Radioligand Therapy
Radioligand therapy is steering a transformative era in cancer treatment, with clinical trials experiencing a significant surge since 2018. This approach, which uses radioactive compounds to target and destroy cancer cells with precision, is rapidly evolving, driven by breakthroughs in radionuclides, linkers, and targeting mechanisms across a wide range of tumor types.
A new era of cancer treatment begins
The initiation of radioligand clinical trials has skyrocketed since 2018, with half of all ongoing trials kicking off in 2023 and 2024. As new radionuclides, linkers, and targets are explored, the scope for broadening therapeutic efficacy across various tumor types continues to expand.
Leading the radioligand charge
58%
of all ongoing industry-sponsored radioligand trials are investigating 177-Lu, of which 40% are targeted to PSMA.1
The most prevalent radionuclide in development is 177-Lu, frequently targeted to PSMA in prostate cancer. The groundbreaking radioligand Pluvicto® (lutetium Lu 177 vipivotide tetraxetan), a conjugate of a PSMA-targeting peptide ligand and 177-Lu, received approval for treating relapsed/refractory mCRPC in the US and EU in 2022. Since its approval, the utilization of Pluvicto® has surged, reaching up to 20% in later lines of therapy, and is currently being investigated in nine ongoing clinical trials (CancerMPact® CancerLandscape, ongoing industry-sponsored trials in the US, Europe, Japan, and China, accessed August 2024; Treatment Architecture 2024). With its optimal emission characteristics (β-emitter with ~7-day half-life), 177-Lu stands out as a premier radionuclide.
The next frontier in cancer targeting
19%
of ongoing industry-sponsored radioligand trials now comprise radionuclides 225-Ac and 4% include 212-Pb, which initially entered clinical trials in 2020.2
With their ability to emit alpha particles for precise, localized treatment and minimize off-target effects, radionuclides 225-Ac and 212-Pb have captured significant attention through strategic acquisitions and agreements (AstraZeneca, PR 19 March 2024; BMS, PR 26 December 2023; Lantheus PR, January 2024). With targets including SSTR2 in neuroendocrine tumors and GRPR in solid tumors such as breast and prostate, these emerging radionuclides hold the potential to revolutionize and redefine the radioligand field.
The expanding horizons of radioligands
While radioligands have already gained approvals in prostate, thyroid, neuroendocrine tumors, and follicular lymphoma, emerging data suggests radioligands are broadening their reach to other solid and hematological malignancies. This is evidenced by almost 50% of ongoing industry-sponsored trials being in tumor types that lack a current radioligand approval.
While most ongoing industry-sponsored trials focus on radioligands as monotherapy, approximately 30% are exploring combinations with immunotherapy, chemotherapy, or hormone therapy. Preliminary data suggests high potential to combine radioligands with the current standard of care.
As healthcare providers and infrastructure adapt to the unique requirements of radioligands (e.g., storage, administration), their utilization is expected to expand with additional regulatory approvals, driven by growing development across a wider range of radionuclides, targets, and tumors.
Improving business outcomes
CancerMPact is an invaluable and comprehensive oncology decision support resource. It can be utilized for market sizing and analysis, strategic planning, and identification of commercial opportunities in the US, Europe, Japan, and China. This resource is composed of cloud-based integrated modules: Patient Metrics (Patient Metrics – Core, Patient Metrics – Expanded Markets, PM Dashboards, and Biomarker Analysis), Treatment Architecture, Future Trends and Insights, and CancerLandscape.
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