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Indonesia: Digital Radiopharmaceuticals for Cancer Care

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The National Research and Innovation Agency (BRIN), in collaboration with the PET Imaging Centre at the University Hospital of Northern Norway (PET IC UNN), is harnessing advanced digital technology to develop a fibroblast-activated protein inhibitor (FAPI). This cutting-edge radioligand holds significant promise for improving cancer diagnosis and therapy.

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The collaboration sees BRIN focusing on the synthesis of FAPI ligands, leveraging their expertise in radiopharmaceutical research. Norway, on the other hand, will conduct in-vitro and in-vivo imaging, utilising their advanced molecular imaging technology.

According to PRTRRB BRIN Research Associate Expert Rien Ritawidya, this initiative is part of a broader effort to reduce cancer morbidity and mortality through a comprehensive national cancer control programme. This programme includes prevention, early detection, diagnosis, and appropriate treatment of cancer, recognising the critical role of early intervention in improving patient outcomes.

Early detection and diagnosis are essential components in the fight against cancer. Protein activation in fibroblast activating protein (FAP) represents a critical target for cancer diagnosis and therapy. Numerous imaging agents targeting FAP are currently in clinical trial stages. For instance, FAPI-46 has demonstrated an increased tumour-to-background ratio, significantly enhancing the quality of imaging.

The collaboration aims to develop various types of FAPI that could be further optimised as theranostic agents, combining therapeutic and diagnostic capabilities. Radioligands, which are radioactively labelled drugs, can target specific receptors, transporters, enzymes, or proteins within the body. This precision targeting allows for highly accurate imaging and treatment of cancer. Clinical trials have shown that FAPI exhibits high uptake in various types of cancer, including gastrointestinal tumours, liver tumours, breast tumours, nasopharyngeal cancer, and bone cancer.

Positron emission tomography (PET) is a cornerstone technology in this research. PET provides detailed molecular imaging, producing comprehensive visualisations that combine functional and structural information about tumors. This advanced imaging technology is crucial for initial diagnosis, treatment evaluation, prognosis, and relapse detection.

The concept of theranostic systems, which apply diagnostic imaging tools to identify specific molecular targets, is central to this research. These systems enable the selection of personalised treatments based on detailed imaging data, ensuring that patients receive the most effective therapy for their specific cancer type.

Through this collaboration, BRIN can learn to use various radioisotopes available in Norway, such as 68Ga and other PET radionuclides. This knowledge transfer can lead to new breakthroughs in the use of radionuclide types for radiopharmaceuticals in Indonesia.

UNN Norway Senior PET IC Researcher, Mathias Kranz, expressed optimism about the potential of FAPI development to initiate broader cooperation between BRIN and UNN. This collaboration represents a significant step forward in utilising advanced digital technology for cancer diagnosis and therapy. By combining the expertise and resources of BRIN and PET-IC UNN, this partnership aims to achieve significant improvements in patient outcomes and advancements in radiopharmaceuticals. The integration of molecular imaging techniques with cutting-edge radiopharmaceutical research holds great promise for the future of cancer treatment, offering new hope to patients worldwide.

Moreover, the incorporation of theranostic systems marks a significant technological advancement. Theranostics combines therapy and diagnostics, using specific imaging agents to identify molecular targets and subsequently delivering targeted treatments. This approach ensures that treatments are tailored to the individual characteristics of each patient’s cancer, potentially improving outcomes and reducing side effects.

The collaboration between BRIN and PET-IC UNN is envisioned to generate valuable data on the effectiveness of various FAPI ligands. This data will be instrumental in optimising these ligands as theranostic agents. The use of radioisotopes like 68Ga, which are not yet widely developed in Indonesia, represents a significant technological leap. By adopting these advanced radioisotopes, Indonesia can enhance its capabilities in radiopharmaceuticals, paving the way for new treatments and diagnostic tools.


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