These interviews highlight the depth and range of experience within Advanced Oncotherapy’s Board and Executive management teams. They also proffer insight into the goals, challenges and opportunities ahead in the commercialisation of LIGHT.

Following the new appointment at Advanced Oncotherapy Plc (LON:AVO) as Senior Independent Non-Executive Director, Mr Hans von Celsing talks about his past experience, the present and his thoughts on the future of the company.

Q: Hans, could you tell us about your experience in radiotherapy and how that relates to your role as an adviser to Advanced Oncotherapy?

A: I have spent most of my career in radiotherapy and have been involved in this market since the mid-80s. I joined Elekta in the early stages of its development and helped grow the business to a global radiotherapy company with a market capitalisation of 30 billion Swedish kroner. I was also involved in the development and promotion of the Gamma Knife, with the aim of creating radiotherapy systems for neurological indications with more accurate tumour targeting and in advanced imaging/3-D positioning systems.

Q: And in addition to Elekta?

A: I was also involved with Mevion at an early stage and helped it in its international development effort. Mevion technology was an important step in making proton therapy systems clinically affordable on a broader scale.

Q: So you have seen the full spectrum of radiotherapy applications and systems: from small start-ups to big corporations and from state-of-the-art radiotherapy systems with advanced treatment room facilities to one-room proton therapy systems?

A: That’s correct.

Q: So you must have seen a lot of changes and evolution in the field of radiotherapy?

A: Absolutely! When I started out in the 80’s, radiotherapy was not a favourable treatment choice. Patients treated by radiotherapy were generally very sick and were some of the worst cancer cases. Radiotherapy had many side effects and outcomes were often not that favourable.

Q: Why was this the case?

A: One of the biggest issues was accuracy of beam delivery and tumour targeting. The imaging systems and computing power used to deliver radiation beams to the tumour site were considerably less accurate by today’s standards. Excessive doses could be delivered to healthy surrounding tissue, with consequential and unwanted side effects.

I am pleased to say there have been many advances in beam targeting and improvements in this area will lead to more accurate dose delivery and improved patient outcomes. The LIGHT system has the potential to provide a further leap forward in the accuracy of tumour targeting.

Q: So Elekta, then Mevion, and now you’re helping Advanced Oncotherapy. Why AVO?

A: AVO and its LIGHT system is amazing technology and offer a great opportunity for the advancement of proton and particle therapy technology. AVO is developing a Linac–based (linear accelerator) proton therapy system; all other competing proton therapy systems use cyclotrons, synchrocyclotron or synchrotron accelerators. This group originated from physics laboratory experiments. A Linac system is designed specifically for medical use and lends itself extremely well to cancer therapy. I also see much of the excitement at AVO that I did when Elekta and Mevion were at similar stages of their development.

Q: So what are some of the key features of LIGHT?

A: One is the ability to electronically control the energy delivered to the tumour site. This energy can be changed rapidly both in terms of energy amount and energy positioning without the need for physical absorbers or other methods. The required dose can be delivered to the exact site many, many times per second.

LIGHT is also an integrated system. An all-in-one or integrated solution, which provides a system for beam production, treatment planning and accurate beam delivery reduces the risk of errors arising in interoperability between different systems. The treatment planning software and solution that is being developed is, I believe, state-of-the-art. It is simple and its one-touch, one-screen panel will enable radiotherapists and radiation oncologists to devise the best treatment solutions for their patients. The ability to serve multiple treatment rooms is another key feature; the LIGHT system can power up to five treatment rooms, thereby reducing the incremental cost for each room.

Q: Ok. So what’s the significance of this in relation to the potential take-up of LIGHT?

A: The economics of any treatment are critical in many healthcare decisions. It is also not just the incremental cost of each room which is relevant. By virtue of being linear, compact and modular, LIGHT lends itself to easier installation and, hence, lower building/installation costs.

Q: What do you think the future holds in store for Advanced Oncotherapy plc? What should they do next?

A: Essentially what they are already doing. Sticking to their plan of building their first machine, with first installation due at Harley Street, London, integrate imaging for adaptive therapy planning and to continue to generate interest globally for the LIGHT Proton Therapy system.

Michel Baelen, head of Regulatory Affairs at Advanced Oncotherapy plc (LON:AVO), talks about the attraction of joining AVO, his past roles and how this experience benefits the company, work done to date and Michel’s plans for regulatory and quality control going forward.

Q: Michel, what attracted you to join AVO?

A:The development of the proton beam therapy system LIGHT, with its innovative and clinically superior approach to the treatment of cancer.

Q: So how does the position fit to what you have done previously?

A: I have a background in electronic engineering and was responsible for IBA’s regulatory and quality assurance affairs for 19 years.

Q: Can you tell us what IBA is?

A: IBA is the current market leader in proton beam therapy. As well as working at IBA, I was previously head of the European Commissions’ industry association for medical devices and worked in a regulatory/quality capacity assurance at the IAEA (International Atomic Energy Agency).

Q: So how does your experience benefit AVO and its investors?

A: Having worked on both sides of the regulatory fence I know exactly what AVO must do to meet all regulatory and quality control requirements.

Q: In that regard, what have you been doing so far?

A:We’ve been in dialogue with the major regulatory bodies and have been working through what we, AVO, must do to ensure we meet their requirements in as efficient and timely manner as possible.

Q: Can we expect any newsflow to that effect?

A:Absolutely, although timing is difficult to predict; we have been very busy in this regard and hope to make announcements to this end.

Q: On the LIGHT system itself, can you tell us some of the key features that will differentiate it from its competitors?

A: From a safety perspective, the ability to monitor the exact nature of the proton beam and completely control its transmission i.e. if the beam needs to be shut off, we will be able to ensure the patient receives no dose at all. Another is to vary the energy of the beam and, accordingly, the dose the target tumour receives at very high frequencies, for more accurate tumour targeting.

Q: For any new technology with the potential to disrupt a market, there must be risks associated with the realisation of that technology?

A:The development of LIGHT will be a process and there are challenges ahead. For example, the accelerating modules will contain a vacuum at much lower pressure than is present in existing radiotherapy systems. In addition, the ability to vary the energy of the proton beam with every pulse requires highly sophisticated and robust software control and management.

Q: Are there any other key safety USPs?

A:Yes, the LIGHT system will not suffer from comparable proton losses and, as a result, will not irradiate and physically/chemically alter, otherwise known as activate, the shielding and surrounding materials that any radiotherapy system is housed in. For example, the decommissioning costs of non-Linac proton accelerators can be up to three times as high as the initial cost. So that can be a major headache for hospitals and clinics; LIGHT is the only proton therapy system using a linear particle accelerator.

Q: And given the potential hurdles inherent in LIGHT’s development, what is AVO doing to manage and overcome those risks?

A: Two key approaches adopted by Advanced Oncotherapy have been to hire industry experts, in all relevant fields, and to partner market leading companies, such as Thales. For example, Thales, which will mass produce LIGHT for AVO, has already demonstrated its ability to create a vacuum at the required level that I previously referred to. We have also hired an expert in safety-critical software from Airbus, a market leader in another industry where it is absolutely essential that software, and the systems that that software controls, perform precisely as required.

Q: Is there anything else you’d like to highlight?

A: Just that we, AVO, are doing everything we can to ensure we clear all regulatory and quality control hurdles in all major markets and with all relevant bodies, globally. Michel, thank you for your time.