The buzz around proton therapy this week at the 57th annual meeting of the American Society of Radiation Oncology (ASTRO) may indicate that the treatment is becoming a more viable option for patients and providers alike. 

While companies like IBA, Hitachi, Mevion, and Varian are currently enjoying the largest installation base, other companies are waiting in the wings to make their own impact on the market.

P-Cure is one such company, and it was at the meeting to promote a unique proton therapy solution that utilizes a moving chair instead of a gantry in order to maneuver the beam around the target. Michael Marash, CEO of P-Cure, told HCB News he believes this innovation may break down some of the fundamental cost hurdles that have historically made proton therapy prohibitively expensive.

Unlike radiation, which may depend on arc therapy approaches requiring a range of different directions, proton therapy usually only requires two to three different angles — so moving the patient instead of the beam itself represents a novel opportunity to cut costs. "The company that builds its expertise in X-ray and tries to replicate that technology for protons, they can miss the point," said Marash.

"Still, some flexibility on the beam is needed," he added. By merging pencil beam scanning and better imaging and adaptive therapy on the patient side, P-Cure believes it has largely met that need.

For treating prostate cancer, the P-Cure solution utilizes a table instead of a chair, meaning there are no parts moving while the beam is on. "Many proton centers already treat prostate with a fixed beam rather than setting the gantry," said Marash.

The P-Cure system will be commercialized "very soon" and is anticipated to cost roughly half as much as other compact proton solutions. According to Marash, the price of today's single room-proton solutions are essentially the same, per-room, as their larger counterparts.

"Single-room solutions have not brought down the cost per room of a full center," said Marash. "If the system costs $25 million and you need $15 million for construction, and then you also need your imaging equipment — you're up to $45 or $50 million. If you multiply that by four [rooms], then you're up to $200 million" — the ballpark price tag of many larger facilities.

The P-Cure solution will slash that price, according to Marash, in part because it requires no gantry and also because the footprint of the system is "like the current, bigger, linac bunkers with the inner space of 100+ square meters, including everything."

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