FRATHEA, FLASH radiotherapy at Institut Curie

Conventional radiotherapy delivers radiation over a period of several hundred milliseconds, with progressive accumulation of the dose in the tumor and surrounding tissues. This approach carries a risk of damaging healthy tissue and reducing the effectiveness of the treatment on the tumor, whereas FLASH radiotherapy is an innovative method of delivering a high dose of radiation locally in less than 100 milliseconds.

For over a decade, scientists at Institut Curie have been researching and accumulating scientific data   on this new radiotherapy approach using low-energy electron or proton beams. However, a significant challenge remains: low-energy electron beams lack the ability to penetrate deeply enough to reach tumors effectively.

To overcome this technological challenge, Institut Curie is focusing on combining FLASH with radiotherapy using Very High Energy Electrons (VHEE).  These VHEE beams, with an energy range of 100 to 250 mega-electronvolts (MeV) compared to just 10 MeV in conventional radiotherapy, offer significant physical and biological advantages for treating deep-seated tumors. This highly precise technology is designed to shorten treatment times and specifically target cancers with poor prognoses located near vital organs—previously considered inaccessible—offering new hope for patients.

Lung cancer, pancreatic cancer, brain tumors, pediatric tumors, re-irradiation: the first therapeutic targets for FLASH-VHEE will be cancers for which treatments are not sufficiently effective or are still too toxic, and for which little or no therapeutic progress has been observed for several years.

To drive its strategic vision forward, Institut Curie is launching the operational phase of the FRATHEA (Flash RAdiation THerapy Electron Acceleration) project in collaboration with the CEA. The project is backed by a €37 million investment over four years: €35 million from the Innovation Healthcare 2030 plan, part of the France 2030 initiative and €2 million from the Île-de-France Region’s “Grands lieux d'innovation” (GLI) scheme in 2023. The GLI scheme fosters the development of cutting-edge R&D and experimental platforms, incubators, and industrial infrastructures essential for advancing technology transfer and collaborative innovation in the Paris Region.

The hope of opening clinical trials by 2028

Once the FRATHEA project is completed, Institut Curie will have an experimental platform open to a range of academic and private partners, in line with other major innovation facilities in the Paris region. It will bring together state-of-the-art equipment, biological models and technological tools to accelerate development phases and clinical trials for all types of treatment, particularly in oncology. Lung cancer, pancreatic cancer, brain tumors, pediatric tumors, re-irradiation: the first therapeutic targets for FLASH-VHEE will be cancers for which treatments are not sufficiently effective or are still too toxic, and for which little or no therapeutic progress has been observed for several years.  
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Expert multidisciplinary teams

To adapt to this new FLASH-VHEE modality using a dose rate 10,000 times higher than that used in conventional radiotherapy, new methods must be implemented. The FRATHEA project therefore calls on the multidisciplinary expertise of Institut Curie and CEA: physicists developing accelerator components and imaging or dosimetry equipment¹ , medical physicists for treatment planning and simulation, radiobiologists testing systems on tumors and animal models, and clinicians developing new treatment protocols.

[1] Determining the dose of X-rays or other radiation to be administered in radiotherapy, and its distribution across the tumor zone.