Targeted alpha therapy (r)evolution: emerging nuclides for clinical applications

Area of Science:

• Nuclear medicine
• Radiochemistry
• Oncology

Background:

• Targeted alpha therapy (TAT) utilizes high linear energy transfer (LET) radiation for potent, localized tumor cell killing.
• Alpha emitters offer improved efficacy and safety compared to conventional cancer treatments.
• Advances in chelator technology enable stable radiometal complexation and molecular targeting.

Purpose of the Study:

• To review progress in targeted alpha therapy (TAT).
• To highlight advancements in radionuclide production, radiochemistry, chelator development, and targeting strategies for alpha emitters.
• To examine the clinical trial landscape for key alpha emitters.

Main Methods:

• Literature review of recent advancements in TAT.
• Analysis of radionuclide production and radiochemistry techniques.
• Evaluation of chelator development and tumor-targeting strategies.
• Survey of ongoing clinical trials for Actinium-225, Astatine-211, and Lead-212.

Main Results:

• Significant progress in chelator design for stable radiometal complexes.
• Identification of Actinium-225, Astatine-211, and Lead-212 as leading alpha emitters.
• Ongoing challenges in scaling up radionuclide production and ensuring global supply.
• Expanding clinical trials demonstrate the therapeutic potential of TAT.

Conclusions:

• TAT shows promise as a potent cancer treatment modality.
• Continued innovation in radionuclide production and delivery is crucial for clinical translation.
• Further research and development are needed to overcome supply challenges and broaden TAT accessibility.