PARIS — France has selected two companies and one consortium as candidates for construction of a national proton therapy center to be constructed at the East Lyon Hospital Center.

The chief project engineer, Joël Rochat, told Medical Device Daily he expects a contract to be negotiated and signed with the finalist for the €100 million ($157 million) by the end of 2009.

France had announced in its original timetable the center would be opening for treatment of the first patients by that date.

Financed in a public-private partnership, the hard cost of constructing the center and installing the cyclotron were estimated at €40 million ($63 million).

There are no surprises among the finalists for the French project considering the narrow number of competitors capable of building a particle beam accelerator and then precisely shooting it into the eye of a patient.

Siemens Healthcare (Erlangen, Germany) and IBA (Ion Beam Applications; Louvain-la-Neuve, Belgium) were confirmed candidates.

The third candidate was reported to be Varian Medical Systems (Palo Alto, California), according to the French business newspaper Les Echos, but project engineer Rochat told MDD that Varian is not in the running and that the third candidate is a consortium of companies and institutions building Italy's national proton therapy center at Pavia in Lombardy.

A Varian spokesman told MDD that Accel Research Instruments, which Varian acquired over a year ago, "may consider a proposal to supply some standard components for this project, but Varian Proton Therapy has no involvement."

Marion Bludszuweit, head of communications for Siemens, told MDD, "We can confirm that we are a candidate for the construction of the new proton therapy project near Lyon, but cannot comment further at the moment."

She also said that Siemens has a cooperative agreement with Danfysik (Jyllinge, Denmark), its partner for the design, construction and installation of the accelerator systems at the Heidelberg Ion Therapy Center (HIT), but that "we can't comment on what this means in this early status of the project."

In late March, Siemens said it was one of the bidders in a consortium selected to build a €250 million ($393 million) particle therapy center for the University Clinic of Schleswig-Holstein (Kiel, Germany) with construction giant Bilfinger Berger (Mannheim, Germany) and HSG Technischer Service (Neu-Isenburg, Germany).

Germany's largest public-private partnership project for healthcare to date, the Kiel center will begin treating 3,000 patients a year from northern Germany and southern Scandinavia beginning in 2012.

With more than 300 accelerator systems installed worldwide, IBA is a formidable competitor in the field of particle accelerators, but the company picked the wrong horse in the French competition.

IBA helped the region of Basse-Normandie develop its dossier, with Caen as the candidate city, but the French Health Ministry chose the Lyon project, ETOILE (Espace de Traitement Oncologique par Ions Légers), or "star" in French.

In March, IBA reported results sales of €213.8 million ($336 million), with a record equipment order backlog worth €216 million that jumped 52% in 2007, including orders for three proton therapy systems in the U.S., two for ProCure Treatment Centers (Bloomington, Indiana) and one for the Hampton University Proton Therapy Institute in Virginia.

In May 2007, IBA announced the first patients undergoing treatment at the National Cancer Center of Korea in Ilsan north of Seoul.

The previous year, IBA opened the 98,000-square-foot University of Florida Proton Therapy Institute at the University of Florida's (Gainesville) Shands Cancer Center.

France may benefit from being a slow starter in the field of proton therapy, provided the program can keep together a formidable patchwork of interests that make up the public wing of the public-private partnership.

The process calls for a "competitive dialogue" over the next 18 months with the three construction consortiums, an opportunity to monitor the progress of each company with several projects.

ETOILE is a joint project of the University Hospital Centers (CHU) of Lyon, Grenoble and Saint-Etienne and the Léon Bérard Regional Center for the Fight Against Cancer and it has taken 10 years to reach the bidding stage.

An alphabet soup of prestigious French research institutes each have a claim to part of the action, including CNRS, Inserm, CLCC, CEA and CERN, and the financing of the project involves a political cocktail of local, regional and national authorities.

Where there is only one national center planned in France and Italy, and there is a single proton therapy center in Switzerland geared more toward research than patient service, Germany has been an aggressive builder of centers that are promoted for their high-throughput capabilities measured in thousands of patients per year.

Drawing on an in-country expertise in the field, Germany seems to be positioning itself to become the central European source for what poses a disruptive technology for traditional oncology practices (MDD, Feb. 5, 2008).

Where European medical device makers wait for years to receive reimbursement approval for innovative therapies from state health insurance funds, proton therapy is already recognized for reimbursement.