The University of Missouri Research Reactor (MURR) recently shipped its first batch of a medical isotope used to diagnose and treat thyroid cancer, making it the first domestic source of Iodine-131 (I-131) in 30 years.
I-131 has only an eight-day half-life, making stockpiling impossible, and demand is expected to increase. Thyroid cancer is “the most rapidly increasing cancer in the U.S.,” with diagnoses tripling in the last three decades, according to the American Cancer Society. The National Cancer Institute expects 53,990 new cases of thyroid cancer in the U.S. in 2018 with an estimated 2,060 deaths from the disease.
I-131 sodium iodide became the first FDA-approved radiopharmaceutical in 1951 and is one of the most widely used radiopharmaceuticals in the United States. The isotope’s unique properties enable both diagnostic imaging and treatment of cancer and hyperthyroidism. Since the thyroid gland naturally absorbs iodine, I‑131 can be targeted directly to thyroid tumors to remove cancerous tissue and treat the disease.
MURR is one of only a handful of research reactors around the world that supply I-131 to drug manufacturers who, in turn, supply radiopharmaceuticals for distribution to hospitals and patients.CentiChem was the last U.S supplier of I-131 but ceased production in the 1980s, according to David Robertson, executive director of MURR.
The only other North American supplier was in Canada – the NRU reactor – which closed at the end of March. Following the shutdown of the NRU facility, two other reactors experienced temporary shutdowns, which further affected the supply of I-131.
“If MURR had not entered the market this summer, patients would have gone without scheduled treatments,” Robertson said in an email to Medical Design & Outsourcing. “Supplying I‑131 is part of a strategic initiative by the University of Missouri and MURR to address medical isotope shortages and further the university’s research mission.”
The university produces approximately 100 Ci of I-131 per week and began shipping in late July.
“Having MURR as a domestic producer for I-131 provides a much higher level of stability and reliability in the U.S. for this important isotope,” said Steve Laflin, president & CEO of International Isotopes, Inc. (INIS), in a prepared statement. “INIS has been supplying I-131 throughout the U.S. for nearly 15 years using only foreign sources of supply. We are pleased to have an opportunity to enter into a long-term supply agreement, and INIS plans to utilize MURR as one of our major suppliers for I-131 in the future.”
Another potential domestic source of I-131, Shine Medical Technologies (Janesville, Wis.), expects to begin production of the medical isotope in 2021 or shortly thereafter.