OnCo
ideasIdea

Fund alpha emitters beyond actinium-225: lead-212, terbium-149 and astatine-211

Almost every alpha cancer therapy in development relies on one scarce isotope. Developing several alternatives at once would stop the whole field waiting on a single supply chain.

Actinium-225 dominates targeted alpha therapy pipelines, but lead-212 (from thorium-228/radium-224 generators, used by Orano Med and Perspective Therapeutics), astatine-211 (cyclotron-produced, short half-life, suited to regional supply) and terbium-149 have complementary properties and independent supply routes. The proposal is a public-private programme that funds isotope-agnostic chelator and linker chemistry, comparative dosimetry and small head-to-head clinical studies so that a given targeting ligand can be paired with whichever alpha emitter is available, and that de-risks generator and cyclotron capacity for each.

Hypothesis
Within five years at least two alpha emitters other than actinium-225 reach late-stage trials with GMP supply exceeding clinical demand, and the proportion of alpha therapy trials delayed by isotope supply falls below 10%.
Rationale
Diversifying supply has repeatedly been cheaper than expanding a single constrained route; lead-212 generators are already in clinical use and astatine-211 chemistry has matured at several centres.
What would test it
Award funding to three ligand programmes to produce matched actinium-225, lead-212 and astatine-211 versions and compare biodistribution, dosimetry and manufacturability in first-in-human studies.
Maturity
preclinical evidence
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

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technologies

1
Targeted alpha therapy

companies

2
Orano MedPerspective Therapeutics

terms

1
Alpha vs beta emitters

bottlenecks

1
Manufacturing cost and time for living and radioactive medicines