Supply and Clinical Application of Actinium-225 and Bismuth-213

The recent development of ²²⁵Ac-PSMA617 for therapy of prostate cancer has strikingly demonstrated the clinical potential of targeted alpha therapy. Further promising applications of the alpha emitters ²²⁵Actinium and its daughter nuclide ²¹³Bismuth include the therapy of brain tumors, bladder cancer, neuroendocrine tumors, and leukemia. This paper will provide a brief overview on the current status of the clinical development of compounds labelled with ²²⁵Ac or ²¹³Bi and describe the various production routes that are in place or are under development to meet the increasing demand for these radionuclides.