# Targeted alpha therapy

Source: https://onco.cc/technologies/targeted-alpha-therapy/  
OnCo record `targeted-alpha-therapy` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Like radioligand therapy but with alpha particles: far more destructive over a much shorter range, so single cells can be killed with less collateral damage.

## Summary

Actinium-225 and lead-212 agents (225Ac-PSMA-617, 225Ac-DOTATATE/RYZ101, 212Pb-DOTAMTATE/AlphaMedix, 225Ac-FAP) are in phase 3. Radium-223 (Xofigo) is the only approved alpha emitter, for bone metastases. Isotope supply (TerraPower, Orano, ITM) is the binding constraint. Alpha therapy after beta failure produces responses in PSMA-refractory disease.

## Fields

- Kind: Technology
- Status: phase-3
- Last checked: 2026-09-04
- Tags: frontier
- Principle: Alpha particles (4-9 MeV, <100 µm range) cause clustered double-strand breaks independent of oxygen and cell cycle.
- Strengths: Overcomes beta resistance; Kills micrometastases with minimal crossfire
- Limitations: Ac-225 supply; Daughter-nuclide redistribution (salivary, renal toxicity); Dosimetry difficult

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Targeted_alpha-particle_therapy
- Wikipedia: https://en.wikipedia.org/wiki/Targeted_alpha-particle_therapy

## Connected records

- technologies: [Accelerator-based BNCT systems (NeuCure, nuBeam, NeuPex)](https://onco.cc/technologies/bnct-accelerator-systems/), [Actinium-225 supply: thorium stocks, accelerators and radium targets](https://onco.cc/technologies/actinium-225-supply/), [Alpha-emitter nanogenerators and daughter trapping](https://onco.cc/technologies/alpha-nanogenerators/), [Astatine-211 alpha therapy](https://onco.cc/technologies/astatine-211-alpha-therapy/), [Auger-electron therapy](https://onco.cc/technologies/auger-electron-therapy/), [Peptide receptor radionuclide therapy (PRRT)](https://onco.cc/technologies/prrt/), [Radio-antibody & radio-ADC](https://onco.cc/technologies/radioimmunotherapy/), [Radioligand dosimetry](https://onco.cc/technologies/radioligand-dosimetry/), [Radioligand plus DNA-repair inhibitor combinations](https://onco.cc/technologies/radionuclide-parp-combination/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/), [Radiopharmacy and cyclotron networks](https://onco.cc/technologies/radiopharmacy-network/), [Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)](https://onco.cc/technologies/therapy-isotope-supply-chain/)
- fronts: [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- targets: [FAP](https://onco.cc/targets/fap/), [PSMA](https://onco.cc/targets/psma/), [Somatostatin receptor 2](https://onco.cc/targets/sstr2/)
- companies: [Abdera Therapeutics](https://onco.cc/companies/abdera-therapeutics/), [Actinium Pharmaceuticals](https://onco.cc/companies/actinium-pharmaceuticals/), [Aktis Oncology](https://onco.cc/companies/aktis-oncology/), [Alpha Tau Medical](https://onco.cc/companies/alpha-tau-medical/), [Alpha-9 Oncology](https://onco.cc/companies/alpha-9-oncology/), [Ariceum Therapeutics](https://onco.cc/companies/ariceum-therapeutics/), [ARTBIO](https://onco.cc/companies/artbio/), [Convergent Therapeutics](https://onco.cc/companies/convergent-therapeutics/), [Fusion Pharmaceuticals (AstraZeneca)](https://onco.cc/companies/fusion-pharma/), [ITM Isotope Technologies Munich](https://onco.cc/companies/itm/), [Orano Med](https://onco.cc/companies/orano-med/), [Perspective Therapeutics](https://onco.cc/companies/perspective-therapeutics/), [RadioMedix](https://onco.cc/companies/radiomedix/), [Ratio Therapeutics](https://onco.cc/companies/ratio-therapeutics/), [RayzeBio (BMS)](https://onco.cc/companies/rayzebio/), [TerraPower Isotopes](https://onco.cc/companies/terrapower-isotopes/)
- cancers: [Extensive-stage small-cell lung cancer](https://onco.cc/cancers/extensive-stage-sclc/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- drugs: [212Pb-DOTAMTATE](https://onco.cc/drugs/alphamedix/), [Actinium-225 DOTATATE](https://onco.cc/drugs/ryz101/), [Actinium-225 PSMA agents](https://onco.cc/drugs/ac225-psma/), [Radium-223 dichloride](https://onco.cc/drugs/radium-223/)
- trials: [ACTION-1](https://onco.cc/trials/action-1/), [AlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)](https://onco.cc/trials/alphabreak/), [ALPHAMEDIX-02](https://onco.cc/trials/alphamedix-02/), [ALSYMPCA](https://onco.cc/trials/alsympca/), [ERA 223](https://onco.cc/trials/era-223/), [PEACE-3 (EORTC 1333)](https://onco.cc/trials/peace-3/), [Trial of 225Ac-DOTATATE (RYZ101) in Subjects With ER+, HER2-negative Unresectable or Metastatic Breast Cancer Expressing SSTRs.](https://onco.cc/trials/nct06590857/)
- ideas: [A global medical isotope supply observatory with forecasts and shortage alerts](https://onco.cc/ideas/idea-reg-isotope-supply-observatory/), [A university cyclotron network with shared regulatory files for new tracers](https://onco.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [Alpha radioligands after ADC failure](https://onco.cc/ideas/idea-alpha-after-adc/), [Alpha-emitting PSMA therapy at first metastatic diagnosis](https://onco.cc/ideas/idea-alpha-first-mhspc/), [CAIX theranostics: 89Zr-girentuximab PET and 177Lu/225Ac-girentuximab therapy](https://onco.cc/ideas/idea-caix-theranostics/), [FAP theranostics as a pan-cancer stromal strategy](https://onco.cc/ideas/idea-fap-theranostics-pancancer/), [Fund alpha emitters beyond actinium-225: lead-212, terbium-149 and astatine-211](https://onco.cc/ideas/idea-reg-alpha-emitter-portfolio/), [Recover legacy radium-226 sources worldwide as the feedstock for actinium-225](https://onco.cc/ideas/idea-reg-legacy-radium-recovery-ac225/), [Regional cyclotron hubs for actinium-225 with an agreed actinium-227 impurity limit](https://onco.cc/ideas/idea-reg-ac225-accelerator-pharmacopoeia/)
- pairings: [Beta PRRT → alpha PRRT](https://onco.cc/pairings/prrt-then-alpha-net/), [Beta radioligand → alpha radioligand](https://onco.cc/pairings/beta-then-alpha/)
- terms: [Alpha vs beta emitters](https://onco.cc/terms/alpha-vs-beta/), [Linear energy transfer (LET)](https://onco.cc/terms/linear-energy-transfer/), [Prostate cancer programmes that failed, and what each failure taught](https://onco.cc/terms/prostate-failed-programmes/), [PRRT (peptide receptor radionuclide therapy)](https://onco.cc/terms/prrt-term/), [Theranostics](https://onco.cc/terms/theranostics/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/)
- institutions: [Chulabhorn Hospital / Chulabhorn Royal Academy](https://onco.cc/institutions/chulabhorn-hospital/), [European Association of Nuclear Medicine](https://onco.cc/institutions/eanm/), [Heidelberg University Hospital / NCT / DKFZ](https://onco.cc/institutions/heidelberg-nct/), [Institut de Cancérologie de l'Ouest (ICO)](https://onco.cc/institutions/ico-angers-nantes/), [Oslo University Hospital, The Norwegian Radium Hospital](https://onco.cc/institutions/oslo-radium-hospital/), [QST Hospital (National Institutes for Quantum Science and Technology)](https://onco.cc/institutions/qst-hospital/), [Society of Nuclear Medicine and Molecular Imaging](https://onco.cc/institutions/snmmi/), [Tel Aviv University](https://onco.cc/institutions/tel-aviv-university/)
- roadmaps: [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://onco.cc/roadmaps/radiopharma-roadmap/), [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)
- people: [Clemens Kratochwil](https://onco.cc/people/clemens-kratochwil/)
- bottlenecks: [Manufacturing cost and time for living and radioactive medicines](https://onco.cc/bottlenecks/b-manufacturing-cell-therapy/)

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