Breakthroughs in Medical Isotope Technology 2019 Mo-99 Topical - PowerPoint PPT Presentation

Breakthroughs in Medical Isotope Technology 2019 Mo-99 Topical Meeting Heather Murphy, Commercial Operations Manager BWXT ITG Canada, Inc.

BWXT Company Overview 1) As of June 30, 2019 2

Nordion Medical Isotopes Business Acquisition  Reputation as a pioneer in reactor and cyclotron isotope and radiopharmaceutical production  Extensive infrastructure – cyclotrons, hotcells, manufacturing suites, labs  40 year relationship with TRIUMF (Vancouver)  Highly trained, experienced, professional staff  CNSC-licensed facilities in Kanata, Ontario and Vancouver, BC  World class nuclear transport container fleet o Acquisition Closed: July 30, 2018  Current Products Include:  Iodine-123/Oral Iodine-123  Strontium-82  Indium-111  Palladium-103  In-111 oxyquinoline (Q3, 2019)  Contract Manufacturing

Tc-99m – A Powerful Diagnostic Tool Why Tc-99m is so critical? How is it made (historically)?  Physiological diagnostic technique  Supplied in a Tc-99m generator  Used in 80% of all nuclear medicine imaging  Decay product of Mo-99 scans, 30-40M patients per year globally  Mo-99 produced from the fission of U-  Applications in cardiology, GI, oncology, 235 targets neurology, pulmonary  Targets irradiated primarily in research and test reactors outside of North America Over 5,000 lives will be directly  Considered the gold standard diagnostic test impacted by Tc-99m in the next 90 min for many conditions

Mo-99/Tc-99m Market Issues  Security of Supply o Desire for long term, reliable and locally manufactured supply  Reduction in use of uranium in targets o Proliferation risk, inefficient, highly active liquid waste  Sustainable economics along supply chain o Nuclear Energy Agency’s High -level Group on Security of Supply of Medical Radioisotopes (HLG-MR) full cost recovery principle  Healthcare System Cost Containment o Diagnostic reimbursement pressure

Tc-99m Generator Development  Designed to be user friendly  Comparable to currently available generators • Sizes (Activity level) • Eluent volume and activity concentration • Elution time • Dimensions/weight Tc-99m Generator Prototype

Darlington Nuclear Irradiation Site  A world leader in reliable operation of multiple CANDU reactors  Proven nuclear safety track record  Multiple reactors on one site  Longtime producer of radioisotopes – Co-60, Tritium

Progress Update  Target Design and Manufacturing o Targets designed o Manufacturing facility constructed and initial targets manufactured for testing  Target Delivery System o Full scale mock-up facility constructed o Testing underway  Target Processing o Processing equipment designed and configured o Full scale pilot plant constructed o Test runs underway  Processing/Manufacturing Facility o Hot cell modifications underway o New hot cells designed and ordered  Tc-99m Generator o Finalizing design elements

BWXT Isotope Technologies: Solving the Key Industry Issues Local irradiation, processing and manufacturing o Returning North America to a leadership role in nuclear medicine o Leveraging BWXT innovation and former Nordion assets to de-risk commercialization o Securing local supply for North American patients Uranium-free targets o Completely eliminate proliferation risk o No long-lived isotopic fission waste Reliable, redundant irradiation in multiple reactors o Utilize highly reliable reactors o Predictable, high operating schedule