forefront of clinical innovation. It not only strengthens our leading position as technology disruptor in proton therapy, but also demonstrates our strong momentum and the clear opportunity to address a significant unmet medical need. Being associated with such world-class names is a great recognition of all the work of our employees and scientists over many years.

Talking about the London Clinic, what progress has been made on construction of the Harley Street site?

The building was handed over to us last summer and we are now finalising the last step of the fit-out process. This reflects the fact that – together with the London Clinic – we have decided to treat patients in two separate rooms. To do so, the London Clinic has granted access to part of the neighbouring building that is on their premises. Usually, such a project consists of excavating a very large space in which the machine is situated, and then the entire facility is built around the machine.

The LIGHT system di‹ers in that it is compact and modular, which provides us with a great deal of flexibility during the installation. Each module can be transported through conventional lifting methods, as opposed to other projects that are based on legacy technologies.

What are Advanced Oncotherapy’s priorities for the year ahead?

There are huge opportunities to upgrade the LIGHT system to make it smaller, cheaper and with better medical features, but our priority at this stage is to finalise and complete the project. As we complete the verification and validation process, we will also be looking at broadening our commercial relationships with a number of hospitals and universities.

Also, we will continue to spread the word that proton therapy doesn’t have to be reserved for a few ‘elite’ patients; it can be democratised and made much more widely available. This is only possible with a new type of technology and a new accelerator. Such treatment should be for everyone.

Obviously, a project such as LIGHT is very costly. What is your vision for Advanced Oncotherapy’s future financing?

Setting up a proton therapy centre is expensive, not just in terms of the acquisition of the system itself, which forms a relatively small fraction of the overall cost, but also the cost of setting up the entire clinical site. Such expenditure can be a barrier to smaller hospitals and clinics, but our vision is to make setting up a proton therapy centre much more aŽordable and, by implication, reduce the cost per treatment.

In order to achieve this, city-centre healthcare centres need to be provided with a range of financing solutions, thereby avoiding the need for significant upfront investment from customers. At the same time, this allows Advanced Oncotherapy to accelerate production, to address more quickly the large unmet need and to create significant cost savings through economies of scale.

If we achieve this, then we can really democratise proton therapy. It is an absurd situation that, given all the benefits of proton therapy, there are currently only 90 centres worldwide that oŽer it, with approximately 230 treatment rooms.

Globally, there is a need for more than 10,000 treatment rooms, so, to bridge that gap, it is important to have not only the latest technology, but also the right financing tools and strategies for our customers.