ROAD MAP PILOT PROJECT PENGEMBANGAN INDUSTRI OBAT
Transcription
ROAD MAP PILOT PROJECT PENGEMBANGAN INDUSTRI OBAT
ROAD MAP PILOT PROJECT PENGEMBANGAN INDUSTRI OBAT KANKER BERBASIS POTENSI SUMBER DAYA INDUSTRI LOKAL Disampaikan oleh :Konsorsium INSINAS BNCT Prof. Ir. Yohannes Sardjono, Ir. Slamet Santosa, M.Sc., Drs. Widarto Prof. Edy Meiyanto, Apt., Dr. Bagaswoto P, Sp.KN.(Rad), Dr. Wigati, Sp. Rad.Onk Drs. M. Wahyuli Syafari, Apt. Dr. Dede Anwar Musadad & Drs. Ahi, MT. Para Peneliti dan Dosen Berkompetensi Fisika Medis, Farmasi, Kedokteran, Biologi Radiasi, Kimia Radiasi, I&C, Mekanik. Di JOGLOSEMARTOGO BALITAN Prof. Koji Ono - Kyoto Univ. Dikawal intensif: Dir. POPB BPOM – Dra. Nurma Hidayati, M.Epid. Dir. PKKR BAPETEN – Dr. Yus Rusdian A, Institusi Pelaksana: Pusat Sains dan Teknologi Akselerator -BATAN BATAN [PSTA, PTRR PTKMR, PRFN, PDK ,PSJMN] FK [UGM,UII,UNTAN], F.FARMASI [UGM+UII] KEMENPERIN PT. KIMIA FISIKA FMIPA &FST & FARMA Tbk FT[UGM, UNY, UKSW, (BUMN) UIN, UNS, UNSOED, BALITBANGKES RSUP SARDJITO UNNES, UNUD] T.MESIN (BLU) BPOM, BAPETEN FT UNY RS PEND UNTAN & RSUD SUDARSO PMPROV KALBAR IAEA Technical Meeting on Research Reactor Users' Networks (RRUNs): advances in neutron therapy, Johanes Berg University, Minz Germany, July 1- 4, 2013 INTERNATIONAL CONFERENCE THE APPLICATION OF NUCLEAR TECHNOLOGY FOR NATIONAL SUSTAINABLE DEVELOPMENT : HEALTH, AGRICULTURE, ENERGY, INDUSTRY & ENVIRONMENT UKSW CENTRE OF JAVA INDONESIA, SEPT . 21-22, 2015 Calculation of estimate Potential Loss (from existing RT Department patients) 12.106 pats Reported new treatments in 2012 from 22 centers in Indonesia (15% from estimated need) 250 million Population 1 million Cancer patients 4.3/ 1000 52.3% Cancer prevalence Need to be irradiated 500.000 pats Need to be irradiated US$ ???? ………. Countable and uncountable Jumlah kunjungan pasien dari Indonesia rata-rata mencapai 1000 pasien per bulan dari 5 agen di Kalimantan Barat Terutama penyakit kronis seperti kanker Road Map of Prototype BNCT 2019 : 2018 : 2017 : - Setup dan uji komponen 2016 : - Pengadaan Prototype Alat Kesehatan (komponen Cyclotron dan Compact Neutron Generator) 2015 : Set up project management : - Dokumen perijinan dan sistem pengujian - Dokumen DED - Dokumen QA and QC - Dokumen kontrak dan kerja sama - Pengadaan Prototype Produksi Obat Baru Boron Compound Pharmaceutical Berbasis Analog Curcumin - Setup dan uji integrasi komponen - Komisioning Prototype Alat Kesehatan (Cyclotron dan Compact Neutron Generator) - Komisioning Prototype Produksi Obat Baru Boron Compound Pharmaceutical Berbasis Analog Curcumin - Pengoperasian Prototype Alat Kesehatan (Cyclotron dan Compact Neutron Generator) - Pengoperasian Prototype Produksi Obat Baru Boron Compound Pharmaceutical Berbasis Analog Curcumin - Uji pre-Klinis dan klinis - Uji Coba Sistem Prototype Alat Kesehatan (Cyclotron dan Compact Neutron Generator) untuk Terapi Kanker - Uji Coba Sistem Prototype Produksi Obat Baru Boron Compound Pharmaceutical Berbasis Analog Curcumin untuk Terapi Kanker -Test kesesuaian komponen (perbedaan penerimaan dan pengiriman) - SDM (training dan studi banding) Badan Tenaga Nuklir Nasional 1/28/2015 6 Outline Introduction Road Map Basic Principle & Conceptual Design Detail Engineering Design & Manufacture [Prototype Boron Carrying Pharmaceutical sebagai Obat baru] Summary Introduction Analisis Lingkungan Strategis Badan Tenaga Nuklir Nasional 1/28/2015 9 Cancer Projection in The World until 2030 12,7 million cases of cancer 2008 14,09 million cases of cancer 2012 22 million cases of cancer 2030 (World Health Organization, 2012) Cancer in Indonesia 7,44 % 8,06 % 9,66 % Brain and Nervous system Incidence: 4903 (1,6 %) (Oemiati et al, 2011) Mortality : 3402 (1,7 %) RADIOTHERAPY CENTER IN INDONESIA 2014 Government hospital Private hospital •Total : •29 radiotherapy center (21 government, 8 private) •43 radiotherapy equipment (25 Linac, 17 Cobalt, 1 GKS) Waiting list of RT Services in Indonesia 43.309.707 11.331.558 14.946.488 4.211.532 121.352.608 11.112.702 SEMARANG 12 months, SURABAYA 03 months, YOGYAKARTA 06 months, JAKARTA 06 weeks CAKUPAN RADIOTERAPI RSCM: Rujukan Nasional 0.5% 0.7% 3% 3% 0.5% 3.2% 0.2% 11% 27% 1.8% 0.2%0.7% 0.5% 0.5% 36% • • • Jumlah pend. DKI (2012): 9.761.407 juta jiwa 1 Jumlah alat radiasi : 13 TT : Pop = 1 : 750rb Data RSCM – Jumlah pasien th 2012 : 2.101 org – Jumlah pasien asal JKT hanya 766 (36,5%) – Sisanya 63.5% rujukan luar Jakarta EXISTING RADIOTHERAPY PATIENTS REFERAL SERVICES 13 RT equipment for 9.7 million population But ………… 63.5 % of our patient come from outside of Jakarta Introduction (Cancer cell) Cancer Cell (Anonim, 2009) Treatment Surgery Radiotherapy Brachitherapy Chemoterapy BNCT RRs and their applications world-wide (RRDB) Application Number of RR involved Involved / Operational, % Number of countries Education & Training 161 67 51 Neutron Activation Analysis 122 51 54 Radioisotope production 90 37 44 Neutron radiography 68 28 40 Material/fuel testing 60 25 25 Neutron scattering 48 21 32 Nuclear Data Measurements 42 18 20 Gem coloration 36 15 22 Si doping 35 15 22 Geochronology 26 11 21 Neutron Therapy (BNCT) 23 8 13 Other 95 40 29 Indonesia is no. 14 in the world Contact: 19 D.Ridikas@iaea.org INTRODUCTION Boron Neutron Capture Therapy Medical patient was injected by boron compound before exposing Neutron thermal will be captured by Boron on cancer cell and selectively irradiate cancer cells that have taken up a sufficient amount of Boron and simultaneously spare normal cells The products of this reaction have high linear energy transfer characteristics (α particle = 150 keV/µm, Lithium-7 = 175 keV/µm ) Alpha Radiations will destruct the cancer cell without hurt another healthy tissues Road Map of R&D Strategic Plan Hilirisasi Produk Litbang BNCT Badan Tenaga Nuklir Nasional 1/28/2015 22 Struktur Organisasi Konsorsium BNCT Badan Tenaga Nuklir Nasional 1/28/2015 23 SRUCTURE ORGANISATION 0F PILOT PROJECT Basic Principle & Conceptual Design Conceptual Design of Collimator Computer Code (Bassler, 2013) The collimator can be design with simulation. MCNP is the most computer code that used to calculated particle transport. So, we can made collimator design using MCNP5 simulation. DESIGN NEUTRON SOURCE BNCT I A E A - R e q u i re m e n t Targeted Cells in deep area need neutron thermal to be captured by boron. Hence, its required epithermal neutron to accomodate moderation Beam effect Intensity Beam Quality If the beam intensity is less than required, exposing timing can be extended. it makes the others beam quality component values increasing. For that reason, beam quality is provided in ratio with epithermal comparison Kartini Nuclear Reactor as Neutron Source for BNCT Reactor Core 15 cm (Part 1) 117 cm 19 cm (Part 2) 156 cm PART OF COLLIMATOR For Boron Neutron Capture Therapy 1. Collimator Wall 3. Thermal Filter 5. Aperture (Output) 2. Moderator 4. Gamma Shielding 1. To keep the neutron flux stay high 2. To reduce the fast neutron and Contribute epithermal neutron (Shifting Methode) 3. To Absorb thermal neutron (Filtering Methode) 4. To Attenuate Gamma Ray 5. To Control beam Convergenity Summary of Collimator Components Mechanical Engineering UNY Partnership Recommendation material Collimator Part Best Availability Collimator Wall Pb, Bi, PbF2 , Ni Ni (95 %) Moderator Al, Al2O3, dan AlF3 Al 1350 (99.5 %) Gamma Shield Pb, Bi Pb Filter 6Li x , 10B , 60Ni - Aperture Pb, Bi, PbF2 , Ni Ni (95 %) Additional Safety Control Boral Boral Some material is unavailable in indonesia, especially the pure version. In this case, we use another material with impurity that can subtitute the pure versi COMPONENTS Optimation material and thickness Material Impurity FluksFluks neutron epitermal Vs Collimator wall thicknesswall of σa barn Isotop (NA) epitermal Percentage neutron Vs Collimator 58Ni (68.07%) , 60Ni (26.23%), variation material thickness of Ni 95% Unsure Ni – nat 4.5 3 Mn - 55 2.5 3.5 61Ni Fe - nat Si - nat Cu - nat C - nat Ti – nat 2) 2x) 10 9 9 Φepi (n/cm x 10 Φ epi(n/cm 4 32 2.5 1.5 2 1.51 1 0.5 0.5 00 46Ti 00 -0.5 -0.5 (1.14 %), 62Ni (3.64%), 64Ni (0.926%), 55Mn (100%), 54Fe (5.8%) , 56Fe (91.72%), 57Fe (2.2 %), 58Fe (0.28%), 28Si 12C 4.619 1.5 13.4118 1 2.585 Pb (92.23%) , 29Si (4.67%), 30Si (3.1 %), 64Cu 95 Bi 0.5 0.1691 (69.15%), Cu (30.9%) 1 Ni 4.4678 (98.9%), 13C (1.1%) 0.5 0.0034 (8.0%), 47Ti (7.3%), 48Ti (73.8%), 0.5 1 1 1.5 50 3 0.5 1.5 2 22.5 2.5 49Ti (5.5%), Ti (5.4%) 3.5 3 4 3.5 4.50.5 4 5 Collimator thickness Collimator wallwall thickness (cm)(cm) PbF2 5.5 4.5 65 17.294 6.5 Several unsure in this material have greater absorption cross section than in 95 % of nickel, there is a shifting of peak point flux optimation nickel. it makes shifting of peek point optimation happened. MATERIALS Optimation material & thickness 6 Al 1350 (99.5 %) 5 df/Φepi x 10-3 Thickne ss (cm) 4 Φepi Ḋf / Φepi Thickne ss (cm) 2 Φepi Ḋf / Φepi 11 5.32E+08 5.56E-11 1.16E+09 3.11E-11 12 8.46E+08 3.42E-11 1.5E+09 0 2.59E-11 13 1.15E+08 9E-11 7.72E+08 5 4.53E-11 10 14 2.77E+08 20 8.45E-12 25 15 5.57E+08 7.1E-13 2.47E-12 7.72E+08 Thickness16(cm) 2.49E+08 2.59E-11 Al AlF3 17Al2O3 2.43E+08 4.53E-11 18 2.99E+08 1.96E+09 1.47E-11 19 2.03E+08 4.53E-11 9 1.47E+09 1.11E-11 20 1.96E+08 9.83E-12 10 1.07E+09 1.99E-11 6 7 8 -2 1.96E+09 5 1.16E+09 6 1.5E+09 7 8 1.47E-11 15 3.11E-11 In this section, we were not only analyse the Fast neutron dose rate per epithermal flux, but also ephitermal 30 neutron Flux it self 1.63E-11 1E-11 The Best material Candidate that can reduce fast neutron flux is Pure Aluminum GAMMA SHIELD Optimation material & thickness Thickness (cm) Φepi Ḋγ / Φepi Without Pb Pb 0.5 5.57E+08 5.06E+08 1.51E-11 1.44E-12 Pb 1 cm 4.05E+08 1.16E-13 Pb 1.5 cm 4.02E+08 1.16E-13 BORAL ADDITIONAL Boron – Aluminum Aperture Surrounding Thickne ss (cm) thermal epithermal Fast total 0.5 2.53E+05 8.21E+06 1.20E+07 2.05E+07 1 1.32E+05 5.88E+06 1.47E+07 2.07E+07 1.5 9.11E+04 9.84E+06 1.40E+07 2.40E+07 2 8.21E+04 8.64E+06 1.23E+07 2.11E+07 Aperture Hole Ḋγ / Φepi Thicknes (cm) Φepi Ḋf / Φepi 0.5 5.12E+08 2.58E-13 1.20E-13 1 5.06E+08 2.49E-13 1.17E-13 1.5 5.03E+08 2.17E-13 1.16E-13 2 4.82E+08 2.26E-13 8.14E-13 FINAL RESULT of Collimator Design & Optimation Parameter Value IAEA Requirement Φepi (n/cm2s) Ḋf / Φepi (Gy-cm2 /n) 5.03 x 108 2.17 x 10-13 > 1,0 x 109 < 2,0 x 10-13 Ḋγ / Φepi (Gy-cm2 /n) Φth / Φepi J / Φepi 1.16 x10-13 0.120 0.835 < 2,0 x 10-13 < 0,05 > 0,7 ANOTHER FACILITIES of BNCT therapy in the world 5 Neutron Flux comparison 4.5 4 3.5 3 2.5 2 Minimum Requirement Of Flux 1.5 1 0.5 0 Petten (NL) Espoo (Fin) Bariloch e (Jpn) Tokai (Jpn) Hsinchu (Taiwan) Yogyaka rta (Ina) Thermal Flux (1E+08 n/cm2s) 0.11 0.72 0.33 4.4 1.34 0.6036 Epithermal Flux (1E+09 n/cm2s) 0.34 1.2 0.65 1.7 1.07 0.503 Fast Flux (1E+08 n/cm2s) 0.26 0.34 0.44 0.95 0.77 2.81 ANOTHER FACILITIES of BNCT therapy in the world Beam Quality comparison 30 25 20 15 10 Maximum thermal/epi ratio Minimum fastgamma neutron Maximum dose contamination dose contamination 5 0 Petten (NL) Espoo (Fin) Bariloche (Jpn) Tokai (Jpn) Hsinchu (Taiwan) Yogyaka rta (Ina) Gamma dose Contam. (1E-13Gy-cm2 /n) 4.74 0.9 0 3 1.95 1.16 Fast Neutron dose Contam. (1E-13Gy-cm2 /n) 10.3 3.3 9.7 3.3 4.2 2.17 Thermal/epi Ratio (%) 3.24 6.00 5.08 25.88 12.52 12.00 DED AND MANUFACTURE OF COLLIMATOR BNCT RESULT OF CNG COLLIMATOR PbF2 Sulfur 40% Al + 60 % AlF3 Litiated Polyetilene Cadmium Φepi 1.7 109 Dγ/Φepi 9.77 10 -14 Df/Φepi Φth/Φepi 1.87 10 -13 6.04 10 -4 J/Φtot 1,69 Detail Engineering Design kolimator: MCNP5 combined SHIELD-HIT12A Kurkumin BNCT compound Kurkumin tersubtitusi karboranil 42 A SUMMARY KESIMPULAN • KEMENPERIN MENDUKUNG ROAD MAP PILOT PROJECT PENGEMBANGAN INDUSTRI OBAT KANKER BERBASIS POTENSI SUMBER DAYA INDUSTRI LOKAL • PERLUNYA DISUSUN REGULASI DAN KEBIJAKAN PENGELOLAAN PENYAKIT KANKER SEBAGAI PEMBUNUH UMAT NO.2. SETELAH JANTUNG SECARA SIMULTAN DAN KOMPREHENSIF. • PERLUNYA INTERVENSI KEMENTERIAN KESEHATAN DALAM MEMASUKKAN INDUSTRI OBAT KANKER DALAM BNCT KE DALAM BPJS Badan Tenaga Nuklir Nasional 1/28/2015 45