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A ligand that binds the target, a chelator that holds the metal, and an isotope whose emission does the work; beta emitters travel millimetres, alpha emitters micrometres. The corpus holds 17 radioligands medicines: 7 approved, 8 in phase 3, 10 trials recruiting, 15 companies named. Every section below says which records it was read from.
From 1 record:Radioligand therapy (beta emitters)
A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.
177Lu emits beta particles with ~2 mm range and gamma photons for SPECT imaging; the ligand determines biodistribution.
TermsTheranosticsRadioiodine-refractory (RAI-R) thyroid cancerAlpha vs beta emittersDosimetry
From 17 records:131I-MIBG (iobenguane I-131) therapy177Lu-edotreotide177Lu-PSMA-I&T212Pb-DOTAMTATEAAA817Actinium-225 DOTATATEActinium-225 PSMA agentsFAP-2286 (177Lu / 68Ga)and 9 more in the JSON
Target against isotope, 7 by 7. Open the grid, where every cell links to its medicines and the records behind its state.
From 7 records:Radioactive iodine (I-131)Samarium-153 lexidronamIbritumomab tiuxetanRadium-223 dichlorideLutetium-177 dotatate131I-MIBG (iobenguane I-131) therapyLutetium-177 vipivotide tetraxetan
Radioactive iodine (I-131) Sodium iodide I-131 | Sodium-iodide symporter (NIS) | 1951 | US | approved | - | |
Samarium-153 lexidronam Quadramet | PSMA | 1997 | USEU | approved | ||
Ibritumomab tiuxetan Zevalin | CD20 | 2002 | USEU | approved | ||
Radium-223 dichloride Xofigo | PSMA | 2013 | US | approved | ||
Lutetium-177 dotatate Lutathera | Somatostatin receptor 2 | 2017 | USEU | approved | ||
| Norepinephrine transporter | 2018 | US | established | |||
| PSMA | 2022 | USEU | approved |
From 8 records:177Lu-edotreotide177Lu-PSMA-I&TAAA817Actinium-225 DOTATATEActinium-225 PSMA agentsFAP-2286 (177Lu / 68Ga)FPI-2265Iomab-B
| Phase 3 trials here | ||||||
|---|---|---|---|---|---|---|
| 177Lu-edotreotide | Somatostatin receptor 2 | 9 | phase 3 | |||
| 177Lu-PSMA-I&T | PSMA | record status only | 4 | phase 3 | ||
| AAA817 | PSMA | 2 | phase 3 | |||
| Actinium-225 DOTATATE | Somatostatin receptor 2 | 1 | phase 3 | |||
| Actinium-225 PSMA agents | PSMA | record status only | 0 | phase 3 | ||
| FAP-2286 (177Lu / 68Ga) | FAP | 1 | phase 2 | |||
| FPI-2265 | PSMA | 2 | phase 2 | |||
| Iomab-B | PTPRC | 1 | phase 3 |
From 17 records:131I-MIBG (iobenguane I-131) therapy177Lu-edotreotide177Lu-PSMA-I&T212Pb-DOTAMTATEAAA817Actinium-225 DOTATATEActinium-225 PSMA agentsFAP-2286 (177Lu / 68Ga)and 9 more in the JSON
From 15 records:NovartisLantheusBayerCuriumAstraZenecaAcrotech BiopharmaAdvanced Accelerator Applications (Novartis)Actinium Pharmaceuticalsand 7 more in the JSON
| Company | Type | Medicines | Approved | Phase 3 | Which |
|---|---|---|---|---|---|
| Novartis CH | pharma | 5 | 2 | 3 | |
| Lantheus US | radiopharma | 3 | 2 | 1 | |
| Bayer DE | pharma | 2 | 1 | 1 | |
| Curium FR | radiopharma | 2 | 1 | 1 | |
| AstraZeneca GB | pharma | 2 | 0 | 2 | |
| Acrotech Biopharma US | pharma | 1 | 1 | 0 | |
| Advanced Accelerator Applications (Novartis) FR | radiopharma | 1 | 1 | 0 | |
| Actinium Pharmaceuticals US | radiopharma | 1 | 0 | 1 | |
| Bristol Myers Squibb US | pharma | 1 | 0 | 1 | |
| Fusion Pharmaceuticals (AstraZeneca) CA | radiopharma | 1 | 0 | 1 | |
| ITM Isotope Technologies Munich DE | radiopharma | 1 | 0 | 1 | |
| Orano Med FR | radiopharma | 1 | 0 | 0 | |
| RadioMedix US | radiopharma | 1 | 0 | 0 | |
| RayzeBio (BMS) US | radiopharma | 1 | 0 | 1 | |
| Sanofi FR | pharma | 1 | 0 | 0 |
From 10 records:ACTION-1An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan Versus Observation in PSMA Positive OMPC.AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01)Study Comparing AAA817+ARPI Versus Standard of Care in Adult Participants With PSMA-positive mCRPCThe Study of 177Lu-TLX591 Plus SOC Versus SOC Alone in Patients With mCRPC (ProstACT Global)A Study of 177Lu-FAP-2286 in Advanced Solid TumorsAnti-tumour Activity of (177Lu) rhPSMA-10.1 InjectionOpen-label Study Comparing AAA817 Versus Standard of Care in the Treatment of Previously Treated PSMA-positive mCRPC Adults Who Have Disease Progressed on or After [177Lu]Lu-PSMA Targeted Therapyand 2 more in the JSON
| Registry | ||||||
|---|---|---|---|---|---|---|
ACTION-1 SSTR-positive GEP-NETs progressing after 177Lu somatostatin-analogue therapy: 225Ac-DOTAT… | Phase 3 | BMS (RayzeBio) | - | NCT05477576 | ||
An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan Versus Observation in PSMA Positive OMPC. An International, Prospective, Open-label, Multi-center, Randomized Phase III Study Compa… | Phase 3 | Novartis Pharmaceuticals | 450 | NCT05939414 | ||
AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01) A Phase III, Multicentre, Randomised Controlled Study to Evaluate the Efficacy and Safety… | Phase 3 | AstraZeneca | 670 | NCT07611110 | ||
Study Comparing AAA817+ARPI Versus Standard of Care in Adult Participants With PSMA-positive mCRPC A Phase III, Open-label, Multi-center, Randomized Study Comparing AAA817+ARPI Versus Stan… | Phase 3 | Novartis Pharmaceuticals | 940 | NCT06855277 | ||
The Study of 177Lu-TLX591 Plus SOC Versus SOC Alone in Patients With mCRPC (ProstACT Global) A Multinational, Multicenter, Prospective, Randomized, Controlled, Open-Label, Phase 3 St… | Phase 3 | Telix Pharmaceuticals (Innovations) Pty Limited | 520 | NCT06520345 | ||
A Study of 177Lu-FAP-2286 in Advanced Solid Tumors LuMIERE: A Phase 1/2, Multicenter, Open-label, Non-randomized Study to Investigate Safety… | Phase 1/2 | Novartis Pharmaceuticals | 222 | NCT04939610 | ||
Anti-tumour Activity of (177Lu) rhPSMA-10.1 Injection An Open-label, Multicentre, Integrated Phase 1 & 2 Study to Evaluate the Safety, Tolerabi… | Phase 1/2 | Blue Earth Therapeutics Ltd | 82 | NCT05413850 | ||
Open-label Study Comparing AAA817 Versus Standard of Care in the Treatment of Previously Treated PSMA-positive mCRPC Adults Who Have Disease Progressed on or After [177Lu]Lu-PSMA Targeted Therapy PSMAcTION: A Phase II/III, Open-label, International, Multicenter, Randomized Study of AA… | Phase 2/3 | Novartis Pharmaceuticals | 443 | NCT06780670 | ||
Phase Ib/II Platform Study of Multiple Anti-Cancer Agents in Participants With Metastatic Prostate Cancer A Phase Ib/II, Open-label, Multi-centre, Platform Study to Assess the Safety, Tolerabilit… | Phase 1/2 | AstraZeneca | 152 | NCT07590934 | ||
Study to Evaluate the Diagnostic Performance of GEH300079 (68Ga) Injection PET/CT for Detection of PC in Patients With Colorectal, Gastric, Ovarian, o A Phase 2/3, Multicenter, Open-Label, Non-Randomized Study to Evaluate Diagnostic Perform… | Phase 2/3 | GE Healthcare | 175 | NCT07219238 |
From no record yet:
No Side effects term is linked from this format's records.
From 3 records:CapivasertibLutetium-177 vipivotide tetraxetanOlaparib
Prostate cancer keeps the androgen receptor working without hormones (amplification, splice variants), or abandons it and becomes a neuroendocrine cancer.
ExemplarsCapivasertibLutetium-177 vipivotide tetraxetanOlaparib
From 34 records:Radioligand therapy (beta emitters)Lutetium-177 radioligand therapyTargeted alpha therapyPeptide receptor radionuclide therapy (PRRT)Radio-antibody & radio-ADCRadioiodine therapy and whole-body iodine scanningMIBG imaging and 131I-MIBG therapyAstatine-211 alpha therapyand 26 more in the JSON
NETTER-2: lutetium-177 dotatate as first treatment for higher-grade gastroenteropancreatic neuroendocrine tumours Using the radioactive drug lutetium dotatate as the first treatment for faster-growing neuroendocrine tumours, rather than saving it for la… | 2,024 | The Lancet | rct | |
VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer A radioactive drug that homes to the PSMA protein on prostate cancer cells helped men with heavily pretreated metastatic prostate cancer li… | 2,021 | New England Journal of Medicine | rct | |
Efficacy and safety of high-specific-activity 131I-MIBG therapy in advanced pheochromocytoma or paraganglioma A purified radioactive form of MIBG, taken up by adrenaline-producing tumour cells, let a quarter of patients halve their blood pressure me… | 2,019 | Journal of Nuclear Medicine | observational |
From 7 records:ADC roadmap: from Mylotarg to bispecific and dual-payload ADCsPaediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children firstPaths to cures: interception, eradication, controlRadical oncology: what could change the war by 2035Radiopharmaceutical roadmap: iodine → lutetium → actiniumRadiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASHTROP2 ADC roadmap: sacituzumab govitecan → Dato-DXd → sac-TMT → bispecifics and PET
From 34 records:Radioligand therapy (beta emitters)Lutetium-177 radioligand therapyTargeted alpha therapyPeptide receptor radionuclide therapy (PRRT)Radio-antibody & radio-ADCRadioiodine therapy and whole-body iodine scanningMIBG imaging and 131I-MIBG therapyAstatine-211 alpha therapyand 26 more in the JSON
18F-MFBG PET replacing 123I-MIBG scintigraphy A same-day PET tracer could replace the two-day, low-resolution MIBG scan children now undergo repeatedly. | Early clinical | |
A coordinated reserve and shared schedule for the world's medical isotope reactors A handful of ageing research reactors make most cancer isotopes. Coordinating their maintenance and funding reserve capacity would prevent the shortages that s… | Early clinical | |
A university cyclotron network with shared regulatory files for new tracers Most new cancer imaging agents and radioactive drugs start in university hospitals. A network sharing production, quality files and regulatory paperwork would… | Early clinical | |
Build Western ytterbium-176 enrichment so lutetium-177 has more than one supplier The lutetium used in approved prostate and neuroendocrine cancer treatments is made from an enriched metal that comes mostly from Russia. Making it elsewhere w… | Early clinical | |
CAIX theranostics: 89Zr-girentuximab PET and 177Lu/225Ac-girentuximab therapy Almost every clear-cell kidney cancer carries the CAIX protein. Image it with one radioactive antibody, then treat with the same antibody carrying a therapeuti… | Early clinical | |
Dosimetry-personalised PRRT instead of four fixed cycles Measure the radiation each patient's tumour and kidneys actually absorb and adjust the number and size of doses, instead of giving everyone four identical cycl… | Early clinical | |
FAP theranostics as a pan-cancer stromal strategy Instead of finding a different target for each cancer, hit the scaffolding cells that almost all solid tumours share. | Early clinical | |
Mutual recognition of GMP inspections for cell, gene and radiopharmaceutical plants Factories making living or radioactive cancer medicines are inspected separately by each country. Accepting each other's inspections would free up inspectors a… | Early clinical | |
Recover legacy radium-226 sources worldwide as the feedstock for actinium-225 Thousands of old radium sources sit in hospital and industrial storage. They are exactly the raw material needed to make actinium-225, the scarcest cancer isot… | Early clinical | |
Regional cyclotron hubs for actinium-225 with an agreed actinium-227 impurity limit Actinium-225 can be made in particle accelerators, but the product contains a trace of a long-lived impurity that regulators have not agreed how to handle. Set… | Early clinical | |
Regional radiopharmacy hubs and harmonised transport rules for short-lived isotopes Radioactive cancer drugs decay while they travel and get stuck at borders. Regional production and simpler transport rules would get more doses to patients on… | Early clinical | |
Regional translational institutes with academic GMP suites and IND teams Build a handful of publicly-funded centres where academic discoveries can be manufactured to clinical grade and written up for regulators, so good ideas do not… | Early clinical | |
SSTR antagonist radioligands to increase tumour dose Radioligand therapy for neuroendocrine tumours built on somatostatin receptor antagonists rather than the agonists used today: antagonists bind the receptor in… | Early clinical | |
Total-body PET for personalised radioligand dosing Ultra-sensitive whole-body scanners can measure exactly where a radioactive drug goes at tiny tracer doses, allowing each patient's therapeutic dose to be tail… | Early clinical | |
Efflux-agnostic therapy for mesenchymal TNBC Some tumours pump out every drug. Use treatments the pumps cannot touch: radiation, radioligands, immune cells, and payloads designed to evade them. | Preclinical evidence | |
Focused-ultrasound BBB opening to deliver ADCs and radioligands to glioma Brain tumours have targets that ADCs could hit, but antibodies cannot cross the barrier. Open the barrier with ultrasound first. | Preclinical evidence | |
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… | Preclinical evidence | |
Tumour-on-a-chip with blood flow to test whether big drugs actually get in Large drugs such as antibody-drug conjugates must cross vessel walls and travel through dense tissue. A chip with flowing channels and human tissue can measure… | Preclinical evidence | |
Which patients' blood clones will become leukaemia after treatment? PARP inhibitors, platinum, and radioligand drugs can push pre-existing blood-cell clones toward leukaemia in a few patients. Predicting who could let us choose… | Preclinical evidence | |
A global medical isotope supply observatory with forecasts and shortage alerts Nobody publishes how much cancer isotope is made, where, or when supply will fall short. A public observatory would let hospitals and investors plan. | Speculative | |
Alpha radioligands after ADC failure When ADCs against a surface protein stop working because the payload no longer kills, use the same protein to deliver radiation instead. | Speculative | |
Alpha-emitting PSMA therapy at first metastatic diagnosis If Pluvicto helps at first diagnosis, an alpha version might do more against microscopic disease, when tumour burden is smallest. | Speculative |
From 6 records:Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)Actinium-225 supply: thorium stocks, accelerators and radium targetsResearch reactors for medical isotopes (Mo-99, Lu-177, I-131)Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)Radiopharmaceutical GMP and releasing a drug that decaysRadiopharmacy and cyclotron networks
Research reactors for lutetium and molybdenum, cyclotrons for fluorine, gallium and copper, generators, the actinium scramble, and release of a drug that decays.
Research reactors for medical isotopes (Mo-99, Lu-177, I-131)Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)Radionuclide generators and cold kitsActinium-225 supply: thorium stocks, accelerators and radium targetsTherapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)Radiopharmaceutical GMP and releasing a drug that decaysRadiopharmacy and cyclotron networksPET tracer manufacturing and distributionMedical cyclotrons, hot cells, and synthesis modules
CompaniesNovartisCuriumITM Isotope Technologies MunichIRE (Institut national des Radioéléments)NTP RadioisotopesANSTO (Australian Nuclear Science and Technology Organisation)Bruce PowerNordion (Sotera Health)Eckert & ZieglerSHINE TechnologiesNorthStar Medical RadioisotopesTerraPower IsotopesNusanoIsotopia Molecular ImagingOrano MedTelix PharmaceuticalsLantheusPETNET Solutions (Siemens Healthineers)Cardinal Health Nuclear & Precision Health Solutions
| Site | Operator | Capabilities | Makes | Source |
|---|---|---|---|---|
| Curium Petten Petten, NL · contract manufacturer | Curium | Radioisotope productionRadiopharmaceutical manufacturing | Curium | |
| Eckert & Ziegler Berlin Berlin, DE · contract manufacturer | Eckert & Ziegler | Radioisotope productionRadiopharmaceutical manufacturing | Eckert & Ziegler | |
| ITM Garching Garching, DE · contract manufacturer | ITM Isotope Technologies Munich | Radioisotope productionRadiopharmaceutical manufacturing | ITM | |
| NorthStar Medical Radioisotopes Beloit Beloit, Wisconsin, US · contract manufacturer | NorthStar Medical Radioisotopes | Radioisotope productionRadiopharmaceutical manufacturing | NorthStar Medical Radioisotopes | |
| Novartis Indianapolis Indianapolis, Indiana, US · in-house | Novartis | Radiopharmaceutical manufacturing | Novartis radioligand manufacturing | |
| Novartis Millburn Millburn, New Jersey, US · in-house | Novartis | Radiopharmaceutical manufacturing | Novartis radioligand manufacturing | |
| Novartis Zaragoza Zaragoza, ES · in-house | Novartis | Radiopharmaceutical manufacturing | Novartis radioligand manufacturing | |
| Orano Med Plano Plano, Texas, US · contract manufacturer | Orano Med | Radioisotope productionRadiopharmaceutical manufacturing | Orano Med | |
| SHINE Technologies Janesville Janesville, Wisconsin, US · contract manufacturer | SHINE Technologies | Radioisotope production | SHINE Technologies | |
| TerraPower Isotopes Philadelphia Philadelphia, Pennsylvania, US · contract manufacturer | TerraPower Isotopes | Radioisotope production | TerraPower Isotopes |
The manufacturing map draws every site and the seven supply chains.
Where the radioactive atoms for imaging and therapy actually come from: ageing reactors, new accelerators, and a scramble for actinium.
Actinium-225 is the alpha-emitting atom behind the most promising next wave of radioligand therapies, and there is not enough of it. Almost all of it used to come from one decaying stock of thorium i…
Most of the world's therapeutic and scanning isotopes are made by putting targets into about half a dozen ageing research reactors and flying the product out within days. When two reactors were down…
Proton-rich isotopes for PET scans and some therapies are made by hitting a target with a beam from a cyclotron. Fluorine-18 is made every morning within driving distance of the scanner; gallium-68 c…
A radioactive medicine loses activity every hour, so it is made to order, tested in hours and often injected before the sterility test has finished. The rules for that are different from ordinary dru…
The factories and courier routes that make and deliver short-lived radioactive tracers to hospitals within hours.
The medicines are the ones the open drug engine files under radioligands, whether it placed them on its grid or listed them as unresolved. The technology records are listed by hand (src/lib/modular-formats.ts) and each carries a pill back here. Everything else follows the graph's links from those two sets: approvals, cancers and toxicity from the medicine records; companies, trials, papers and ideas from the records that name a medicine or technology; roadmap steps from their refs; resistance from the atlas; manufacturing from the site and supply chain records.
Nothing here is written for the hub. Where the corpus holds no record for a section, the section says so rather than filling the gap, and the counts are counts of records in OnCo, not of the world. The JSON companion carries every section with the record ids behind it. Not medical advice.