How Norway will remain a leader in radiopharmaceuticals

- We owe a lot to serial entrepreneurs Roy Larsen and Øyvind Bruland, says Hilde Nebb, Director of the Growth House for Value Creation at the University of Oslo.

Thanks to the nuclear chemist and medical professor, international pharmaceutical companies have made significant investments in the Oslo area.

- More than 25 years ago, they began developing the targeted radioactive drug alfaradin, today known as Xofigo - specially designed for patients with metastatic prostate cancer. They later established the startup company Algeta, which was acquired by Bayer for 17.6 billion NOK. The Algeta invention has meant a lot for Oslo. It has sparked ripple effects for the basic research communities at the University of Oslo (UiO) and Oslo University Hospital (OUS). Not least, it has put Oslo on the global map within radiopharmacy, said Nebb.

Why is Norway successful?

She was one of many speakers when UiO:Life Science and Oslo Science City invited to a breakfast meeting about radioactive medicines at Domus Bibliotheca on Wednesday morning.

- So why is Oslo especially well positioned in radioligand therapy? It is a complete value chain with research, education, clinics, startups, and industry in a unique ecosystem, she said.

This ecosystem and its unique story were highlighted by all speakers. Key players such as Oslo Science Park, OCC Innovation Park and Oslo Science City bring together business clusters, research environments and global companies in one place, ensuring direct contact between ideas, development and commercialization. The University of Oslo (UiO) has invested in a unique scientific infrastructure, attractive study programs and interdisciplinary collaboration, including pharmacy, nuclear chemistry, artificial intelligence and quantum technology. Together, this environment enables us to compete at the very forefront internationally.

The source of many startups and pharmaceutical companies

Hanne Harbo, Dean of the Faculty of Medicine at UiO, mentioned a number of companies that have either sprung from radiopharmacy research or have taken it further.

- The Norwegian Medical Cyclotron Center is a collaboration between the hospitals and UiO, and GE Healthcare is a very important partner there. Agilera (spun out from IFE) is called a kind of pharmacy for nuclear medicine products while also making a significant contribution to research, and GE contributes to the development of PET diagnostics. This fantastic collaboration is the reason we can sit here and discuss this area as a very important player. It is collaboration that matters, said Harbo.

Other examples of Norwegian companies investing in radiopharmacy include Thor Medical, Oncoinvent, Actithera, NucliThera, Node Pharma and Artbio.

Competition is intensifying - Norway must not rest

But competition from outside is intensifying, and if we are to retain our lead in the field -and have a chance to create both jobs, export income, and other value creation - several speakers were clear: now is the time to act. Among them was Håvar Gausemel at Bayer.

- The advantage we have in Norway in this field - the good environment - must not be used as a resting pillow; we must work to further develop it and make sure we use it as best we can. What has previously been a challenge has been access to these radioactive materials, but that is now starting to change. Competition is increasing, so now we really have the opportunity to take charge of this, said Gausemel.

Endless opportunities for new treatments

Caroline Stokke is among the best-known names in the field in Norway. She is a researcher, section leader, and associate professor at UiO and OUS, and the head of the dosimetry committee in the European Association of Nuclear Medicine.

- Especially in the last 10 years, a lot has happened in this field. Many therapies have been tested over the years, though not all have reached the clinic yet. So far, 72 different radionuclides have been proposed for radionuclide therapy, and 18 different molecular targets have been suggested. This results in a total of 1,296 combinations. In addition, there are 922 suitable radionuclides and perhaps around 1,000 different targets, so we have a very large potential and opportunity space. As long as we have the right combination of radionuclide and targeting molecule, we can treat almost anything, says Stokke.

Major players are investing in Norway

Both GE and Bayer are investing in Norway, as are several competitors.

- Radiopharmacy currently constitutes about one-third of Bayer's oncology investment, and studies in this field are being conducted from our environment in Oslo, says Thomas Eden Jensen, Head of External Supply Management at Bayer.

- At our Centre of Excellence for Radiopharmaceuticals at Lysaker and Kjeller, we are around 100 people working on research, development, production and supply of medicines. We are also working with a number of contract manufacturers (CDMOs), such as Agilera, and with companies in the USA and Germany. We are investing heavily in this to remain competitive. We are now seeing that many other large pharmaceutical companies are also investing in radiopharmacy, including Novartis, AstraZeneca, Lilly, and Bristol Myers Squibb (BMS). For us, it is important that we have good cooperation with the rest of the ecosystem in Norway; I think we have a huge advantage because we are located in Europe, says Jensen.

Evy Stavik, Global Head of CMC Development at GE Healthcare, says they are also investing in Norway.

- We have 11,000 employees in Norway, and every four seconds, patients worldwide receive a product from us. Much of that comes from innovation in Norway. We are about 150 employees working on innovation of new products, and some of that is radiopharmacy. Diagnostics, and possibly also therapy, we will see. Norway is an important field for us, says Stavik.

Carl Henrik Gørbitz, Director at UiO:Life Science, summed it up like this:

- No one can be world champions in everything, so we must focus on where we are strong. For Norway, that is - among other things - radiopharmacy.

History:

The element radium was discovered by Pierre and Marie Curie in Paris in 1898. They named it after the rays (Latin: radii) of soft blue light that surrounded the metal in dark rooms. There are three naturally occurring isotopes of radium: radium-223, radium-224, and radium-226.

Radium Hospital in Oslo is named after this element. Radioactive radiation therapy was the most common way to treat cancer in the early 1900s and was the direct reason why Radium Hospital was built in 1932. At that time, Radium-226 was used for radiation therapy. Nearly half of all cancer patients still receive radiation therapy as part of their cancer treatment, but not with radium-226. Radium-223 is used in the cancer medicine Xofigo, which Bruland and Larsen, Algeta, and Bayer have developed.

Terms:

Theranostics: Combination of therapy (treatment) and diagnostics.

Radiopharmacy and Radiotherapy: Both are applications of radioactivity in medicine, but are used differently: radiopharmacy involves the use of radioactive medicines for both diagnosis and targeted treatment, while radiotherapy (radiation therapy) is an external treatment method that uses high-energy rays to destroy cancer cells.

Radioligand Therapy: Precision treatment using radioactivity to directly target cancer cells. It works by attaching a radioactive substance (radionuclide) to a molecule (ligand) that binds to specific markers on cancer cells. When the ligand binds, it delivers the radioactive radiation directly into the cancer cell to kill it, with minimal damage to healthy tissue

The text was translated from Norwegian using  Perplexity and quality checked and edited by Eline Feiring.