Experimental 'radiation missile' therapy offers hope to children with hard-to-treat cancers

Some children continue to see their cancer progress despite repeated rounds of chemotherapy, radiation therapy, also known as radiotherapy, or stem cell transplants. With few treatment options remaining, their families can do little more than watch their loved one’s condition worsen.

But researchers in Korea are now testing a treatment that could offer hope to those pediatric patients.

Since February 2024, Seoul National University Hospital (SNUH) has been working with Samsung Medical Center and other institutions on a study of personalized radiotherapy — specifically radiopharmaceutical therapy — for children with treatment-resistant solid tumors. The project is part of SNUH’s Pediatric Cancer and Rare Disease Project Group, funded by donations from the Lee Kun-Hee Foundation.

In 2021, the family of the late Samsung Chairman Lee Kun-hee donated 300 billion won ($193.1 million) to SNUH to support children with cancer and rare diseases.

The program aims to provide a new treatment option for children whose cancer has either returned or failed to respond to conventional therapies.

Patients typically undergo one of two types of radiotherapy: external beam radiotherapy, which requires a radiation machine, or internal radiotherapy, which places radioactive material inside the body through an implant or a liquid in an injectable or pill form. 

With the experimental radiopharmaceutical treatment, patients are injected with a drug that seeks out and delivers radiation directly to cancer cells. The drug combines a radioactive isotope with a molecule designed to bind to cancer cells.

“[The experimental treatment] is like a radiation missile targeting cancer cells,” said Suh Min-seok, a professor of nuclear medicine at SNUH.

The study primarily focuses on children with neuroblastoma, a cancer that develops when immature nerve cells become cancerous. Although treatment outcomes have improved over the years, some children’s cancer returns or metastasizes despite multiple rounds of treatment.

“We began this research by asking what we could do for the patients who had run out of options,” said Suh.

Treatment begins with a PET-CT scan to determine whether the patient’s cancer cells are likely to respond to the drug. If the scan clearly identifies the target, doctors administer the experimental injection.

Since 2024, the research team has administered nine rounds of treatment to five children with returned or treatment-resistant solid tumors. None of the patients’ diseases have progressed, and the children themselves remain in stable condition.

The treatment is provided after receiving individual compassionate-use approval from the Ministry of Food and Drug Safety.

A Korean pharmaceutical company imports the radioactive isotope and manufactures the drug. The Lee Kun-Hee Foundation covers the treatment costs and has spared families nearly 10 million won in treatment costs per session.

“The donation reduced the financial burden on patients and allowed us to study whether this treatment could be applied to pediatric patients, who are often overlooked in research simply because there are fewer of them than there are adult patients,” said Suh. “As medical professionals, we’re truly grateful.”

However, researchers caution that it is still too early to draw conclusions about the therapy’s effectiveness.

The treatment is not intended to cure the disease completely. Instead, researchers are evaluating whether it can slow the progression in children who have exhausted other treatment options.

Medical experts say that the project’s significance lies in establishing a pathway to bring this treatment to pediatric patients in Korea.

Hospitals have successfully taken responsibility for the entire experimental treatment process, from selecting eligible patients, obtaining compassionate-use approval, coordinating hospital admissions and evaluating patients after treatment to even manufacturing and supplying the drug. This precedent can pave the way for future treatments of pediatric cancer patients.

BY RHEE ESTHER [[email protected]]