[{"id":"page:/find/","kind":"page","name":"Start here","aka":"","tldr":"Begin from an isotope, an agent, a target or a question, and follow the links in any direction.","tags":"page","route":"/find/","status":""},{"id":"page:/opportunities/","kind":"page","name":"Opportunities","aka":"","tldr":"Where a clinical decision cannot be made today and a radiopharmaceutical might settle it, each with the evidence read and the study that would test it.","tags":"page","route":"/opportunities/","status":""},{"id":"page:/universe/","kind":"page","name":"The universe","aka":"","tldr":"Every approved product, trial, paper, congress abstract, patent and published unmet need in radiopharmaceuticals, cross-linked and searchable.","tags":"page","route":"/universe/","status":""},{"id":"page:/universe/ideas/","kind":"page","name":"Ideas from the data","aka":"","tldr":"Openings computed from the cross-links, each with the evidence behind it.","tags":"page","route":"/universe/ideas/","status":""},{"id":"page:/universe/gaps/","kind":"page","name":"Unmet needs","aka":"","tldr":"Quoted statements of unmet need from papers and congress abstracts, filterable by indication, target and theme.","tags":"page","route":"/universe/gaps/","status":""},{"id":"page:/explore/","kind":"page","name":"Explore","aka":"","tldr":"Pick an indication, switch kind, get a ranked and sortable list.","tags":"page","route":"/explore/","status":""},{"id":"page:/search/","kind":"page","name":"Search","aka":"","tldr":"Word and concept search side by side, each result explaining why it matched.","tags":"page","route":"/search/","status":""},{"id":"page:/path/","kind":"page","name":"Path finder","aka":"","tldr":"How any two objects are related: shortest routes with every relationship named.","tags":"page","route":"/path/","status":""},{"id":"page:/compare/","kind":"page","name":"Compare","aka":"","tldr":"Up to five agents, isotopes, targets, trials or indications side by side, differences highlighted.","tags":"page","route":"/compare/","status":""},{"id":"page:/pivot/","kind":"page","name":"Landscape grid","aka":"","tldr":"Count agents, trials or technologies by indication, target, isotope or company in one grid.","tags":"page","route":"/pivot/","status":""},{"id":"page:/timeline/","kind":"page","name":"Timeline","aka":"","tldr":"Scrub through the years: approvals, trials and practice as it stood.","tags":"page","route":"/timeline/","status":""},{"id":"page:/query/","kind":"page","name":"Query","aka":"","tldr":"Build a graph query and get a table.","tags":"page","route":"/query/","status":""},{"id":"page:/graph/","kind":"page","name":"Graph explorer","aka":"","tldr":"Navigate the knowledge graph visually.","tags":"page","route":"/graph/","status":""},{"id":"page:/saved/","kind":"page","name":"Saved","aka":"","tldr":"Your saved table views and watched pages, with what changed since you looked. Stored in your browser only.","tags":"page","route":"/saved/","status":""},{"id":"page:/map/","kind":"page","name":"Isotopes & agents","aka":"","tldr":"Every radionuclide, every labelled molecule, every target, indication and trial. One page each, plain English first.","tags":"page","route":"/map/","status":""},{"id":"page:/isotopes/","kind":"page","name":"Isotopes","aka":"","tldr":"Half-life, what it emits, how it is made, how tight supply is.","tags":"page","route":"/isotopes/","status":""},{"id":"page:/drugs/","kind":"page","name":"Agents","aka":"","tldr":"Therapeutic radiopharmaceuticals and diagnostic tracers, approved and in trials.","tags":"page","route":"/drugs/","status":""},{"id":"page:/targets/","kind":"page","name":"Targets","aka":"","tldr":"PSMA, SSTR2, FAP and the rest: what the ligand is aimed at.","tags":"page","route":"/targets/","status":""},{"id":"page:/technologies/","kind":"page","name":"Technologies","aka":"","tldr":"Chelators, generators, production routes, scanners, dosimetry.","tags":"page","route":"/technologies/","status":""},{"id":"page:/indications/","kind":"page","name":"Indications","aka":"","tldr":"What these agents are used for, in oncology, neurology, cardiology and infection.","tags":"page","route":"/indications/","status":""},{"id":"page:/fronts/","kind":"page","name":"Fronts","aka":"","tldr":"The areas of the field, from molecular imaging to alpha therapy and supply.","tags":"page","route":"/fronts/","status":""},{"id":"page:/trials/","kind":"page","name":"Trials","aka":"","tldr":"Landmark and current trials, with results where they have reported.","tags":"page","route":"/trials/","status":""},{"id":"page:/pairings/","kind":"page","name":"Pairings","aka":"","tldr":"Theranostic pairs, combinations, sequences and the pairs to avoid.","tags":"page","route":"/pairings/","status":""},{"id":"page:/roadmaps/","kind":"page","name":"Roadmaps","aka":"","tldr":"History to horizon for each part of the field.","tags":"page","route":"/roadmaps/","status":""},{"id":"page:/dependencies/","kind":"page","name":"Dependency map","aka":"","tldr":"What each technology cannot exist without, drawn in layers.","tags":"page","route":"/dependencies/","status":""},{"id":"page:/molecules/","kind":"page","name":"Molecule gallery","aka":"","tldr":"Every agent with a 3D structure, filterable by modality, isotope and target.","tags":"page","route":"/molecules/","status":""},{"id":"page:/bottlenecks/","kind":"page","name":"Bottlenecks","aka":"","tldr":"The constraints holding the field back, and the ideas that could break each one.","tags":"page","route":"/bottlenecks/","status":""},{"id":"page:/ideas/","kind":"page","name":"Ideas","aka":"","tldr":"Hypotheses and fixes, each with a proposed test.","tags":"page","route":"/ideas/","status":""},{"id":"page:/terms/","kind":"page","name":"Glossary","aka":"","tldr":"Physics, chemistry, dosimetry, safety and regulation, in plain words.","tags":"page","route":"/terms/","status":""},{"id":"page:/collections/","kind":"page","name":"Collections","aka":"","tldr":"The open databases and standards the field runs on.","tags":"page","route":"/collections/","status":""},{"id":"page:/pathways/","kind":"page","name":"Pathways","aka":"","tldr":"The biology behind the targets, drawn and explained.","tags":"page","route":"/pathways/","status":""},{"id":"page:/intel/","kind":"page","name":"News & evidence","aka":"","tldr":"What is happening and how strong the evidence is: readouts, approvals, supply, failures and the money.","tags":"page","route":"/intel/","status":""},{"id":"page:/supply/","kind":"page","name":"Isotope supply","aka":"","tldr":"Who makes Lu-177, Ac-225, Mo-99 and Pb-212, and how tight each is.","tags":"page","route":"/supply/","status":""},{"id":"page:/evidence/","kind":"page","name":"Evidence","aka":"","tldr":"Every trial ranked by evidence strength, endpoints as people out of 100.","tags":"page","route":"/evidence/","status":""},{"id":"page:/explained/","kind":"page","name":"Trials in plain words","aka":"","tldr":"Every trial result as people out of 100, medians explained, surrogate endpoints flagged.","tags":"page","route":"/explained/","status":""},{"id":"page:/key-papers/","kind":"page","name":"Key papers","aka":"","tldr":"The papers that changed practice, each explained: what it found and what to be careful about.","tags":"page","route":"/key-papers/","status":""},{"id":"page:/journals/","kind":"page","name":"Journals","aka":"","tldr":"Where the evidence is published: scope, access model and the papers each venue carried.","tags":"page","route":"/journals/","status":""},{"id":"page:/calendar/","kind":"page","name":"Readout calendar","aka":"","tldr":"Decisions, readouts, advisory committees, congresses.","tags":"page","route":"/calendar/","status":""},{"id":"page:/catalysts/","kind":"page","name":"Catalyst calendar","aka":"","tldr":"Regulatory decisions, expected readouts, filings and deal closings by company.","tags":"page","route":"/catalysts/","status":""},{"id":"page:/regulatory/","kind":"page","name":"Regulatory timeline","aka":"","tldr":"Every dated filing, approval, CRL and label change.","tags":"page","route":"/regulatory/","status":""},{"id":"page:/deals/","kind":"page","name":"Deals and licences","aka":"","tldr":"Who bought or licensed what, for how much.","tags":"page","route":"/deals/","status":""},{"id":"page:/failures/","kind":"page","name":"Failure museum","aka":"","tldr":"What did not work, and the lesson.","tags":"page","route":"/failures/","status":""},{"id":"page:/trial-designs/","kind":"page","name":"Trial design picker","aka":"","tldr":"Every trial design as a card: when to use it, a worked example and its main risk.","tags":"page","route":"/trial-designs/","status":""},{"id":"page:/preprints/","kind":"page","name":"Preprint tracker","aka":"","tldr":"Recent preprints per target, agent and technology, and which have since been published.","tags":"page","route":"/preprints/","status":""},{"id":"page:/papers/","kind":"page","name":"Publishing trends","aka":"","tldr":"Fastest-growing topics in the literature, refreshed weekly from Europe PMC.","tags":"page","route":"/papers/","status":""},{"id":"page:/pulse/","kind":"page","name":"Research pulse","aka":"","tldr":"What the leading journals, regulators and news sources are saying this month.","tags":"page","route":"/pulse/","status":""},{"id":"page:/changelog/","kind":"page","name":"Changelog","aka":"","tldr":"What changed in Nuclide, and when.","tags":"page","route":"/changelog/","status":""},{"id":"page:/status/","kind":"page","name":"Data currency","aka":"","tldr":"When each automated feed last ran, what is stale, and the incident log.","tags":"page","route":"/status/","status":""},{"id":"page:/freshness/","kind":"page","name":"Freshness","aka":"","tldr":"How old is too old for each kind of record, and what is past due.","tags":"page","route":"/freshness/","status":""},{"id":"page:/history/","kind":"page","name":"Recent changes","aka":"","tldr":"What changed on which record, field by field, from the git history.","tags":"page","route":"/history/","status":""},{"id":"page:/audit/","kind":"page","name":"Audit","aka":"","tldr":"Staleness, contradictions and registry mismatches, recomputed each build.","tags":"page","route":"/audit/","status":""},{"id":"page:/corrections/","kind":"page","name":"Corrections","aka":"","tldr":"Every factual correction, what was wrong and how it was found.","tags":"page","route":"/corrections/","status":""},{"id":"page:/institutions/","kind":"page","name":"Institutions & people","aka":"","tldr":"The theranostic centres, the isotope producers, the companies and the people behind them.","tags":"page","route":"/institutions/","status":""},{"id":"page:/people/","kind":"page","name":"People","aka":"","tldr":"The physicians, physicists and chemists doing the work.","tags":"page","route":"/people/","status":""},{"id":"page:/companies/","kind":"page","name":"Companies","aka":"","tldr":"Radiopharma, isotope producers, generator and scanner makers.","tags":"page","route":"/companies/","status":""},{"id":"page:/leadership/","kind":"page","name":"Trial leadership","aka":"","tldr":"Who led the pivotal trials.","tags":"page","route":"/leadership/","status":""},{"id":"page:/manufacturing/","kind":"page","name":"Manufacturing map","aka":"","tldr":"Where isotopes are produced and where agents are labelled and released.","tags":"page","route":"/manufacturing/","status":""},{"id":"page:/sponsors/","kind":"page","name":"Trial sponsors","aka":"","tldr":"Who runs the most phase 2 and 3 trials, from the registry and the corpus.","tags":"page","route":"/sponsors/","status":""},{"id":"page:/learn/","kind":"page","name":"Learn & contribute","aka":"","tldr":"Curated paths through the material, how the site works, and how to make it better.","tags":"page","route":"/learn/","status":""},{"id":"page:/about/","kind":"page","name":"About & methodology","aka":"","tldr":"Rules for facts, ranking formulas, licence.","tags":"page","route":"/about/","status":""},{"id":"page:/roadmap/","kind":"page","name":"Roadmap","aka":"","tldr":"Corpus health, every idea by status, and how Nuclide expands and stays current.","tags":"page","route":"/roadmap/","status":""},{"id":"page:/gaps/","kind":"page","name":"Gaps to fill","aka":"","tldr":"Objects and fields that need work.","tags":"page","route":"/gaps/","status":""},{"id":"page:/review/","kind":"page","name":"Review queue","aka":"","tldr":"Which pages most need a named reviewer.","tags":"page","route":"/review/","status":""},{"id":"page:/reviewers/","kind":"page","name":"Reviewer roster","aka":"","tldr":"Who has signed off pages, with declared conflicts of interest.","tags":"page","route":"/reviewers/","status":""},{"id":"page:/contributors/","kind":"page","name":"Contributors","aka":"","tldr":"Everyone who wrote or reviewed records, from the repository history.","tags":"page","route":"/contributors/","status":""},{"id":"page:/newsletter/","kind":"page","name":"Weekly issue","aka":"","tldr":"What changed, regulatory events, upcoming readouts. No tracking.","tags":"page","route":"/newsletter/","status":""},{"id":"page:/suggest/","kind":"page","name":"Suggest an edit","aka":"","tldr":"Propose a correction; organisations can edit their own records.","tags":"page","route":"/suggest/","status":""},{"id":"page:/eval/","kind":"page","name":"Open evaluation","aka":"","tldr":"Questions, a rubric and a public leaderboard.","tags":"page","route":"/eval/","status":""},{"id":"page:/schema/","kind":"page","name":"Data dictionary","aka":"","tldr":"Every kind, every field, its type and meaning, with a real example per kind.","tags":"page","route":"/schema/","status":""},{"id":"page:/build/","kind":"page","name":"Build on Nuclide","aka":"","tldr":"Recipes, OpenAPI spec, TypeScript types and the MCP server.","tags":"page","route":"/build/","status":""},{"id":"page:/api/","kind":"page","name":"Open API","aka":"","tldr":"The corpus as JSON.","tags":"page","route":"/api/","status":""},{"id":"page:/data-sources/","kind":"page","name":"Open data","aka":"","tldr":"Every open database Nuclide pulls from, with licences and cadence.","tags":"page","route":"/data-sources/","status":""},{"id":"page:/open-tools/","kind":"page","name":"Open tools","aka":"","tldr":"Open-source viewers, planners and pipelines you can use or build on.","tags":"page","route":"/open-tools/","status":""},{"id":"page:https://github.com/casadesante/Nuclide","kind":"page","name":"GitHub","aka":"","tldr":"Code and data. Propose changes through the issue forms.","tags":"page","route":"https://github.com/casadesante/Nuclide","status":""},{"id":"page:/terms-of-use/","kind":"page","name":"Terms of use","aka":"","tldr":"The rules for using Nuclide: not medical advice, accuracy not guaranteed, accounts, licences, liability and contact.","tags":"page","route":"/terms-of-use/","status":""},{"id":"page:/privacy/","kind":"page","name":"Privacy policy","aka":"","tldr":"What Nuclide collects and where it lives: hosting, analytics, accounts, browser storage, your rights and how to contact us.","tags":"page","route":"/privacy/","status":""},{"id":"breast-her2-positive","kind":"indication","name":"HER2-positive breast cancer","aka":"","tldr":"HER2-positive breast cancer was once the most aggressive subtype and is now one of the most treatable, thanks to trastuzumab and, more recently, Enhertu.","tags":"breast spike","route":"/indications/breast-her2-positive/"},{"id":"dlbcl","kind":"indication","name":"Diffuse large B-cell lymphoma","aka":"","tldr":"Diffuse large B-cell lymphoma (DLBCL) is an aggressive but curable lymphoma. CAR-T cures about 40% of relapsed patients, and off-the-shelf bispecifics are now approved.","tags":"heme spike","route":"/indications/dlbcl/"},{"id":"follicular-lymphoma","kind":"indication","name":"Follicular lymphoma","aka":"","tldr":"Follicular lymphoma is the most common slow-growing lymphoma, defined in about 85% of cases by a BCL2 translocation. Most people live with it for decades, treated only when it causes problems; it can be controlled repeatedly with anti-CD20 antibodies, chemotherapy, bispecifics or CAR-T but rarely cured, and a small share transform into an aggressive lymphoma each year.","tags":"gap-fill haematologic","route":"/indications/follicular-lymphoma/"},{"id":"glioblastoma","kind":"indication","name":"Glioma & glioblastoma","aka":"","tldr":"Gliomas are now diagnosed by molecular class, and three classes got their first targeted drugs in 2024-25 (vorasidenib for IDH-mutant glioma, tovorafenib for BRAF-altered paediatric glioma, dordaviprone for H3 K27M). Glioblastoma itself is the hardest to treat and has kept the same standard since 2005; CAR-T delivered into the brain and focused-ultrasound drug delivery are the live directions.","tags":"cns spike","route":"/indications/glioblastoma/"},{"id":"grade-3-net","kind":"indication","name":"Grade 3 well-differentiated neuroendocrine tumour","aka":"NET G3 Grade 3 NET Well-differentiated grade 3 neuroendocrine tumour High-grade well-differentiated NET","tldr":"Grade 3 well-differentiated neuroendocrine tumours divide fast enough to be called grade 3 yet still look and behave like their slower relatives rather than like neuroendocrine carcinoma. Recognised as separate since 2017, they keep the somatostatin receptor, respond less well to platinum chemotherapy, and in the NETTER-2 trial were among the first treated with lutetium-177 dotatate up front.","tags":"subtype-page endocrine","route":"/indications/grade-3-net/"},{"id":"hcc","kind":"indication","name":"Hepatocellular carcinoma","aka":"Liver Cancer","tldr":"Liver cancer almost always grows in a liver already damaged by hepatitis, alcohol or fatty liver disease. It is one of the most preventable cancers, and since 2020 immunotherapy combinations have roughly doubled how long people with advanced disease live.","tags":"gi spike","route":"/indications/hcc/"},{"id":"hcc-intermediate","kind":"indication","name":"Intermediate hepatocellular carcinoma (BCLC B)","aka":"Intermediate-stage HCC Multinodular HCC TACE-eligible hepatocellular carcinoma BCLC B","tldr":"Intermediate hepatocellular carcinoma is several tumours inside a working liver, too many to cut out but with no spread beyond it. The standard treatment for two decades has been chemoembolisation through the hepatic artery, and trials now show that adding immunotherapy and anti-angiogenic drugs to it delays progression.","tags":"subtype-page","route":"/indications/hcc-intermediate/"},{"id":"hereditary-ppgl","kind":"indication","name":"Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)","aka":"Familial paraganglioma syndromes SDHB-related paraganglioma SDHD-related head and neck paraganglioma VHL-associated pheochromocytoma MEN2-associated pheochromocytoma Hereditary PPGL","tldr":"Hereditary pheochromocytoma and paraganglioma is the inherited form of these adrenaline-producing tumours, caused by a fault in one of more than a dozen genes, most often SDHB, SDHD, VHL and RET. Knowing the gene changes care: SDHB carriers have the highest risk of spread, VHL and MEN2 patients get adrenal-sparing surgery because tumours arise on both sides, and relatives are screened.","tags":"subtype-page endocrine","route":"/indications/hereditary-ppgl/"},{"id":"lung-net","kind":"indication","name":"Lung neuroendocrine tumours (typical and atypical carcinoid)","aka":"Bronchial carcinoid Pulmonary carcinoid Typical carcinoid Atypical carcinoid Lung NET Bronchopulmonary neuroendocrine tumour","tldr":"Lung neuroendocrine tumours, called typical and atypical carcinoids, are slow-growing tumours of the airways that are usually cured by surgery. When they spread, everolimus is the one drug tested in a randomised trial for this site, cabozantinib was approved in 2025, and somatostatin analogues and lutetium radioligand therapy are borrowed from gut tumours.","tags":"subtype-page endocrine lung","route":"/indications/lung-net/"},{"id":"meningioma","kind":"indication","name":"Meningioma","aka":"Meningeal tumour Atypical meningioma Anaplastic meningioma Malignant meningioma","tldr":"Meningiomas grow from the membranes covering the brain and spinal cord rather than from the brain itself. Most are slow and benign and are either watched or removed; radiotherapy or radiosurgery treats what surgery cannot reach or what grows back, and no drug has yet been approved for them.","tags":"subtype-page cns","route":"/indications/meningioma/"},{"id":"metastatic-ppgl","kind":"indication","name":"Metastatic pheochromocytoma and paraganglioma","aka":"Malignant pheochromocytoma Metastatic paraganglioma Advanced PPGL Unresectable pheochromocytoma and paraganglioma","tldr":"Metastatic pheochromocytoma and paraganglioma is disease that has spread to bone, lymph nodes, liver or lungs, the only way these adrenaline-producing tumours are called malignant. It is often slow, so treatment starts with blood pressure control and watching, then moves through radioactive drugs that home to the tumour, the kinase inhibitor sunitinib, chemotherapy and, since 2025, belzutifan.","tags":"subtype-page endocrine","route":"/indications/metastatic-ppgl/"},{"id":"multiple-endocrine-neoplasia","kind":"indication","name":"Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)","aka":"MEN1 MEN2A MEN2B MEN4 Wermer syndrome Sipple syndrome","tldr":"The MEN syndromes are inherited faults in a single gene that cause tumours in several hormone glands over a lifetime. Because the gene can be found in childhood, at-risk relatives can be tested, watched and in MEN2 have the thyroid removed before cancer develops; and for MEN2 thyroid cancer that does spread there is now a precise pill, selpercatinib, that blocks the faulty RET protein.","tags":"nci-coverage rare endocrine hereditary","route":"/indications/multiple-endocrine-neoplasia/"},{"id":"neuroblastoma","kind":"indication","name":"Neuroblastoma (paediatric)","aka":"","tldr":"Neuroblastoma is a childhood nerve-cell cancer where anti-GD2 antibodies and, recently, GD2 CAR-T have improved survival in high-risk disease.","tags":"paediatric spike","route":"/indications/neuroblastoma/"},{"id":"neuroblastoma-high-risk","kind":"indication","name":"High-risk neuroblastoma","aka":"INRG high-risk neuroblastoma Metastatic neuroblastoma MYCN-amplified neuroblastoma Stage 4 neuroblastoma","tldr":"High-risk neuroblastoma has spread widely in a child over 18 months old or carries extra copies of the MYCN gene. Treatment lasts about 18 months and uses every tool: chemotherapy, surgery, high-dose chemotherapy with stem cell rescue, radiotherapy, and the anti-GD2 antibody dinutuximab, which raised survival in ANBL0032; eflornithine, given afterwards, was approved in 2023 to lower relapse.","tags":"subtype-page paediatric","route":"/indications/neuroblastoma-high-risk/"},{"id":"neuroendocrine","kind":"indication","name":"Neuroendocrine tumours","aka":"Gastrointestinal Neuroendocrine Tumors Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)","tldr":"A family of usually slow-growing tumours that start in hormone-producing cells of the gut, pancreas and lungs. They pioneered the idea of using the same molecule to see a tumour on a scan and then to treat it with radiation.","tags":"endocrine spike","route":"/indications/neuroendocrine/"},{"id":"osteosarcoma","kind":"indication","name":"Osteosarcoma","aka":"","tldr":"Osteosarcoma is the most common bone cancer, mostly in teenagers. Chemotherapy plus surgery cures about two-thirds when it has not spread; because no new drug has beaten that chemotherapy in a large trial in 30 years, the next gains are being sought in cellular therapy against GD2, HER2 and B7-H3.","tags":"gap-fill paediatric sarcoma aya","route":"/indications/osteosarcoma/"},{"id":"pancreatic-net","kind":"indication","name":"Pancreatic neuroendocrine tumours","aka":"pNET Islet cell tumour Pancreatic NET Insulinoma Gastrinoma Non-functioning pancreatic neuroendocrine tumour","tldr":"Pancreatic neuroendocrine tumours arise from the hormone-producing islet cells of the pancreas and behave very differently from ordinary pancreatic cancer, often growing for years. Surgery cures localised tumours; advanced disease is treated in sequence with somatostatin analogues, lutetium-177 dotatate, targeted tablets and oral chemotherapy, and a minority secrete insulin or gastrin.","tags":"subtype-page endocrine","route":"/indications/pancreatic-net/"},{"id":"pheochromocytoma-paraganglioma","kind":"indication","name":"Pheochromocytoma and paraganglioma (PPGL)","aka":"Pheochromocytoma Paraganglioma PPGL Phaeochromocytoma","tldr":"Pheochromocytomas and paragangliomas are tumours of adrenaline-producing tissue that cause dangerous blood pressure surges. Surgery after careful blood-pressure blockade cures most, genetic testing finds an inherited cause in nearly half, and for the minority that spread there are now radioactive drugs that home to the tumour and, since 2025, the first oral targeted pill, belzutifan.","tags":"nci-coverage rare endocrine","route":"/indications/pheochromocytoma-paraganglioma/"},{"id":"prostate","kind":"indication","name":"Prostate cancer","aka":"","tldr":"Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype.","tags":"gu spike","route":"/indications/prostate/"},{"id":"prostate-bcr","kind":"indication","name":"Biochemical recurrence of prostate cancer","aka":"Biochemically recurrent prostate cancer PSA recurrence Rising PSA after local therapy nmHSPC","tldr":"Biochemical recurrence of prostate cancer is a rising PSA after surgery or radiotherapy with nothing yet visible on scans. Salvage radiotherapy can still cure it after surgery, and for a fast-doubling PSA the EMBARK trial showed that enzalutamide with or without hormone therapy delays spread.","tags":"subtype-page","route":"/indications/prostate-bcr/"},{"id":"prostate-high-risk","kind":"indication","name":"Localised prostate cancer, high and very high risk","aka":"High-risk prostate cancer Very high risk prostate cancer Locally advanced prostate cancer Grade Group 4 and 5 prostate cancer Non-metastatic high-risk prostate cancer","tldr":"High-risk prostate cancer has Grade Group 4 or 5 disease, a PSA above 20 or a tumour growing beyond the gland. It is still curable, but needs radiotherapy with two to three years of hormone therapy, or surgery followed by radiotherapy, and adding abiraterone to hormone therapy now lengthens life in the highest-risk men.","tags":"subtype-page","route":"/indications/prostate-high-risk/"},{"id":"prostate-mcrpc","kind":"indication","name":"Metastatic castration-resistant prostate cancer","aka":"mCRPC Metastatic CRPC Castration-resistant metastatic prostate cancer Hormone-refractory prostate cancer (older term)","tldr":"Metastatic castration-resistant prostate cancer is disease that grows despite castrate testosterone. Sequenced treatments now include androgen receptor inhibitors, docetaxel and cabazitaxel, PARP inhibitors for men with BRCA-type mutations, the radioligand 177Lu-PSMA-617 and radium-223 for bone-predominant disease.","tags":"subtype-page","route":"/indications/prostate-mcrpc/"},{"id":"prostate-mhspc","kind":"indication","name":"Metastatic hormone-sensitive prostate cancer","aka":"mHSPC Metastatic castration-sensitive prostate cancer mCSPC De novo metastatic prostate cancer Hormone-naive metastatic prostate cancer","tldr":"Metastatic hormone-sensitive prostate cancer is disease that has spread but still responds to lowering testosterone. Hormone therapy alone is no longer enough: adding an androgen receptor inhibitor, and docetaxel for high-volume disease, lengthens life by years.","tags":"subtype-page","route":"/indications/prostate-mhspc/"},{"id":"prostate-nepc","kind":"indication","name":"Neuroendocrine and small-cell prostate cancer","aka":"NEPC Treatment-emergent neuroendocrine prostate cancer t-NEPC Small-cell carcinoma of the prostate Aggressive variant prostate cancer","tldr":"Neuroendocrine prostate cancer is a form that has stopped depending on the androgen receptor, either from the start or after years of hormone therapy. It no longer shows up on PSA, spreads to the liver and brain, and is treated with the platinum chemotherapy used for small-cell lung cancer.","tags":"subtype-page","route":"/indications/prostate-nepc/"},{"id":"prostate-nmcrpc","kind":"indication","name":"Non-metastatic castration-resistant prostate cancer","aka":"nmCRPC M0 CRPC Non-metastatic CRPC Rising PSA on hormone therapy without metastases","tldr":"Non-metastatic castration-resistant prostate cancer is a PSA that keeps rising on hormone therapy while scans still show nothing. Three androgen receptor blockers, apalutamide, enzalutamide and darolutamide, each delay metastasis by about two years and lengthen life, and darolutamide is the gentlest.","tags":"subtype-page","route":"/indications/prostate-nmcrpc/"},{"id":"rcc","kind":"indication","name":"Renal cell carcinoma","aka":"RCC","tldr":"Kidney cancer is where anti-angiogenic drugs and immunotherapy came together, and where a Nobel-winning oxygen-sensing pathway yielded a drug, belzutifan.","tags":"gu","route":"/indications/rcc/"},{"id":"sclc","kind":"indication","name":"Small-cell lung cancer","aka":"","tldr":"A fast-growing lung cancer that responds to chemotherapy then relapses quickly. After 30 years without progress, T-cell engagers and ADCs are finally moving the needle.","tags":"lung","route":"/indications/sclc/"},{"id":"small-intestinal-net","kind":"indication","name":"Small intestinal neuroendocrine tumours","aka":"Midgut neuroendocrine tumour Small bowel NET Ileal carcinoid Jejunoileal neuroendocrine tumour SI-NET","tldr":"Small intestinal neuroendocrine tumours are slow-growing hormone-producing tumours of the ileum and jejunum, often found only after they have spread to lymph nodes and the liver. Monthly somatostatin analogue injections control symptoms and growth, lutetium-177 dotatate is the main second treatment, and everolimus, cabozantinib and surgery fill in.","tags":"subtype-page endocrine","route":"/indications/small-intestinal-net/"},{"id":"thyroid","kind":"indication","name":"Thyroid cancer","aka":"","tldr":"Thyroid cancer is usually curable with surgery and radioactive iodine, the original theranostic. Rare aggressive forms respond to RET and BRAF inhibitors.","tags":"endocrine spike","route":"/indications/thyroid/"},{"id":"actinium-225-supply","kind":"technology","name":"Actinium-225 supply: thorium stocks, accelerators and radium targets","aka":"","tldr":"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 in a US national laboratory. New routes use accelerators and old radium.","tags":"manufacturing-wave","route":"/technologies/actinium-225-supply/","status":"phase-3","indications":"prostate neuroendocrine"},{"id":"alpha-nanogenerators","kind":"technology","name":"Alpha-emitter nanogenerators and daughter trapping","aka":"","tldr":"Actinium-225 releases four alpha particles as it decays, but the daughters escape and irradiate the kidneys and salivary glands. Nanocarriers try to hold them in place.","tags":"frontier radical","route":"/technologies/alpha-nanogenerators/","status":"preclinical"},{"id":"astatine-211-alpha-therapy","kind":"technology","name":"Astatine-211 alpha therapy","aka":"","tldr":"A rare alpha-emitting halogen that can be attached to antibodies and small molecules like iodine, tested in leukaemia conditioning and brain and ovarian cancer.","tags":"","route":"/technologies/astatine-211-alpha-therapy/","status":"phase-1","indications":"prostate"},{"id":"auger-electron-therapy","kind":"technology","name":"Auger-electron therapy","aka":"","tldr":"Auger-electron therapy uses radioactive atoms such as iodine-125 or terbium-161 that release cascades of low-energy electrons travelling only nanometres to micrometres, so they kill a cell only if the atom sits on or inside its DNA and spare the neighbours. Terbium-161 can replace lutetium-177 in existing PSMA ligands; true nuclear delivery remains preclinical.","tags":"frontier radical","route":"/technologies/auger-electron-therapy/","status":"preclinical"},{"id":"caix-pet","kind":"technology","name":"CAIX PET (89Zr-girentuximab)","aka":"","tldr":"CAIX PET is a scan using an antibody against a protein almost unique to clear-cell kidney cancer, to tell cancer from benign kidney lumps without a biopsy.","tags":"","route":"/technologies/caix-pet/","status":"phase-3","indications":"rcc"},{"id":"ct","kind":"technology","name":"CT (computed tomography)","aka":"","tldr":"A CT scan is a fast 3D X-ray that shows the size and shape of tumours and whether they have spread.","tags":"","route":"/technologies/ct/","status":"standard-of-care"},{"id":"cyclotron-isotope-production","kind":"technology","name":"Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)","aka":"","tldr":"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 comes from either a generator or a cyclotron; copper-64 and zirconium-89 last long enough to ship across a country.","tags":"manufacturing-wave","route":"/technologies/cyclotron-isotope-production/","status":"standard-of-care"},{"id":"fapi-pet","kind":"technology","name":"FAPI PET","aka":"","tldr":"FAPI PET is a PET scan that lights up the scaffolding around almost any solid tumour, including cancers the standard sugar scan misses.","tags":"","route":"/technologies/fapi-pet/","status":"phase-3","indications":"hcc"},{"id":"fdg-pet","kind":"technology","name":"FDG PET","aka":"","tldr":"FDG PET is the standard PET scan. A radioactive sugar shows which tissues are burning glucose fast, which most cancers do.","tags":"","route":"/technologies/fdg-pet/","status":"standard-of-care","indications":"nsclc"},{"id":"fes-pet","kind":"technology","name":"FES PET (oestrogen receptor imaging)","aka":"18F-fluoroestradiol PET Cerianna oestrogen receptor PET ER PET","tldr":"A PET scan using a radioactive form of oestrogen that lights up every tumour deposit still carrying the oestrogen receptor, so doctors can see whether metastases across the body will respond to hormone treatment without biopsying each one.","tags":"","route":"/technologies/fes-pet/","status":"approved"},{"id":"gamma-probes-dose-calibrators","kind":"technology","name":"Gamma probes, handheld gamma cameras and dose calibrators","aka":"","tldr":"The small radiation detectors that make nuclear medicine and sentinel node surgery work: a pen-sized probe that clicks when the surgeon nears the radioactive lymph node, and the well counter in the hot lab that checks every dose before it is injected.","tags":"machines-wave2","route":"/technologies/gamma-probes-dose-calibrators/","status":"standard-of-care","indications":"prostate"},{"id":"her2-pet","kind":"technology","name":"HER2 PET","aka":"","tldr":"HER2 PET is a PET scan using radiolabelled trastuzumab or smaller HER2 binders to map HER2 across all metastases at once.","tags":"","route":"/technologies/her2-pet/","status":"phase-2","indications":"breast-her2-positive"},{"id":"immuno-pet","kind":"technology","name":"Immuno-PET","aka":"","tldr":"PET scans built from radiolabelled antibodies or their fragments, to see any protein an antibody can reach, including immune cells inside tumours.","tags":"","route":"/technologies/immuno-pet/","status":"phase-2"},{"id":"in-vivo-dosimetry","kind":"technology","name":"In vivo dosimetry and patient-specific quality assurance","aka":"","tldr":"Measuring the dose the patient actually receives, with detectors on the skin or the imaging panel behind them, to catch errors before they cause harm.","tags":"radiation-wave1","route":"/technologies/in-vivo-dosimetry/","status":"established"},{"id":"ldr-seed-brachytherapy","kind":"technology","name":"Low-dose-rate seed brachytherapy","aka":"","tldr":"Dozens of rice-grain-sized radioactive seeds are implanted permanently in the prostate in a single procedure and deliver their dose over months.","tags":"radiation-wave1","route":"/technologies/ldr-seed-brachytherapy/","status":"established","indications":"prostate"},{"id":"lu177-radioligand-therapy","kind":"technology","name":"Lutetium-177 radioligand therapy","aka":"177Lu Lu-177 Lutetium-177","tldr":"Cancer-seeking molecules carrying the radioactive metal lutetium-177, which delivers short-range radiation to tumours it binds; approved for neuroendocrine tumours and prostate cancer.","tags":"","route":"/technologies/lu177-radioligand-therapy/","status":"approved","indications":"prostate neuroendocrine"},{"id":"medical-cyclotrons-synthesis-modules","kind":"technology","name":"Medical cyclotrons, hot cells, and synthesis modules","aka":"","tldr":"The particle accelerators and shielded robotic chemistry boxes that make PET tracers in hospital basements and commercial pharmacies.","tags":"supporting","route":"/technologies/medical-cyclotrons-synthesis-modules/","status":"standard-of-care"},{"id":"medical-imaging-scanner-manufacturing","kind":"technology","name":"CT, MRI and PET scanner manufacturing","aka":"","tldr":"The scanners that find and stage cancer are built by five companies in a dozen factories. Detectors, superconducting magnets and the helium that cools them are the parts that run short.","tags":"manufacturing-wave","route":"/technologies/medical-imaging-scanner-manufacturing/","status":"standard-of-care"},{"id":"mibg-theranostics","kind":"technology","name":"MIBG imaging and 131I-MIBG therapy","aka":"","tldr":"A noradrenaline look-alike that neuroblastoma cells swallow: labelled with a small amount of radioactivity it shows the tumour on a scan; with a large amount it treats it.","tags":"","route":"/technologies/mibg-theranostics/","status":"established","indications":"neuroblastoma neuroendocrine"},{"id":"nuclear-medicine-hardware","kind":"technology","name":"Nuclear medicine and total-body PET hardware","aka":"","tldr":"Nuclear medicine hardware means the scanners themselves: PET/CT, SPECT/CT, and new total-body PET that images the whole body at once.","tags":"supporting","route":"/technologies/nuclear-medicine-hardware/","status":"established"},{"id":"parp-pet","kind":"technology","name":"PARP PET","aka":"","tldr":"A PET tracer that measures how much of the DNA repair enzyme PARP a tumour has, to predict response to PARP inhibitors.","tags":"","route":"/technologies/parp-pet/","status":"phase-2"},{"id":"peptide-drug-conjugate","kind":"technology","name":"Peptide-drug & small-molecule-drug conjugates","aka":"","tldr":"Like an ADC but with a small targeting peptide instead of an antibody, so it penetrates tumours faster and is cheaper to make.","tags":"","route":"/technologies/peptide-drug-conjugate/","status":"approved"},{"id":"pet","kind":"technology","name":"PET (positron emission tomography)","aka":"","tldr":"A scan that shows where a radioactive tracer accumulates, so it images what tumours are doing rather than what they look like.","tags":"","route":"/technologies/pet/","status":"standard-of-care"},{"id":"pet-adapted-therapy","kind":"technology","name":"PET-adapted (response-adapted) therapy","aka":"","tldr":"Scan after two cycles of chemotherapy; if the tumour has gone dark, give less treatment, and if not, give more. Hodgkin lymphoma pioneered this.","tags":"","route":"/technologies/pet-adapted-therapy/","status":"standard-of-care","indications":"dlbcl"},{"id":"pet-ct","kind":"technology","name":"PET/CT","aka":"","tldr":"PET and CT in one machine, so hot spots on the PET are pinned to exact locations on the CT.","tags":"","route":"/technologies/pet-ct/","status":"standard-of-care"},{"id":"pet-mri","kind":"technology","name":"PET/MRI","aka":"","tldr":"PET combined with MRI instead of CT, giving biology plus the best soft-tissue detail, at lower radiation dose.","tags":"","route":"/technologies/pet-mri/","status":"established"},{"id":"pet-tracer-manufacturing","kind":"technology","name":"PET tracer manufacturing and distribution","aka":"","tldr":"Making PSMA, FDG, and new tracers under drug-manufacturing rules and delivering them daily.","tags":"supporting","route":"/technologies/pet-tracer-manufacturing/","status":"standard-of-care"},{"id":"prrt","kind":"technology","name":"Peptide receptor radionuclide therapy (PRRT)","aka":"","tldr":"A radioactive version of the hormone mimic used for the scan; it homes to neuroendocrine tumour cells and irradiates them from inside.","tags":"","route":"/technologies/prrt/","status":"approved","indications":"neuroendocrine"},{"id":"psma-pet","kind":"technology","name":"PSMA PET","aka":"","tldr":"A prostate-cancer-specific PET scan that finds spread far earlier than CT or bone scan, and tells you whether a matched radioactive drug will work.","tags":"","route":"/technologies/psma-pet/","status":"standard-of-care","indications":"prostate"},{"id":"quantitative-imaging-biomarkers","kind":"technology","name":"Quantitative imaging biomarkers (RECIST, PERCIST, SUV, ADC)","aka":"imaging biomarkers response criteria PERCIST standardised uptake value apparent diffusion coefficient Deauville score PI-RADS QIBA","tldr":"The numbers pulled from scans that decide whether a cancer is shrinking, growing or dead: tumour diameters for RECIST, sugar uptake on PET, water movement on MRI; they run every trial and most clinic decisions, and they are only as good as the way the scan was taken.","tags":"","route":"/technologies/quantitative-imaging-biomarkers/","status":"standard-of-care","indications":"prostate hcc"},{"id":"radioembolisation-tare","kind":"technology","name":"Radioembolisation (TARE / SIRT, yttrium-90)","aka":"","tldr":"Millions of tiny radioactive glass or resin beads are injected into the liver artery, lodging in the tumour and irradiating it from within.","tags":"","route":"/technologies/radioembolisation-tare/","status":"established","indications":"hcc neuroendocrine"},{"id":"radioimmunotherapy","kind":"technology","name":"Radio-antibody & radio-ADC","aka":"","tldr":"Attaching a radioactive atom to an antibody, so an ADC's targeting is used to deliver radiation instead of chemotherapy.","tags":"frontier","route":"/technologies/radioimmunotherapy/","status":"phase-2"},{"id":"radioiodine-therapy","kind":"technology","name":"Radioiodine therapy and whole-body iodine scanning","aka":"","tldr":"Using the thyroid's natural appetite for iodine to image and treat thyroid cancer with a radioactive form of it. The oldest theranostic, and now used more selectively than it was.","tags":"","route":"/technologies/radioiodine-therapy/","status":"standard-of-care","indications":"thyroid"},{"id":"radioligand-dosimetry","kind":"technology","name":"Radioligand dosimetry","aka":"","tldr":"Measuring, from scans taken after each dose, how much radiation a radioligand actually delivers to the tumour and to kidneys and marrow, so treatment can be personalised.","tags":"","route":"/technologies/radioligand-dosimetry/","status":"established"},{"id":"radioligand-therapy","kind":"technology","name":"Radioligand therapy (beta emitters)","aka":"","tldr":"A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.","tags":"","route":"/technologies/radioligand-therapy/","status":"approved","indications":"prostate neuroendocrine"},{"id":"radiomics","kind":"technology","name":"Radiomics","aka":"","tldr":"Turning ordinary CT, MRI and PET scans into hundreds of measured features of shape and texture that computers relate to tumour biology and outcome.","tags":"","route":"/technologies/radiomics/","status":"emerging"},{"id":"radionuclide-generators-kits","kind":"technology","name":"Radionuclide generators and cold kits","aka":"","tldr":"Bench-top devices that 'milk' a short-lived isotope from a long-lived parent, plus vials of ready-to-label ligand. How most hospitals make PSMA and somatostatin PET tracers without a cyclotron.","tags":"supporting","route":"/technologies/radionuclide-generators-kits/","status":"standard-of-care"},{"id":"radionuclide-parp-combination","kind":"technology","name":"Radioligand plus DNA-repair inhibitor combinations","aka":"","tldr":"Adding a PARP or ATR inhibitor to a radioactive drug so the tumour cannot repair the damage the radiation causes.","tags":"frontier promising","route":"/technologies/radionuclide-parp-combination/","status":"phase-1","indications":"prostate neuroendocrine"},{"id":"radiopharmaceutical-gmp-release","kind":"technology","name":"Radiopharmaceutical GMP and releasing a drug that decays","aka":"","tldr":"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 drugs, and the handful of plants that make lutetium therapies have had their own shortages.","tags":"manufacturing-wave","route":"/technologies/radiopharmaceutical-gmp-release/","status":"standard-of-care","indications":"prostate neuroendocrine"},{"id":"radiopharmacy-network","kind":"technology","name":"Radiopharmacy and cyclotron networks","aka":"","tldr":"The factories and courier routes that make and deliver short-lived radioactive tracers to hospitals within hours.","tags":"supporting","route":"/technologies/radiopharmacy-network/","status":"standard-of-care"},{"id":"research-reactor-isotope-production","kind":"technology","name":"Research reactors for medical isotopes (Mo-99, Lu-177, I-131)","aka":"","tldr":"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 at once in 2009 and 2010, hospitals worldwide ran short of the most used scan isotope.","tags":"manufacturing-wave","route":"/technologies/research-reactor-isotope-production/","status":"standard-of-care","indications":"prostate neuroendocrine"},{"id":"site-specific-conjugation","kind":"technology","name":"Site-specific conjugation & linker chemistry","aka":"","tldr":"Site-specific conjugation and linker chemistry decide exactly where and how many payloads attach to the antibody, which determines how safe and effective an ADC is.","tags":"","route":"/technologies/site-specific-conjugation/","status":"established"},{"id":"spect","kind":"technology","name":"SPECT & bone scan","aka":"","tldr":"SPECT and the bone scan are an older type of nuclear scan, still used for bone metastases and to check where a radioactive drug went after treatment.","tags":"","route":"/technologies/spect/","status":"standard-of-care"},{"id":"spect-ct","kind":"technology","name":"SPECT/CT","aka":"","tldr":"A gamma camera with a CT scanner bolted on, so a hot spot on a bone scan or a sentinel-node scan is pinned to the exact bone or lymph node, and the dose from a radioactive drug can be measured after treatment.","tags":"machines-wave","route":"/technologies/spect-ct/","status":"standard-of-care","indications":"prostate thyroid neuroblastoma neuroendocrine"},{"id":"sstr-pet","kind":"technology","name":"Somatostatin receptor PET (68Ga/64Cu-DOTATATE)","aka":"","tldr":"A PET scan using a radioactive hormone mimic that lights up neuroendocrine tumours and shows whether the matching radioactive treatment will work.","tags":"","route":"/technologies/sstr-pet/","status":"standard-of-care","indications":"neuroendocrine sclc"},{"id":"sterile-fill-finish","kind":"technology","name":"Sterile fill-finish and lyophilisation","aka":"","tldr":"Sterile fill-finish is putting the finished drug into vials under sterile conditions. It is a frequent cause of shortages when capacity is tight.","tags":"supporting","route":"/technologies/sterile-fill-finish/","status":"standard-of-care"},{"id":"targeted-alpha-therapy","kind":"technology","name":"Targeted alpha therapy","aka":"","tldr":"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.","tags":"frontier","route":"/technologies/targeted-alpha-therapy/","status":"phase-3"},{"id":"therapy-isotope-supply-chain","kind":"technology","name":"Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)","aka":"","tldr":"Where the radioactive atoms for imaging and therapy actually come from: ageing reactors, new accelerators, and a scramble for actinium.","tags":"supporting","route":"/technologies/therapy-isotope-supply-chain/","status":"established"},{"id":"total-body-pet-screening","kind":"technology","name":"Total-body PET for screening and ultra-low-dose imaging","aka":"","tldr":"Scanners sensitive enough to image the whole body in seconds at a fraction of the radiation dose, which raises the question of whether healthy people should be scanned at all.","tags":"frontier","route":"/technologies/total-body-pet-screening/","status":"concept"},{"id":"trop2-pet","kind":"technology","name":"TROP2 PET","aka":"","tldr":"An experimental PET scan that shows whether a tumour carries the TROP2 protein, so doctors could pick the right ADC before giving it.","tags":"frontier","route":"/technologies/trop2-pet/","status":"phase-1"},{"id":"b7h3","kind":"target","name":"B7-H3","aka":"","tldr":"B7-H3 is an immune checkpoint-like surface protein found on 60 to 70% of small-cell lung cancers and 80 to 90% of castration-resistant prostate cancers, with little on normal tissue. It is used as an ADC address, chiefly by ifinatamab deruxtecan, now in phase 3 in small-cell lung cancer; whether blocking its immune-dampening role adds anything beyond payload delivery is unresolved.","tags":"adc-target","route":"/targets/b7h3/","indications":"sclc prostate"},{"id":"cd20","kind":"target","name":"CD20","aka":"","tldr":"CD20 is a B-cell marker; rituximab against it was the first antibody approved for cancer, in 1997.","tags":"antibody-target","route":"/targets/cd20/","indications":"dlbcl"},{"id":"ceacam5","kind":"target","name":"CEACAM5","aka":"","tldr":"The classic 'CEA' tumour marker measured in blood, also present on the cell surface where ADCs can reach it.","tags":"adc-target biomarker","route":"/targets/ceacam5/"},{"id":"cxcr4","kind":"target","name":"CXCR4","aka":"","tldr":"A chemokine receptor that anchors blood cells in the marrow and helps cancer cells home to it; mutated in a third of Waldenström patients and targeted by plerixafor for stem-cell mobilisation.","tags":"gap-fill","route":"/targets/cxcr4/"},{"id":"dll3","kind":"target","name":"DLL3","aka":"","tldr":"A protein that appears on the surface of small-cell lung cancer cells, now hit by a drug that pulls T cells onto them.","tags":"t-cell-engager-target","route":"/targets/dll3/","indications":"sclc prostate"},{"id":"fap","kind":"target","name":"FAP","aka":"","tldr":"FAP (fibroblast activation protein) sits on the cancer-associated fibroblasts that scaffold more than 90% of epithelial cancers and is almost absent from normal adult tissue. FAPI PET tracers therefore light up tumours with high contrast, including pancreatic, gastric and low-grade cancers where FDG PET is weak, and FAP-targeted radioligands are in development.","tags":"theranostic pet-target stroma","route":"/targets/fap/"},{"id":"folr1","kind":"target","name":"Folate receptor alpha","aka":"","tldr":"Folate receptor alpha is a vitamin receptor that ovarian cancer cells carry in large numbers, used as the docking site for the ADC mirvetuximab.","tags":"adc-target","route":"/targets/folr1/"},{"id":"gpc3","kind":"target","name":"Glypican-3","aka":"","tldr":"Glypican-3 is a fetal liver protein that reappears in liver cancer, giving CAR-T and bispecifics a clean target.","tags":"car-t-target","route":"/targets/gpc3/","indications":"hcc"},{"id":"grpr","kind":"target","name":"GRPR (gastrin-releasing peptide receptor)","aka":"","tldr":"GRPR is a hormone receptor abundant in early and hormone-sensitive prostate cancer, imaged and treated with bombesin-like radioligands.","tags":"theranostic","route":"/targets/grpr/","indications":"prostate"},{"id":"her2","kind":"target","name":"HER2","aka":"","tldr":"A growth-signal receptor. Some cancers make far too much of it, and drugs that block it or use it as a docking site have transformed those cancers.","tags":"adc-target driver","route":"/targets/her2/","indications":"breast-her2-positive"},{"id":"klk2","kind":"target","name":"KLK2 (kallikrein-2)","aka":"","tldr":"A relative of PSA that stays attached to prostate cancer cells, used as a T-cell engager address by J&J.","tags":"t-cell-engager-target","route":"/targets/klk2/","indications":"prostate"},{"id":"nectin4","kind":"target","name":"Nectin-4","aka":"","tldr":"Nectin-4 is an adhesion protein plentiful on bladder cancer cells, used as the docking site for the ADC enfortumab vedotin.","tags":"adc-target","route":"/targets/nectin4/"},{"id":"parp","kind":"target","name":"PARP","aka":"PARP1/2 Poly [ADP-ribose] polymerase 2","tldr":"PARP is a DNA repair enzyme. Cancers that have already lost one repair system (BRCA) die when this second one is blocked; healthy cells survive.","tags":"synthetic-lethality","route":"/targets/parp/","indications":"prostate"},{"id":"psma","kind":"target","name":"PSMA","aka":"","tldr":"A protein on prostate cancer cells that lets doctors both see the cancer on a PET scan and hit it with a radioactive drug.","tags":"theranostic pet-target","route":"/targets/psma/","indications":"prostate"},{"id":"sstr2","kind":"target","name":"Somatostatin receptor 2","aka":"","tldr":"Somatostatin receptor 2 is a hormone receptor densely present on neuroendocrine tumours, and was the first theranostic target to reach routine care.","tags":"theranostic","route":"/targets/sstr2/","indications":"neuroendocrine sclc"},{"id":"steap1","kind":"target","name":"STEAP1","aka":"","tldr":"STEAP1 is a protein on the surface of most prostate cancer cells, now the address for a T-cell engager in phase 3.","tags":"t-cell-engager-target","route":"/targets/steap1/","indications":"prostate"},{"id":"trop2","kind":"target","name":"TROP2","aka":"","tldr":"TROP2 is a surface glycoprotein present at high levels on most epithelial cancers (breast, lung, urothelial, gastric, pancreatic) and at low levels on normal tissue. It does not drive the cancer; it is a delivery address, used by the approved ADCs sacituzumab govitecan and datopotamab deruxtecan and by sacituzumab tirumotecan, with a TROP2 PET tracer in development to pick patients.","tags":"adc-target pet-target","route":"/targets/trop2/"},{"id":"aaa817","kind":"drug","name":"AAA817","aka":"[225Ac]Ac-PSMA-617","tldr":"AAA817 is an experimental radioligand therapy from Novartis Pharmaceuticals in phase 3 trials for prostate cancer, aimed at PSMA.","tags":"pipeline ctgov-ingest","route":"/drugs/aaa817/","status":"phase-3","indications":"prostate"},{"id":"abiraterone","kind":"drug","name":"Abiraterone acetate","aka":"","tldr":"Abiraterone is a pill that shuts down testosterone production everywhere, including inside the tumour. Discovered at the Institute of Cancer Research, now generic and used from the first metastatic diagnosis.","tags":"","route":"/drugs/abiraterone/","status":"approved","indications":"prostate prostate-mhspc prostate-mcrpc prostate-high-risk"},{"id":"ac225-psma","kind":"drug","name":"Actinium-225 PSMA agents","aka":"","tldr":"Alpha-emitting PSMA drugs that produce responses even after Pluvicto fails, held back mainly by isotope supply.","tags":"","route":"/drugs/ac225-psma/","status":"phase-3","indications":"prostate prostate-mcrpc"},{"id":"al2846","kind":"drug","name":"AL2846","aka":"","tldr":"AL2846 is an experimental small-molecule drug from Chia Tai Tianqing Pharmaceutical in phase 3 trials for thyroid cancer, aimed at MET and RET.","tags":"pipeline ctgov-ingest","route":"/drugs/al2846/","status":"phase-3","indications":"thyroid"},{"id":"alphamedix","kind":"drug","name":"212Pb-DOTAMTATE","aka":"","tldr":"An alpha-particle version of neuroendocrine radioligand therapy that produced responses in over half of patients who had never had PRRT, with FDA Breakthrough designation.","tags":"","route":"/drugs/alphamedix/","status":"phase-2","indications":"neuroendocrine"},{"id":"cabazitaxel","kind":"drug","name":"Cabazitaxel","aka":"","tldr":"A second taxane that works after docetaxel and beat a second hormone pill head-to-head (CARD).","tags":"","route":"/drugs/cabazitaxel/","status":"approved","indications":"prostate prostate-mcrpc"},{"id":"cabozantinib","kind":"drug","name":"Cabozantinib","aka":"","tldr":"A pill that blocks both blood-vessel growth and the MET escape pathway, used in kidney, liver, thyroid and, since 2025, neuroendocrine cancers.","tags":"","route":"/drugs/cabozantinib/","status":"approved","indications":"hcc rcc neuroendocrine thyroid"},{"id":"capecitabine","kind":"drug","name":"Capecitabine","aka":"","tldr":"Capecitabine (Xeloda) is a tablet form of the chemotherapy fluorouracil. It is a backbone of treatment for bowel cancer and a standard option in advanced breast cancer.","tags":"nci-list generic","route":"/drugs/capecitabine/","status":"approved","indications":"breast-her2-positive"},{"id":"choline-c11","kind":"drug","name":"Choline C-11","aka":"[11C]choline","tldr":"Choline C-11 was the first PET tracer approved in the United States, in 2012, to find where prostate cancer has come back when PSA rises after treatment; PSMA tracers have now largely replaced it.","tags":"gap-fill chembl-universe","route":"/drugs/choline-c11/","status":"established","indications":"prostate"},{"id":"dexrazoxane","kind":"drug","name":"Dexrazoxane","aka":"Cardioxane Savene","tldr":"Dexrazoxane protects the heart from the cumulative damage of doxorubicin in women with metastatic breast cancer who need to keep receiving it, and, as Totect, limits tissue destruction when an anthracycline leaks out of a vein.","tags":"nci-list supportive","route":"/drugs/dexrazoxane/","status":"approved"},{"id":"docetaxel","kind":"drug","name":"Docetaxel","aka":"","tldr":"The first chemotherapy to extend life in prostate cancer (2004), now part of triplet therapy at first metastatic diagnosis.","tags":"","route":"/drugs/docetaxel/","status":"approved","indications":"prostate prostate-mhspc prostate-mcrpc"},{"id":"donafenib","kind":"drug","name":"Donafenib","aka":"","tldr":"Donafenib is a Chinese redesign of sorafenib that lived longer than the original in a head-to-head liver cancer trial and is approved in China as a first-line option.","tags":"china","route":"/drugs/donafenib/","status":"approved","indications":"hcc thyroid"},{"id":"durvalumab","kind":"drug","name":"Durvalumab","aka":"","tldr":"A PD-L1 blocker that became standard after chemoradiation for stage III lung cancer, and now in bladder, biliary, and gastric cancers.","tags":"","route":"/drugs/durvalumab/","status":"approved","indications":"sclc hcc hcc-intermediate"},{"id":"enzalutamide","kind":"drug","name":"Enzalutamide","aka":"","tldr":"Enzalutamide is a second-generation androgen-receptor blocker that stops the receptor binding testosterone, entering the nucleus and switching on genes. It is approved at every stage of advanced prostate cancer, from rising PSA after surgery to castration-resistant disease, and fatigue, falls and memory problems are its main drawbacks.","tags":"","route":"/drugs/enzalutamide/","status":"approved","indications":"prostate prostate-mhspc prostate-nmcrpc prostate-mcrpc prostate-bcr"},{"id":"everolimus","kind":"drug","name":"Everolimus","aka":"","tldr":"An mTOR-blocking pill that doubled progression-free time with exemestane in 2012 and is now paired with the oral SERD giredestrant.","tags":"","route":"/drugs/everolimus/","status":"approved","indications":"rcc neuroendocrine"},{"id":"fap-2286","kind":"drug","name":"FAP-2286 (177Lu / 68Ga)","aka":"","tldr":"A FAP-targeted theranostic pair: one version images almost any solid tumour, the other treats it with radiation.","tags":"","route":"/drugs/fap-2286/","status":"phase-2"},{"id":"florastamin-f18","kind":"drug","name":"Florastamin F-18","aka":"18F-florastamin ProstaView Prostaview Injection florastamine flortastamine F-18","tldr":"Florastamin is FutureChem's fluorine-18 PSMA PET tracer, and the first prostate cancer diagnostic developed in South Korea to be approved there — Korea's 43rd domestically developed new drug.","tags":"diagnostic psma korea ctgov-ingest","route":"/drugs/florastamin-f18/","status":"approved","indications":"prostate"},{"id":"flotufolastat","kind":"drug","name":"Flotufolastat F-18","aka":"","tldr":"Flotufolastat is a third PSMA PET tracer, with a radiohybrid chemistry designed to be reused for therapy.","tags":"","route":"/drugs/flotufolastat/","status":"approved","indications":"prostate"},{"id":"fluciclovine-f18","kind":"drug","name":"Fluciclovine F-18","aka":"","tldr":"Fluciclovine F-18 was the first PET tracer approved for finding recurrent prostate cancer after treatment (2016), and has been largely superseded since 2020 by PSMA PET.","tags":"gap-fill diagnostic","route":"/drugs/fluciclovine-f18/","status":"approved","indications":"prostate glioblastoma"},{"id":"fludeoxyglucose-f18","kind":"drug","name":"Fludeoxyglucose F-18 (FDG)","aka":"","tldr":"The radioactive sugar used in almost every cancer PET scan, approved in the 1990s and made fresh each day by regional cyclotrons.","tags":"test","route":"/drugs/fludeoxyglucose-f18/","status":"approved","indications":"nsclc"},{"id":"fluoroestradiol-f18","kind":"drug","name":"Fluoroestradiol F-18 (FES PET)","aka":"","tldr":"A PET scan that shows which breast cancer deposits still have oestrogen receptors, helping decide whether hormone therapy will work when biopsy is impractical.","tags":"gap-fill diagnostic","route":"/drugs/fluoroestradiol-f18/","status":"approved"},{"id":"fpi-2265","kind":"drug","name":"FPI-2265","aka":"Ac225-PSMA I&T","tldr":"FPI-2265 is an experimental radioligand therapy from Fusion Pharmaceuticals in phase 2 trials for prostate cancer, aimed at PSMA.","tags":"pipeline ctgov-ingest","route":"/drugs/fpi-2265/","status":"phase-2","indications":"prostate"},{"id":"ga68-dotatate","kind":"drug","name":"Gallium-68 DOTATATE (and Cu-64 DOTATATE)","aka":"","tldr":"The PET scan for neuroendocrine tumours that finds far more disease than older scans and confirms eligibility for lutetium radioligand therapy (the theranostic pair).","tags":"gap-fill diagnostic","route":"/drugs/ga68-dotatate/","status":"approved","indications":"neuroendocrine small-intestinal-net pancreatic-net lung-net"},{"id":"ga68-psma-11","kind":"drug","name":"Gallium-68 gozetotide (PSMA-11)","aka":"","tldr":"Gallium-68 PSMA-11 was the first PSMA PET tracer approved in the US (2020), and is made on site from a generator or cyclotron.","tags":"","route":"/drugs/ga68-psma-11/","status":"approved","indications":"prostate"},{"id":"girentuximab-zr89","kind":"drug","name":"Zirconium-89 girentuximab","aka":"89Zr-DFO-girentuximab Zircaix","tldr":"Zirconium-89 girentuximab is Telix's PET scan that tells whether a kidney mass is clear cell renal cell carcinoma without a biopsy; the phase 3 ZIRCON trial met its endpoints in 2023 and the product is under regulatory review.","tags":"pipeline ctgov-ingest","route":"/drugs/girentuximab-zr89/","status":"phase-3","indications":"rcc"},{"id":"hrs-4357","kind":"drug","name":"HRS-4357","aka":"","tldr":"HRS-4357 is an experimental investigational agent whose form is not stated in the registry from Jiangsu HengRui Medicine in phase 3 trials for prostate cancer, aimed at PSMA.","tags":"pipeline ctgov-ingest","route":"/drugs/hrs-4357/","status":"phase-3","indications":"prostate"},{"id":"i131-mibg","kind":"drug","name":"131I-MIBG (iobenguane I-131) therapy","aka":"","tldr":"High-dose radioactive MIBG delivers radiation from inside neuroblastoma cells that take up noradrenaline; used for relapsed disease and tested in upfront therapy.","tags":"","route":"/drugs/i131-mibg/","status":"established","indications":"neuroblastoma neuroblastoma-high-risk metastatic-ppgl"},{"id":"ibritumomab-tiuxetan","kind":"drug","name":"Ibritumomab tiuxetan","aka":"Y-90 ibritumomab Zevalin therapeutic regimen","tldr":"Zevalin is an antibody carrying a radioactive isotope that seeks out CD20 on lymphoma cells. It treats follicular lymphoma that has relapsed and is given as a one-off consolidation after chemotherapy.","tags":"nci-list","route":"/drugs/ibritumomab-tiuxetan/","status":"approved","indications":"follicular-lymphoma"},{"id":"illuccix","kind":"drug","name":"Illuccix (kit for Ga-68 gozetotide)","aka":"","tldr":"Telix's ready-to-label kit that lets any nuclear medicine department make the gallium PSMA scan for prostate cancer.","tags":"test","route":"/drugs/illuccix/","status":"approved","indications":"prostate"},{"id":"iobenguane-i-131","kind":"drug","name":"Iobenguane I-131 (therapeutic)","aka":"131I-MIBG Ultratrace iobenguane","tldr":"Azedra was a radioactive drug that homed in on adrenal-type tumours (phaeochromocytoma and paraganglioma) that could not be removed and delivered radiation from inside. It was approved in 2018 and discontinued by its maker in 2024.","tags":"nci-list","route":"/drugs/iobenguane-i-131/","status":"withdrawn","indications":"neuroendocrine"},{"id":"iomab-b","kind":"drug","name":"Iomab-B","aka":"Apamistamab-I131 131I-apamistamab","tldr":"Iomab-B is Actinium's radioactive antibody that clears the bone marrow before a transplant for older patients with active relapsed acute myeloid leukaemia; the phase 3 SIERRA trial met its primary endpoint but the FDA asked for another study.","tags":"pipeline ctgov-ingest","route":"/drugs/iomab-b/","status":"phase-3"},{"id":"itm-11","kind":"drug","name":"177Lu-edotreotide","aka":"","tldr":"A second lutetium radioligand for neuroendocrine tumours that beat the standard pill everolimus in a head-to-head trial and is awaiting an FDA decision.","tags":"","route":"/drugs/itm-11/","status":"phase-3","indications":"neuroendocrine grade-3-net"},{"id":"jnj-87189401","kind":"drug","name":"JNJ-87189401","aka":"","tldr":"JNJ-87189401 is an experimental costimulatory agent from Janssen Research & Development in phase 3 trials for prostate cancer, aimed at PSMA.","tags":"pipeline ctgov-ingest","route":"/drugs/jnj-87189401/","status":"phase-3","indications":"prostate"},{"id":"locametz","kind":"drug","name":"Locametz (kit for Ga-68 gozetotide)","aka":"","tldr":"Novartis' gallium PSMA scan kit, approved the same day as Pluvicto as the test that qualifies men for that radioactive drug.","tags":"test","route":"/drugs/locametz/","status":"approved","indications":"prostate"},{"id":"lu177-psma-it","kind":"drug","name":"177Lu-PSMA-I&T","aka":"","tldr":"177Lu-PSMA-I&T is a second PSMA radioligand, chemically different from Pluvicto, that has passed two phase 3 trials on progression but has not yet shown a survival benefit.","tags":"","route":"/drugs/lu177-psma-it/","status":"phase-3","indications":"prostate prostate-mcrpc"},{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","aka":"","tldr":"Lutetium-177 dotatate was the first modern radioligand therapy (2018), for neuroendocrine tumours, and is now used in first line.","tags":"","route":"/drugs/lutathera/","status":"approved","indications":"neuroendocrine small-intestinal-net pancreatic-net grade-3-net metastatic-ppgl"},{"id":"olaparib","kind":"drug","name":"Olaparib","aka":"","tldr":"Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.","tags":"","route":"/drugs/olaparib/","status":"approved","indications":"prostate prostate-mcrpc"},{"id":"pasireotide","kind":"drug","name":"Pasireotide","aka":"SOM230","tldr":"Pasireotide is a second-generation somatostatin analogue that hits more receptor types than octreotide. It is approved for Cushing's disease and acromegaly caused by pituitary tumours when surgery has not cured them, at the cost of frequent high blood sugar.","tags":"subtype-drugs-wave","route":"/drugs/pasireotide/","status":"approved","indications":"lung-net"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","aka":"","tldr":"Pembrolizumab is a PD-1 blocking antibody approved in more than 40 settings, from melanoma and lung cancer to the first tumour-agnostic approval for mismatch-repair-deficient tumours in 2017, and before and after surgery in triple-negative breast cancer. A subcutaneous form arrived in 2025, and it is the backbone partner for ADCs and personalised neoantigen vaccines.","tags":"","route":"/drugs/pembrolizumab/","status":"approved","indications":"hcc rcc"},{"id":"phosphorus-32","kind":"drug","name":"Phosphorus-32 (radiophosphorus)","aka":"Radiophosphorus Sodium phosphate P-32 32P","tldr":"Radiophosphorus was one of the first treatments for polycythaemia vera, from the 1940s: a radioactive phosphate injection that quietened the overactive bone marrow for a year or more. It was abandoned when trials showed it raised the risk of leukaemia.","tags":"subtype-drugs-wave","route":"/drugs/phosphorus-32/","status":"historic"},{"id":"pluvicto","kind":"drug","name":"Lutetium-177 vipivotide tetraxetan","aka":"","tldr":"A radioactive drug that seeks out PSMA on prostate cancer cells; the best-selling radiopharmaceutical ever.","tags":"","route":"/drugs/pluvicto/","status":"approved","indications":"prostate prostate-mcrpc prostate-mhspc"},{"id":"psma-1007-f18","kind":"drug","name":"PSMA-1007 F-18","aka":"Prostalumin","tldr":"PSMA-1007 is a fluorine-18 PSMA PET tracer from ABX in Germany, widely used in Europe for prostate cancer staging because little of it reaches the bladder, and in a phase 3 trial registered by its maker.","tags":"pipeline ctgov-ingest","route":"/drugs/psma-1007-f18/","status":"phase-3","indications":"prostate"},{"id":"pylarify","kind":"drug","name":"Piflufolastat F-18 / Pylarify TruVu","aka":"","tldr":"Piflufolastat F-18 (Pylarify) is the leading PSMA PET tracer for prostate cancer, with a new formulation approved in March 2026.","tags":"","route":"/drugs/pylarify/","status":"approved","indications":"prostate"},{"id":"radioactive-iodine","kind":"drug","name":"Radioactive iodine (I-131)","aka":"","tldr":"The original targeted radiotherapy: thyroid cells soak up iodine, so radioactive iodine destroys leftover thyroid tissue and metastases while sparing everything else.","tags":"","route":"/drugs/radioactive-iodine/","status":"approved","indications":"thyroid"},{"id":"radium-223","kind":"drug","name":"Radium-223 dichloride","aka":"","tldr":"Radium-223 was the first alpha-emitting drug ever approved (2013). It homes to bone like calcium and treats prostate cancer that has spread only to bone.","tags":"","route":"/drugs/radium-223/","status":"approved","indications":"prostate prostate-mcrpc"},{"id":"rituximab","kind":"drug","name":"Rituximab","aka":"Rituximab and Hyaluronidase Human Rituxan Hycela","tldr":"Rituximab was the first antibody ever approved for cancer (1997). It made chemoimmunotherapy the CLL standard for a decade, and biosimilars keep it cheap and everywhere.","tags":"","route":"/drugs/rituximab/","status":"approved","indications":"dlbcl"},{"id":"ryz101","kind":"drug","name":"Actinium-225 DOTATATE","aka":"","tldr":"An alpha-particle version of Lutathera for neuroendocrine tumours that have stopped responding to the beta version.","tags":"","route":"/drugs/ryz101/","status":"phase-3","indications":"neuroendocrine sclc"},{"id":"samarium-153-lexidronam","kind":"drug","name":"Samarium-153 lexidronam","aka":"153Sm-EDTMP Samarium Sm 153 lexidronam pentasodium","tldr":"Quadramet (samarium-153 lexidronam) is a radioactive bone-seeking injection that lodges in bone metastases and irradiates them from inside, approved in 1997 to relieve pain from prostate, breast and other cancers spread to bone. Most patients get relief within one to two weeks, but marrow suppression follows at three to five weeks, and radium-223 and PSMA radioligands have largely replaced it.","tags":"ema-list supportive","route":"/drugs/samarium-153-lexidronam/","status":"approved","indications":"prostate"},{"id":"sorafenib","kind":"drug","name":"Sorafenib","aka":"","tldr":"The first drug ever to extend life in advanced liver cancer (2007), now mostly a comparator arm that newer combinations are measured against.","tags":"","route":"/drugs/sorafenib/","status":"approved","indications":"hcc rcc thyroid"},{"id":"sunitinib","kind":"drug","name":"Sunitinib","aka":"","tldr":"Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.","tags":"","route":"/drugs/sunitinib/","status":"approved","indications":"neuroendocrine rcc metastatic-ppgl"},{"id":"technetium-sulfur-colloid","kind":"drug","name":"Technetium Tc-99m sulfur colloid","aka":"Tc-99m sulphur colloid","tldr":"Technetium sulfur colloid is the radioactive tracer injected around a breast cancer or melanoma before surgery so the surgeon can find the first lymph node the tumour drains to and remove only that node instead of the whole basin.","tags":"gap-fill chembl-universe","route":"/drugs/technetium-sulfur-colloid/","status":"established"},{"id":"temozolomide","kind":"drug","name":"Temozolomide","aka":"","tldr":"The only chemotherapy proven to extend life in glioblastoma, given during and after radiation. It works best when the tumour has switched off a repair gene called MGMT.","tags":"","route":"/drugs/temozolomide/","status":"standard-of-care","indications":"glioblastoma"},{"id":"thyrotropin-alfa","kind":"drug","name":"Thyrotropin alfa","aka":"Recombinant human TSH rhTSH","tldr":"Thyrogen is an injected version of thyroid-stimulating hormone that lets people with thyroid cancer have radioiodine treatment and follow-up blood tests without stopping their thyroid hormone tablets and suffering weeks of hypothyroidism.","tags":"ema-list supportive","route":"/drugs/thyrotropin-alfa/","status":"approved","indications":"thyroid"},{"id":"tilmanocept-tc99m","kind":"drug","name":"Technetium-99m tilmanocept","aka":"","tldr":"The purpose-built tracer for sentinel lymph node mapping in breast cancer, melanoma and oral cancer, replacing off-label sulfur colloid.","tags":"gap-fill diagnostic","route":"/drugs/tilmanocept-tc99m/","status":"approved"},{"id":"abdera-therapeutics","kind":"company","name":"Abdera Therapeutics","aka":"","tldr":"Abdera Therapeutics engineered antibodies that carry a radioactive isotope to cancer cells, tuning how long they circulate so more radiation reaches the tumour and less reaches healthy tissue. Its first medicine targets a protein on small cell lung cancer.","tags":"","route":"/companies/abdera-therapeutics/","indications":"sclc"},{"id":"abx-advanced-biochemical-compounds","kind":"company","name":"ABX advanced biochemical compounds","aka":"ABX advanced biochemical compounds GmbH ABX GmbH ABX","tldr":"ABX is a German maker of the precursors and kits behind PET imaging tracers, including PSMA agents for prostate cancer, and sponsors the trials that register them.","tags":"ctgov-sponsor","route":"/companies/abx-advanced-biochemical-compounds/","indications":"prostate"},{"id":"acrotech-biopharma","kind":"company","name":"Acrotech Biopharma","aka":"","tldr":"Acrotech Biopharma, part of Aurobindo, owns the former Spectrum Pharmaceuticals haematology portfolio: the radioimmunotherapy Zevalin, pralatrexate (Folotyn), belinostat (Beleodaq) and vincristine liposome (Marqibo).","tags":"","route":"/companies/acrotech-biopharma/","indications":"follicular-lymphoma"},{"id":"actinium-pharmaceuticals","kind":"company","name":"Actinium Pharmaceuticals","aka":"","tldr":"Actinium Pharmaceuticals attaches the alpha-emitting isotope actinium-225 to antibodies to treat acute myeloid leukaemia and, more recently, solid tumours such as prostate and lung cancer. It is a small listed company whose lead programme is approaching new clinical milestones.","tags":"","route":"/companies/actinium-pharmaceuticals/","indications":"prostate"},{"id":"advanced-accelerator-applications","kind":"company","name":"Advanced Accelerator Applications (Novartis)","aka":"","tldr":"The CERN spin-out that Novartis bought in 2018 for Lutathera, which now makes Pluvicto and the Locametz and Netspot imaging kits.","tags":"","route":"/companies/advanced-accelerator-applications/","indications":"prostate neuroendocrine"},{"id":"aktis-oncology","kind":"company","name":"Aktis Oncology","aka":"","tldr":"Miniprotein alpha-radiopharmaceutical company; the first biotech IPO of 2026 (~$365M) funds Ac-225 programmes against Nectin-4 and B7-H3.","tags":"frontier","route":"/companies/aktis-oncology/","indications":"sclc prostate"},{"id":"alpha-9-oncology","kind":"company","name":"Alpha-9 Oncology","aka":"","tldr":"Alpha-9 Oncology designs bespoke molecules that deliver radioactive isotopes to cancer cells, with early human trials under way in melanoma and in breast and other solid tumours.","tags":"","route":"/companies/alpha-9-oncology/"},{"id":"ansto","kind":"company","name":"ANSTO (Australian Nuclear Science and Technology Organisation)","aka":"ANSTO Nuclear Medicine","tldr":"ANSTO runs the OPAL research reactor near Sydney and a molybdenum-99 plant that supplies Australia's nuclear medicine and exports, and produces lutetium-177 for radioligand therapy.","tags":"manufacturing-wave","route":"/companies/ansto/"},{"id":"ariceum-therapeutics","kind":"company","name":"Ariceum Therapeutics","aka":"","tldr":"Ariceum Therapeutics is a Berlin company developing a treatment that carries the alpha-emitting isotope actinium-225 to small cell lung cancer and Merkel cell skin cancer. Its first human trial began in late 2025.","tags":"","route":"/companies/ariceum-therapeutics/","indications":"sclc"},{"id":"artbio","kind":"company","name":"ARTBIO","aka":"","tldr":"ARTBIO makes cancer treatments that deliver short-range alpha radiation from lead-212 directly to tumour cells, starting with prostate cancer. Its first medicine is in early human trials, currently paused by the company while it reviews data.","tags":"","route":"/companies/artbio/","indications":"prostate"},{"id":"astrazeneca","kind":"company","name":"AstraZeneca","aka":"Acerta Pharma Alexion Pharmaceuticals MedImmune LLC MedImmune","tldr":"AstraZeneca is the most ADC-committed large pharma, co-owner of Enhertu and Datroway, with deep targeted-therapy and radiopharma bets.","tags":"","route":"/companies/astrazeneca/"},{"id":"atomic-alchemy","kind":"company","name":"Atomic Alchemy","aka":"","tldr":"Atomic Alchemy set out to build small reactors dedicated to making the radioactive isotopes used in cancer scans and treatments, so hospitals no longer depend on a handful of ageing government reactors. It was bought by the nuclear company Oklo.","tags":"isotope-supply","route":"/companies/atomic-alchemy/"},{"id":"bayer","kind":"company","name":"Bayer","aka":"","tldr":"Bayer owns Xofigo, the only approved alpha emitter, and is developing next-generation actinium PSMA agents.","tags":"","route":"/companies/bayer/"},{"id":"blue-earth-diagnostics","kind":"company","name":"Blue Earth Diagnostics (Bracco)","aka":"","tldr":"Blue Earth Diagnostics makes Posluma (18F-rhPSMA-7.3) and Axumin (fluciclovine) PET agents for prostate cancer.","tags":"","route":"/companies/blue-earth-diagnostics/","indications":"prostate"},{"id":"bms","kind":"company","name":"Bristol Myers Squibb","aka":"Bristol-Myers Squibb Juno Therapeutics Mirati Therapeutics Celgene American Regent, Inc. American Regent YM BioSciences","tldr":"Pioneer of checkpoint inhibitors (Opdivo, Yervoy), now betting on the first successful bispecific ADC and alpha radiopharmaceuticals.","tags":"","route":"/companies/bms/"},{"id":"boston-scientific","kind":"company","name":"Boston Scientific","aka":"","tldr":"Medical device giant whose TheraSphere glass microspheres deliver yttrium-90 radioembolisation in liver cancer.","tags":"","route":"/companies/boston-scientific/","indications":"hcc"},{"id":"canon-medical","kind":"company","name":"Canon Medical Systems","aka":"","tldr":"Canon Medical is the Japanese imaging vendor (formerly Toshiba Medical) with CT, MRI, ultrasound, and the Cartesion Prime PET/CT.","tags":"supporting","route":"/companies/canon-medical/"},{"id":"cardinal-health","kind":"company","name":"Cardinal Health Nuclear & Precision Health Solutions","aka":"","tldr":"Nuclear pharmacy network (>130 sites) that compounds and delivers SPECT and PET doses, and a distributor of oncology drugs to community practices.","tags":"supporting","route":"/companies/cardinal-health/"},{"id":"cellectar","kind":"company","name":"Cellectar Biosciences","aka":"Cellectar Biosciences, Inc. Cellectar","tldr":"Cellectar is a New Jersey radiopharmaceutical company whose iodine-131 phospholipid drug conjugate iopofosine targets the lipid rafts of cancer cells, with a pivotal trial (CLOVER-WaM) in relapsed Waldenström macroglobulinaemia.","tags":"ctgov-sponsor","route":"/companies/cellectar/"},{"id":"clarity-pharmaceuticals","kind":"company","name":"Clarity Pharmaceuticals","aka":"","tldr":"Clarity Pharmaceuticals, a Sydney radiopharmaceutical company, pairs copper isotopes with SAR-bisPSMA, a molecule that binds PSMA on prostate cancer cells: copper-64 for PET imaging, in the phase 3 AMPLIFY and CLARIFY trials, and copper-67 for therapy in the SECuRE trial. The copper-67 therapy is still at the dose-finding stage.","tags":"","route":"/companies/clarity-pharmaceuticals/","indications":"prostate"},{"id":"comecer","kind":"company","name":"Comecer (ATS)","aka":"","tldr":"Comecer, of Castel Bolognese, Italy, and part of ATS Corporation, makes hot cells, isolators and dose calibrators, the shielded enclosures and automation that radiopharmacies need to handle radioactive drugs aseptically. Therapeutic radioligands need more shielding than diagnostic tracers, and whether hospitals build enough of it is the open question.","tags":"supporting","route":"/companies/comecer/"},{"id":"convergent-therapeutics","kind":"company","name":"Convergent Therapeutics","aka":"","tldr":"Convergent Therapeutics attaches an alpha-emitting isotope to an antibody that homes in on prostate cancer cells, for men whose disease has progressed after standard radioligand treatment. Its lead medicine has reported mid-stage trial results.","tags":"","route":"/companies/convergent-therapeutics/","indications":"prostate"},{"id":"curium","kind":"company","name":"Curium","aka":"","tldr":"Curium is one of the largest nuclear-medicine companies, developing 177Lu-PSMA-I&T (ECLIPSE) as a competitor to Pluvicto.","tags":"","route":"/companies/curium/","indications":"prostate"},{"id":"eckert-ziegler","kind":"company","name":"Eckert & Ziegler","aka":"","tldr":"German isotope and radiopharmaceutical services company supplying Lu-177, Ga-68 generators, Ac-225 development, and contract manufacturing.","tags":"supporting","route":"/companies/eckert-ziegler/"},{"id":"eli-lilly","kind":"company","name":"Eli Lilly (incl. Loxo)","aka":"","tldr":"Eli Lilly makes Verzenio and Retevmo, as well as the oral SERD imlunestrant and the BTK inhibitor pirtobrutinib.","tags":"","route":"/companies/eli-lilly/"},{"id":"evergreen-theragnostics","kind":"company","name":"Evergreen Theragnostics","aka":"","tldr":"Evergreen Theragnostics manufactures radioactive cancer medicines for other companies and develops its own imaging agent for neuroendocrine tumours and a treatment for small cell lung cancer. Lantheus agreed to buy it in 2025.","tags":"","route":"/companies/evergreen-theragnostics/","indications":"neuroendocrine sclc"},{"id":"fusion-pharma","kind":"company","name":"Fusion Pharmaceuticals (AstraZeneca)","aka":"","tldr":"Alpha-emitter company acquired by AstraZeneca ($2.4B, 2024); FPI-2265 (225Ac-PSMA-I&T) in phase 3.","tags":"","route":"/companies/fusion-pharma/"},{"id":"futurechem","kind":"company","name":"FutureChem","aka":"","tldr":"FutureChem is a South Korea-based radiopharmaceutical company running 2 late-stage cancer trials of [F-18]Florastamin in prostate cancer.","tags":"ctgov-sponsor","route":"/companies/futurechem/","indications":"prostate"},{"id":"ge-healthcare","kind":"company","name":"GE HealthCare","aka":"","tldr":"GE HealthCare, of Chicago, makes PET/CT, MRI and CT scanners (Omni Legend, SIGNA, Revolution) and PET tracers through its Pharmaceutical Diagnostics business, including Cerianna, the fluoroestradiol F-18 agent that images oestrogen receptors in breast cancer. Whether receptor-imaging tracers change treatment decisions often enough to be reimbursed is its tracer business's open question.","tags":"","route":"/companies/ge-healthcare/"},{"id":"hamamatsu","kind":"company","name":"Hamamatsu Photonics","aka":"","tldr":"Hamamatsu is the photonics company behind the NanoZoomer slide scanners and the photodetectors inside most PET scanners.","tags":"supporting","route":"/companies/hamamatsu/"},{"id":"iba","kind":"company","name":"IBA (Ion Beam Applications)","aka":"","tldr":"IBA (Ion Beam Applications), of Louvain-la-Neuve, Belgium, is the largest supplier of proton therapy equipment: its Proteus One and Proteus Plus systems equip proton centres worldwide, and it also builds cyclotrons for PET isotope production. Proton therapy's capital cost is the problem its compact systems try to answer.","tags":"","route":"/companies/iba/"},{"id":"ire","kind":"company","name":"IRE (Institut national des Radioéléments)","aka":"IRE ELiT","tldr":"IRE in Belgium is one of the world's few molybdenum-99 processors, taking irradiated targets from European research reactors, and its IRE ELiT arm makes the Galli Eo gallium-68 generator.","tags":"manufacturing-wave","route":"/companies/ire/"},{"id":"isotopia","kind":"company","name":"Isotopia Molecular Imaging","aka":"","tldr":"Isotopia is an Israeli producer of non-carrier-added lutetium-177 and PET tracers that supplies several radioligand developers.","tags":"manufacturing-wave","route":"/companies/isotopia/"},{"id":"itm","kind":"company","name":"ITM Isotope Technologies Munich","aka":"ITM Solucin GmbH","tldr":"ITM is the largest non-carrier-added lutetium-177 supplier and the developer of ITM-11 (177Lu-edotreotide).","tags":"","route":"/companies/itm/"},{"id":"johnson-johnson","kind":"company","name":"Johnson & Johnson","aka":"Alza Corporation Janssen Ortho Biotech Products, L.P. Ortho Biotech Sequus Pharmaceuticals Centocor, Inc. Centocor Alza Corporation, DE, USA Cougar Biotechnology, Inc. Cougar Biotechnology McNeil Consumer & Specialty Pharmaceuticals McNeil","tldr":"Johnson & Johnson leads in multiple myeloma (Darzalex, Carvykti, Tecvayli, Talvey) and in bispecific antibodies for lung cancer (Rybrevant).","tags":"","route":"/companies/johnson-johnson/"},{"id":"jubilant-radiopharma","kind":"company","name":"Jubilant Radiopharma","aka":"","tldr":"Jubilant Radiopharma is a radiopharmacy network and the manufacturer of I-131 MIBG (AdreView), Ruby-Fill, and PET tracers.","tags":"supporting","route":"/companies/jubilant-radiopharma/"},{"id":"lantheus","kind":"company","name":"Lantheus","aka":"Progenics Pharmaceuticals, Inc. Progenics Molecular Insight Pharmaceuticals, Inc. Molecular Insight Pharmaceuticals","tldr":"Lantheus makes Pylarify, the leading PSMA PET agent, with a new TruVu formulation approved in March 2026.","tags":"","route":"/companies/lantheus/"},{"id":"mariana-oncology","kind":"company","name":"Mariana Oncology","aka":"","tldr":"Mariana Oncology designs small protein fragments that carry a radioactive isotope to tumours, starting with small cell lung cancer. Novartis bought the company in 2024 for 1 billion dollars up front.","tags":"","route":"/companies/mariana-oncology/","indications":"sclc"},{"id":"mediso","kind":"company","name":"Mediso","aka":"","tldr":"Mediso is a Hungarian nuclear medicine company making AnyScan SPECT/CT and PET/CT cameras for hospitals and nanoScan PET/MRI and SPECT/CT scanners for preclinical research.","tags":"machines-wave","route":"/companies/mediso/"},{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","aka":"","tldr":"Merck & Co. (MSD) makes Keytruda, the world's best-selling cancer drug, and is now building the next act around TROP2 ADCs and personalised vaccines.","tags":"","route":"/companies/merck/"},{"id":"mim-software","kind":"company","name":"MIM Software (GE HealthCare)","aka":"","tldr":"Contouring, image fusion, and dosimetry software (MIM Maestro, SurePlan) for radiotherapy and radioligand therapy, acquired by GE HealthCare in 2024.","tags":"supporting","route":"/companies/mim-software/"},{"id":"monopar","kind":"company","name":"Monopar Therapeutics","aka":"Monopar Therapeutics Inc. Monopar","tldr":"Monopar is a Chicago-area biotech that took the mucositis drug validive into a phase 3 trial in head and neck cancer, which failed in 2023, and now develops radiopharmaceuticals against the uPAR protein.","tags":"ctgov-sponsor","route":"/companies/monopar/"},{"id":"navidea","kind":"company","name":"Navidea Biopharmaceuticals","aka":"Navidea Neoprobe Corporation","tldr":"Navidea developed technetium-99m tilmanocept (Lymphoseek), the radiotracer approved in 2013 for mapping sentinel lymph nodes in breast cancer, melanoma and head and neck cancer.","tags":"ctgov-sponsor","route":"/companies/navidea/"},{"id":"nordion","kind":"company","name":"Nordion (Sotera Health)","aka":"","tldr":"Nordion supplies most of the world's cobalt-60, which sterilises single-use bioprocess bags and medical devices and powers Gamma Knife units, and was the largest molybdenum-99 processor until Canada's NRU reactor stopped.","tags":"manufacturing-wave","route":"/companies/nordion/"},{"id":"northstar-medical-radioisotopes","kind":"company","name":"NorthStar Medical Radioisotopes","aka":"","tldr":"NorthStar is a non-reactor producer of Mo-99 in the US and an emerging supplier of non-carrier-added Lu-177 and Ac-225 made with electron accelerators.","tags":"supporting","route":"/companies/northstar-medical-radioisotopes/"},{"id":"novartis","kind":"company","name":"Novartis","aka":"Endocyte","tldr":"The company that made radioligand therapy a business, with Pluvicto and Lutathera, and the maker of Kisqali and Gleevec.","tags":"","route":"/companies/novartis/"},{"id":"ntp-radioisotopes","kind":"company","name":"NTP Radioisotopes","aka":"NTP","tldr":"NTP, part of South Africa's state nuclear corporation, processes molybdenum-99 and other isotopes from the SAFARI-1 reactor and was the first major producer to switch to low-enriched uranium targets.","tags":"manufacturing-wave","route":"/companies/ntp-radioisotopes/"},{"id":"nucleus-radiopharma","kind":"company","name":"Nucleus RadioPharma","aka":"","tldr":"Nucleus RadioPharma does not make its own cancer drugs; it manufactures and ships radioactive cancer medicines for other companies, which is hard because the drugs decay within days. It is expanding its plants in Minnesota and Pennsylvania.","tags":"","route":"/companies/nucleus-radiopharma/"},{"id":"nusano","kind":"company","name":"Nusano","aka":"","tldr":"Nusano is a Utah company building an isotope production plant around its own ion beam technology, aiming at actinium-225 and other therapeutic isotopes that are in short supply.","tags":"manufacturing-wave","route":"/companies/nusano/"},{"id":"orano-med","kind":"company","name":"Orano Med","aka":"","tldr":"Orano Med is the leading lead-212 producer and the developer of 212Pb-DOTAMTATE (AlphaMedix).","tags":"","route":"/companies/orano-med/"},{"id":"perspective-therapeutics","kind":"company","name":"Perspective Therapeutics","aka":"","tldr":"Lead-212 alpha-therapy company whose SSTR2 agent [212Pb]VMT-α-NET reported a 43% response rate in neuroendocrine tumours and is heading for phase 3.","tags":"","route":"/companies/perspective-therapeutics/","indications":"neuroendocrine"},{"id":"petnet-solutions","kind":"company","name":"PETNET Solutions (Siemens Healthineers)","aka":"","tldr":"PETNET Solutions is the largest network of PET radiopharmacies in the US, producing FDG and PSMA tracers daily.","tags":"supporting","route":"/companies/petnet-solutions/"},{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","aka":"Seagen Seagen (Pfizer) Seattle Genetics","tldr":"Bought Seagen for $43B to become an ADC leader; also makes Ibrance, Lorbrena, Braftovi, and the first PROTAC.","tags":"","route":"/companies/pfizer/"},{"id":"point-biopharma","kind":"company","name":"POINT Biopharma","aka":"","tldr":"POINT Biopharma developed radioactive medicines that home in on prostate cancer and neuroendocrine tumours, and built a large manufacturing campus in Indianapolis. Eli Lilly bought the company at the end of 2023.","tags":"","route":"/companies/point-biopharma/","indications":"prostate neuroendocrine"},{"id":"precirix","kind":"company","name":"Precirix","aka":"","tldr":"Precirix, of Brussels, develops radiopharmaceuticals built on small single-domain antibody fragments that carry a radioactive isotope to HER2-positive cancers. Its lead, CAM-H2, is in a phase 1/2 trial in HER2-positive breast, gastric and gastro-oesophageal cancer, including patients with brain metastases, with an imaging dose given first to confirm HER2 in the lesions.","tags":"","route":"/companies/precirix/","indications":"breast-her2-positive"},{"id":"radiomedix","kind":"company","name":"RadioMedix","aka":"","tldr":"RadioMedix is developing AlphaMedix (212Pb-DOTAMTATE) with Orano Med, the first targeted alpha therapy to receive FDA Breakthrough designation.","tags":"","route":"/companies/radiomedix/","indications":"neuroendocrine"},{"id":"radionetics-oncology","kind":"company","name":"Radionetics Oncology","aka":"","tldr":"Radionetics Oncology makes small-molecule drugs that carry a radioactive isotope to receptors on the surface of cancer cells that have rarely been targeted before. Eli Lilly paid 140 million dollars in 2024 for the right to buy the company for 1 billion dollars.","tags":"","route":"/companies/radionetics-oncology/"},{"id":"radiopharm-theranostics","kind":"company","name":"Radiopharm Theranostics","aka":"Radiopharm Theranostics, Ltd","tldr":"Radiopharm Theranostics is an Australia-based radiopharmaceutical company that leads 3 cancer trials in Nuclide, testing the radiopharmaceuticals 161Tb-RAD402, 177Lu-BetaBart and the PET tracer RAD101 in prostate cancer, colorectal cancer, non-small-cell lung cancer and ovarian cancer.","tags":"ctgov-sponsor","route":"/companies/radiopharm-theranostics/","indications":"prostate"},{"id":"ratio-therapeutics","kind":"company","name":"Ratio Therapeutics","aka":"","tldr":"Ratio Therapeutics, of Boston, designs small molecules that carry a radioactive isotope to fibroblast activation protein, a protein on the supporting tissue of sarcomas and other solid tumours, so radiation is delivered from inside the body. Its lead, an actinium-225 radioligand, is in the ATLAS phase 1/2 trial in advanced sarcomas.","tags":"","route":"/companies/ratio-therapeutics/"},{"id":"rayzebio","kind":"company","name":"RayzeBio (BMS)","aka":"","tldr":"RayzeBio is the actinium-225 radiopharma company that BMS bought for $4.1B; its RYZ101 is in phase 3.","tags":"","route":"/companies/rayzebio/"},{"id":"shine-technologies","kind":"company","name":"SHINE Technologies","aka":"","tldr":"SHINE Technologies is a fusion-based isotope company that produces non-carrier-added Lu-177 (Ilumira) and is building the Chrysalis Mo-99 plant.","tags":"supporting","route":"/companies/shine-technologies/"},{"id":"siemens-healthineers","kind":"company","name":"Siemens Healthineers","aka":"","tldr":"Siemens Healthineers makes the Biograph Vision Quadra total-body PET and photon-counting CT, and owns Varian.","tags":"","route":"/companies/siemens-healthineers/"},{"id":"sinotau-pharmaceutical","kind":"company","name":"Sinotau Pharmaceutical","aka":"Sinotau Pharmaceutical Group","tldr":"Sinotau Pharmaceutical is a China-based radiopharmaceutical company running 2 late-stage cancer trials of Octreotide LAR in neuroendocrine tumours.","tags":"ctgov-sponsor","route":"/companies/sinotau-pharmaceutical/","indications":"neuroendocrine"},{"id":"sirtex","kind":"company","name":"Sirtex Medical","aka":"","tldr":"Sirtex makes SIR-Spheres, yttrium-90 resin microspheres used for radioembolisation of liver tumours.","tags":"","route":"/companies/sirtex/","indications":"hcc"},{"id":"sofie-biosciences","kind":"company","name":"SOFIE Biosciences","aka":"","tldr":"SOFIE Biosciences is a US radiopharmacy network running two phase 3 trials of the FAP PET tracer [18F]FAPI-74 in pancreatic and gastro-oesophageal cancer.","tags":"","route":"/companies/sofie-biosciences/"},{"id":"spectrum-pharmaceuticals","kind":"company","name":"Spectrum Pharmaceuticals","aka":"Spectrum Pharmaceuticals, Inc Spectrum Pharmaceuticals, Inc.","tldr":"Spectrum Pharmaceuticals was a US cancer company that sold its haematology portfolio to Acrotech in 2019, won approval for the long-acting G-CSF eflapegrastim (Rolvedon) in 2022, and was acquired by Assertio in 2023.","tags":"ctgov-sponsor","route":"/companies/spectrum-pharmaceuticals/"},{"id":"telix","kind":"company","name":"Telix Pharmaceuticals","aka":"","tldr":"Telix is the Australian theranostics company behind Illuccix and Gozellix PSMA imaging and a broad therapeutic pipeline.","tags":"","route":"/companies/telix/"},{"id":"terrapower-isotopes","kind":"company","name":"TerraPower Isotopes","aka":"","tldr":"Bill Gates-backed producer of actinium-225 from thorium-229, building a Philadelphia facility to raise supply 20-fold.","tags":"isotope-supply","route":"/companies/terrapower-isotopes/"},{"id":"trasis","kind":"company","name":"Trasis","aka":"","tldr":"Belgian maker of radiopharmaceutical synthesis modules (AllinOne, miniAiO) and dose dispensers used in PET and therapy radiopharmacies.","tags":"supporting","route":"/companies/trasis/"},{"id":"united-imaging","kind":"company","name":"United Imaging","aka":"","tldr":"Chinese imaging company that built uEXPLORER, the first total-body PET scanner.","tags":"","route":"/companies/united-imaging/"},{"id":"y-mabs","kind":"company","name":"Y-mAbs Therapeutics","aka":"","tldr":"MSK spin-out that commercialises naxitamab, the humanised anti-GD2 antibody for relapsed neuroblastoma, and develops pretargeted radioimmunotherapy.","tags":"","route":"/companies/y-mabs/","indications":"neuroblastoma"},{"id":"aiims-delhi","kind":"institution","name":"All India Institute of Medical Sciences, New Delhi","aka":"AIIMS Dr B.R. Ambedkar Institute Rotary Cancer Hospital National Cancer Institute Jhajjar","tldr":"AIIMS New Delhi is India's flagship public medical institute; its Rotary Cancer Hospital and the National Cancer Institute campus at Jhajjar anchor government cancer research, and its investigators lead Indian studies in paediatric oncology, gallbladder cancer, PSMA radioligand therapy and low-cost CAR-T.","tags":"","route":"/institutions/aiims-delhi/","indications":"prostate"},{"id":"anzup","kind":"institution","name":"ANZUP Cancer Trials Group","aka":"Australian and New Zealand Urogenital and Prostate Cancer Trials Group ANZUP","tldr":"The Australian genitourinary trials group behind TheraP and proPSMA, the trials that put PSMA imaging and lutetium-PSMA therapy on the map.","tags":"","route":"/institutions/anzup/","indications":"prostate rcc"},{"id":"ccc-wuerzburg","kind":"institution","name":"Comprehensive Cancer Center Mainfranken, University Hospital Würzburg","aka":"CCC Mainfranken Universitätsklinikum Würzburg NCT WERA","tldr":"The university where Röntgen discovered X-rays, now a world centre for CAR-T and bispecific antibodies in multiple myeloma under Hermann Einsele.","tags":"","route":"/institutions/ccc-wuerzburg/","indications":"dlbcl"},{"id":"centre-eugene-marquis","kind":"institution","name":"Centre Eugène Marquis","aka":"","tldr":"The Unicancer cancer centre for Brittany in Rennes, accredited by OECI as a Comprehensive Cancer Centre.","tags":"oeci-accredited oeci-comprehensive-cancer-centre unicancer","route":"/institutions/centre-eugene-marquis/"},{"id":"charite","kind":"institution","name":"Charité Universitätsmedizin Berlin","aka":"Charité Comprehensive Cancer Center Charité Comprehensive Cancer Center (CCCC)","tldr":"Charité is Europe's largest university hospital, with a Comprehensive Cancer Center and the Berlin Institute of Health.","tags":"","route":"/institutions/charite/"},{"id":"curanosticum","kind":"institution","name":"Curanosticum Wiesbaden-Frankfurt","aka":"","tldr":"Curanosticum is a nuclear medicine practice in Wiesbaden and Frankfurt led by Richard Baum, one of the pioneers of peptide receptor radionuclide therapy, offering FAPI PET and investigational radioligand therapies.","tags":"fcct-directory","route":"/institutions/curanosticum/"},{"id":"dana-farber","kind":"institution","name":"Dana-Farber Brigham Cancer Center","aka":"","tldr":"Where chemotherapy began (Farber, 1948) and where much of modern breast, lung, and myeloma oncology was defined.","tags":"","route":"/institutions/dana-farber/"},{"id":"eanm","kind":"institution","name":"European Association of Nuclear Medicine","aka":"EANM","tldr":"Europe's nuclear medicine society, whose congress and guidelines shaped the clinical adoption of PSMA PET and lutetium radioligand therapy that began in European centres.","tags":"","route":"/institutions/eanm/"},{"id":"ema","kind":"institution","name":"European Medicines Agency","aka":"EMA CHMP","tldr":"The EU agency whose Committee for Medicinal Products for Human Use recommends the marketing authorisations for cancer drugs across all member states.","tags":"","route":"/institutions/ema/"},{"id":"erasmus-mc","kind":"institution","name":"Erasmus MC Cancer Institute","aka":"Erasmus MC Daniel den Hoed Erasmus University Medical Center","tldr":"Rotterdam's OECI-accredited comprehensive cancer centre, where peptide receptor radionuclide therapy with lutetium-177 was pioneered and Europe's largest screening trials were led.","tags":"","route":"/institutions/erasmus-mc/","indications":"neuroendocrine prostate glioblastoma"},{"id":"essen-wtz","kind":"institution","name":"West German Cancer Center (WTZ), University Hospital Essen","aka":"Westdeutsches Tumorzentrum Universitätsklinikum Essen NCT West","tldr":"One of Germany's oldest and largest cancer centres, home to the West German Proton Therapy Centre and a leading melanoma and theranostics programme.","tags":"","route":"/institutions/essen-wtz/","indications":"prostate neuroendocrine"},{"id":"excel-diagnostics-nuclear-oncology","kind":"institution","name":"Excel Diagnostics and Nuclear Oncology Center","aka":"","tldr":"Excel Diagnostics is a Houston nuclear medicine centre offering molecular imaging and radioligand therapies, bookable through an oncology referral.","tags":"fcct-directory","route":"/institutions/excel-diagnostics-nuclear-oncology/"},{"id":"fuscc","kind":"institution","name":"Fudan University Shanghai Cancer Center","aka":"","tldr":"Fudan University Shanghai Cancer Center is China's leading breast cancer centre and the site of first-in-human TROP2 PET imaging.","tags":"","route":"/institutions/fuscc/"},{"id":"heidelberg-nct","kind":"institution","name":"Heidelberg University Hospital / NCT / DKFZ","aka":"","tldr":"Heidelberg is Germany's cancer research capital, home to the DKFZ (largest cancer research institute in Germany) and the NCT, and the birthplace of FAPI PET and the brain tumour methylation classifier.","tags":"","route":"/institutions/heidelberg-nct/"},{"id":"iaea","kind":"institution","name":"International Atomic Energy Agency: Rays of Hope","aka":"IAEA Rays of Hope PACT","tldr":"The UN nuclear agency's programme to bring radiotherapy and nuclear medicine to the dozens of countries that have no or too few treatment machines.","tags":"","route":"/institutions/iaea/"},{"id":"ico-angers-nantes","kind":"institution","name":"Institut de Cancérologie de l'Ouest (ICO)","aka":"ICO Paul Papin ICO René Gauducheau Integrated Center for Oncology","tldr":"The Unicancer cancer centre for western France, with sites in Angers and Nantes, accredited by OECI as a Comprehensive Cancer Centre.","tags":"oeci-accredited oeci-comprehensive-cancer-centre unicancer","route":"/institutions/ico-angers-nantes/"},{"id":"inselspital-bern","kind":"institution","name":"Inselspital, Bern University Hospital / University Cancer Center Inselspital","aka":"Inselspital UCI Bern Bern Center for Precision Medicine","tldr":"Bern's university hospital, a high-volume radioligand therapy centre and home to the Bern Center for Precision Medicine and the SAKK trial group.","tags":"","route":"/institutions/inselspital-bern/","indications":"prostate neuroendocrine glioblastoma"},{"id":"institut-jules-bordet","kind":"institution","name":"Institut Jules Bordet","aka":"Jules Bordet Institute Bordet Hôpital Universitaire de Bruxelles","tldr":"Belgium's only hospital devoted entirely to cancer, birthplace of the Breast International Group and a world centre for breast cancer trials.","tags":"","route":"/institutions/institut-jules-bordet/","indications":"breast-her2-positive dlbcl"},{"id":"iov-veneto","kind":"institution","name":"Istituto Oncologico Veneto IRCCS","aka":"IOV Veneto Institute of Oncology","tldr":"The Veneto region's OECI-accredited comprehensive cancer centre in Padua, strong in breast cancer trials, melanoma and tumour immunology.","tags":"","route":"/institutions/iov-veneto/","indications":"breast-her2-positive"},{"id":"irst-meldola","kind":"institution","name":"IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)","aka":"IRST Meldola IRST IRCCS","tldr":"The Romagna cancer institute, known for radioligand therapy, nuclear medicine and genitourinary and sarcoma trials.","tags":"","route":"/institutions/irst-meldola/","indications":"neuroendocrine prostate"},{"id":"ivo-valencia","kind":"institution","name":"Fundación Instituto Valenciano de Oncología (IVO)","aka":"IVO","tldr":"A private non-profit dedicated cancer hospital in Valencia, accredited by OECI as a Cancer Centre.","tags":"oeci-accredited oeci-cancer-centre","route":"/institutions/ivo-valencia/"},{"id":"johns-hopkins","kind":"institution","name":"Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center","aka":"","tldr":"Johns Hopkins is the birthplace of cancer genomics (Vogelstein), MSI-high immunotherapy (Le, Diaz), and liquid biopsy and MCED science (CancerSEEK).","tags":"","route":"/institutions/johns-hopkins/"},{"id":"karolinska","kind":"institution","name":"Karolinska University Hospital","aka":"Karolinska Comprehensive Cancer Center","tldr":"Sweden's leading cancer hospital, linked to the Karolinska Institutet and Nobel Assembly, with strong registry-based research.","tags":"","route":"/institutions/karolinska/"},{"id":"kfshrc","kind":"institution","name":"King Faisal Specialist Hospital and Research Centre","aka":"KFSH&RC KFSHRC مستشفى الملك فيصل التخصصي","tldr":"Saudi Arabia's flagship tertiary hospital, whose Oncology Centre runs the Gulf's largest transplant, CAR-T and proton therapy programmes.","tags":"","route":"/institutions/kfshrc/","indications":"thyroid dlbcl"},{"id":"la-fe-valencia","kind":"institution","name":"Hospital Universitari i Politècnic La Fe","aka":"Hospital La Fe IIS La Fe","tldr":"Valencia's flagship public hospital, with a haematology department that shaped the treatment of acute promyelocytic leukaemia through the PETHEMA group.","tags":"","route":"/institutions/la-fe-valencia/"},{"id":"lmu-munich","kind":"institution","name":"LMU Klinikum München","aka":"","tldr":"LMU Klinikum is Munich's university cancer centre, with strengths in PSMA theranostics and haematology.","tags":"","route":"/institutions/lmu-munich/"},{"id":"mayo-clinic","kind":"institution","name":"Mayo Clinic","aka":"","tldr":"Consistently the top-ranked US hospital overall, with strong proton therapy and the first US carbon-ion centre under construction.","tags":"","route":"/institutions/mayo-clinic/"},{"id":"md-anderson","kind":"institution","name":"MD Anderson Cancer Center","aka":"","tldr":"MD Anderson is the largest cancer centre in the world by patient volume, with the biggest phase 1 programme and a leading CAR-NK effort.","tags":"","route":"/institutions/md-anderson/"},{"id":"mhra","kind":"institution","name":"Medicines and Healthcare products Regulatory Agency","aka":"MHRA","tldr":"The UK medicines and devices regulator, which since Brexit runs its own approvals, joins Project Orbis and uses international reliance routes to speed cancer drug access.","tags":"","route":"/institutions/mhra/"},{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","aka":"","tldr":"The world's top-ranked cancer hospital, home of MSK-IMPACT sequencing, the dostarlimab rectal cancer study, and CAR-T pioneers.","tags":"","route":"/institutions/mskcc/"},{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","aka":"","tldr":"The NCI is the US government's cancer research agency, spending ~$7B a year and running the Cancer Centers Program, TCGA, and Rosenberg's cell therapy lab.","tags":"","route":"/institutions/nci/"},{"id":"nct-dresden","kind":"institution","name":"NCT/UCC Dresden, University Hospital Carl Gustav Carus","aka":"National Center for Tumor Diseases Dresden University Cancer Center Dresden OncoRay National Cancer Center Dresden NCT Dresden","tldr":"The second National Center for Tumor Diseases site, known for proton therapy research at OncoRay and AI in pathology and surgery.","tags":"","route":"/institutions/nct-dresden/"},{"id":"oslo-radium-hospital","kind":"institution","name":"Oslo University Hospital, The Norwegian Radium Hospital","aka":"Radiumhospitalet Institute for Cancer Research Oslo OUS","tldr":"Norway's national cancer hospital and research institute, where the alpha emitter radium-223 (Xofigo) and Photocure's bladder imaging agent were born.","tags":"","route":"/institutions/oslo-radium-hospital/","indications":"prostate"},{"id":"penn-abramson","kind":"institution","name":"Abramson Cancer Center, University of Pennsylvania","aka":"","tldr":"Where CAR-T became a drug (June, Levine; Emily Whitehead), mRNA was made druggable (Karikó, Weissman), and PARP PET was invented.","tags":"","route":"/institutions/penn-abramson/"},{"id":"peter-mac","kind":"institution","name":"Peter MacCallum Cancer Centre","aka":"","tldr":"Peter Mac is Australia's only dedicated cancer hospital and a leader in theranostics, CAR-T, and radiation oncology.","tags":"","route":"/institutions/peter-mac/"},{"id":"pla-general-hospital","kind":"institution","name":"Chinese PLA General Hospital","aka":"301 Hospital 解放军总医院","tldr":"China's military flagship hospital, known in oncology for early CAR-T and gene-edited T-cell trials, minimally invasive liver surgery and nuclear medicine.","tags":"","route":"/institutions/pla-general-hospital/","indications":"dlbcl hcc prostate"},{"id":"pmda","kind":"institution","name":"Pharmaceuticals and Medical Devices Agency","aka":"PMDA 独立行政法人医薬品医療機器総合機構","tldr":"Japan's drug and device review agency, which works with the health ministry to approve cancer drugs and has largely closed the historical 'drug lag' with the US and Europe.","tags":"","route":"/institutions/pmda/"},{"id":"qst-hospital","kind":"institution","name":"QST Hospital (National Institutes for Quantum Science and Technology)","aka":"NIRS Hospital HIMAC QST病院","tldr":"The world's first carbon-ion therapy hospital (HIMAC, 1994), which established the clinical evidence base for heavy-ion radiotherapy.","tags":"","route":"/institutions/qst-hospital/","indications":"prostate hcc"},{"id":"radboudumc","kind":"institution","name":"Radboudumc Centre for Oncology","aka":"Radboud University Medical Center","tldr":"The university hospital of Nijmegen, a leading Dutch centre for prostate imaging, dendritic cell vaccines and tumour immunology, currently in OECI accreditation.","tags":"oeci-in-accreditation","route":"/institutions/radboudumc/","indications":"prostate"},{"id":"royal-marsden","kind":"institution","name":"The Royal Marsden","aka":"","tldr":"The Royal Marsden was the world's first hospital dedicated to cancer (1851) and is paired with the Institute of Cancer Research.","tags":"","route":"/institutions/royal-marsden/"},{"id":"sacro-cuore-don-calabria","kind":"institution","name":"IRCCS Sacro Cuore Don Calabria Hospital","aka":"Ospedale Sacro Cuore Don Calabria, Negrar","tldr":"Sacro Cuore Don Calabria Hospital in Negrar, near Verona, is a Catholic non-profit hospital recognised as an IRCCS research hospital; it runs medical oncology, radiotherapy, robotic and hepatobiliary surgery and an early-phase trials unit, and OECI accredits it as a Cancer Centre.","tags":"oeci-accredited oeci-cancer-centre irccs","route":"/institutions/sacro-cuore-don-calabria/"},{"id":"sahlgrenska","kind":"institution","name":"Sahlgrenska University Hospital / Sahlgrenska Center for Cancer Research","aka":"Sahlgrenska Gothenburg University Hospital","tldr":"Western Sweden's university hospital, with a cancer research centre known for melanoma models, radionuclide dosimetry and childhood cancer.","tags":"","route":"/institutions/sahlgrenska/","indications":"neuroblastoma"},{"id":"sant-orsola-bologna","kind":"institution","name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola","aka":"Sant'Orsola-Malpighi Policlinico Sant'Orsola Istituto di Ematologia Seràgnoli","tldr":"Bologna's university hospital, home of the Seràgnoli haematology institute and a leading Italian centre for myeloma, lymphoma and CAR-T.","tags":"","route":"/institutions/sant-orsola-bologna/","indications":"dlbcl"},{"id":"shandong-cancer-hospital","kind":"institution","name":"Shandong Cancer Hospital and Institute","aka":"Shandong First Medical University Affiliated Cancer Hospital 山东省肿瘤医院","tldr":"Shandong Cancer Hospital runs one of China's largest radiotherapy departments under Jinming Yu, with a proton therapy centre and PET-guided adaptive radiotherapy; it has led Chinese trials combining radiotherapy with immunotherapy in lung and oesophageal cancer and studies of brain metastasis management.","tags":"","route":"/institutions/shandong-cancer-hospital/","indications":"sclc"},{"id":"snmmi","kind":"institution","name":"Society of Nuclear Medicine and Molecular Imaging","aka":"SNMMI Society of Nuclear Medicine","tldr":"The Society of Nuclear Medicine and Molecular Imaging represents US nuclear medicine and publishes the Journal of Nuclear Medicine; its annual meeting is where new PET tracers and radioligand therapy results are presented, and its procedure standards guide PSMA and somatostatin receptor imaging.","tags":"","route":"/institutions/snmmi/"},{"id":"tum-munich","kind":"institution","name":"TUM Klinikum rechts der Isar / CCC München","aka":"Klinikum rechts der Isar Technical University of Munich Comprehensive Cancer Center Munich (TUM)","tldr":"Munich's technical university hospital, one half of the Comprehensive Cancer Center Munich and a leader in PSMA imaging and radiopharmaceutical chemistry.","tags":"","route":"/institutions/tum-munich/","indications":"prostate neuroendocrine"},{"id":"turku-university-hospital","kind":"institution","name":"Turku University Hospital Cancer Centre","aka":"Tyks FICAN West","tldr":"The university hospital of south-west Finland and host of FICAN West, with OECI Cancer Centre accreditation and a strong PET imaging tradition.","tags":"oeci-accredited oeci-cancer-centre","route":"/institutions/turku-university-hospital/"},{"id":"ucla-jonsson","kind":"institution","name":"UCLA Jonsson Comprehensive Cancer Center","aka":"","tldr":"Where trastuzumab (Slamon) and palbociclib were developed clinically, and a leader in PSMA PET and melanoma immunotherapy (Ribas).","tags":"","route":"/institutions/ucla-jonsson/"},{"id":"ucsf","kind":"institution","name":"UCSF Helen Diller Family Comprehensive Cancer Center","aka":"","tldr":"UCSF is the birthplace of oncogene biology (Bishop, Varmus) and KRAS G12C drugging (Shokat), and a leader in I-SPY adaptive breast trials.","tags":"","route":"/institutions/ucsf/"},{"id":"uk-duesseldorf","kind":"institution","name":"University Hospital Düsseldorf / CIO Düsseldorf","aka":"Universitätsklinikum Düsseldorf UKD Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf","tldr":"Düsseldorf's university hospital, a partner in the CIO cancer centre alliance and a leading site for FAPI and PSMA imaging under Frederik Giesel.","tags":"","route":"/institutions/uk-duesseldorf/","indications":"prostate neuroendocrine hcc"},{"id":"umcg-groningen","kind":"institution","name":"University Medical Center Groningen Comprehensive Cancer Center","aka":"UMCG UMCG Cancer Center","tldr":"The university hospital of the northern Netherlands, home of the country's first proton therapy centre and accredited by OECI as a Comprehensive Cancer Centre.","tags":"oeci-accredited oeci-comprehensive-cancer-centre","route":"/institutions/umcg-groningen/"},{"id":"uppsala-akademiska","kind":"institution","name":"Uppsala University Hospital / Uppsala University","aka":"Akademiska sjukhuset Skandion Clinic Rudbeck Laboratory","tldr":"Uppsala University Hospital is Sweden's oldest; its neuroendocrine tumour centre built by Kjell Öberg is an ENETS Centre of Excellence with long experience of somatostatin analogues and radionuclide therapy, and Sweden's national Skandion proton clinic opened next door in 2015.","tags":"","route":"/institutions/uppsala-akademiska/","indications":"neuroendocrine prostate glioblastoma"},{"id":"usb-basel","kind":"institution","name":"University Hospital Basel / Tumour Centre","aka":"USB Universitätsspital Basel Tumorzentrum Basel","tldr":"University Hospital Basel coordinates cancer care in the home city of Roche and Novartis; its groups run early-phase tumour immunology trials, study breast cancer metastasis, and develop peptide radioligands such as exendin-based imaging of insulinomas.","tags":"","route":"/institutions/usb-basel/","indications":"neuroendocrine"},{"id":"usz-zurich","kind":"institution","name":"University Hospital Zurich / Comprehensive Cancer Center Zurich","aka":"USZ CCCZ UniversitätsSpital Zürich","tldr":"Zurich's university hospital and cancer centre, a world reference in neuro-oncology, melanoma and single-cell tumour imaging.","tags":"","route":"/institutions/usz-zurich/","indications":"glioblastoma dlbcl"},{"id":"choline-metabolism-in-cancer","kind":"pathway","name":"Choline metabolism in cancer","aka":"KEGG hsa05231 Choline metabolism in cancer","tldr":"This KEGG map shows how cancer cells rewire the handling of choline, a nutrient used to build cell membranes, so that growth signals and membrane building feed each other. It matters because the resulting build-up of phosphocholine is visible on MR spectroscopy and PET scans and is one of the metabolic hallmarks of cancer.","tags":"","route":"/pathways/choline-metabolism-in-cancer/"},{"id":"hif-vhl","kind":"pathway","name":"VHL / HIF oxygen sensing","aka":"","tldr":"The VHL/HIF pathway is how cells sense oxygen (the 2019 Nobel Prize). VHL destroys HIF when oxygen is present. Kidney cancers lose VHL, so HIF-2α is permanently on and drives blood vessel growth and proliferation.","tags":"","route":"/pathways/hif-vhl/","indications":"rcc"},{"id":"lineage-plasticity-neuroendocrine","kind":"pathway","name":"Lineage plasticity & neuroendocrine transformation","aka":"","tldr":"Under pressure from a drug that blocks its identity (the androgen receptor in prostate cancer, EGFR in lung cancer), a tumour can change what kind of cell it is, becoming a small-cell neuroendocrine cancer that no longer needs the blocked signal. It is the ultimate escape: not a new mutation in the engine, but a new engine.","tags":"mechanism mechanics-atlas","route":"/pathways/lineage-plasticity-neuroendocrine/","indications":"prostate sclc"},{"id":"prostate-cancer-signalling","kind":"pathway","name":"Prostate cancer (KEGG map)","aka":"KEGG hsa05215 Prostate cancer","tldr":"KEGG's prostate cancer map centres on the androgen receptor, the hormone switch that prostate cells depend on, plus loss of PTEN and NKX3.1 that lets PI3K/AKT growth signalling run free. Hormone therapy, AR antagonists and now AKT inhibitors act on these two arms.","tags":"","route":"/pathways/prostate-cancer-signalling/","indications":"prostate"},{"id":"alpha-vs-beta","kind":"term","name":"Alpha vs beta emitters","aka":"","tldr":"Beta particles (lutetium-177) travel millimetres and are good for bulky disease; alpha particles (actinium-225) travel a few cells' width and kill with far higher energy.","tags":"","route":"/terms/alpha-vs-beta/"},{"id":"anaemia","kind":"term","name":"Anaemia","aka":"anemia anaemic anemic low haemoglobin low hemoglobin haemoglobin hemoglobin transfusion-dependent transfusion dependence transfusion independence red cell transfusion erythropoiesis-stimulating agent ESA ESAs iron deficiency erythropoiesis-stimulating agents","tldr":"A shortage of red blood cells or haemoglobin, causing tiredness and breathlessness. In cancer it comes from the disease itself (marrow infiltration, bleeding, inflammation), from chemotherapy suppressing the marrow, and from some targeted drugs.","tags":"","route":"/terms/anaemia/"},{"id":"antigen","kind":"term","name":"Antigen","aka":"antigens tumour antigen tumour antigens tumor antigen tumor antigens target antigen target antigens antigenic tumour-associated antigen tumour-associated antigens tumor-associated antigen tumor-associated antigens antigen-negative antigen loss","tldr":"Anything an antibody or immune cell can recognise, typically a protein on a cell's surface. In cancer, an antigen is the flag that tells a drug or an immune cell 'this is the cell to attack'.","tags":"","route":"/terms/antigen/"},{"id":"arpi","kind":"term","name":"Androgen receptor pathway inhibitor (ARPI)","aka":"ARPI ARPIs ARSI androgen receptor signalling inhibitor androgen receptor pathway inhibitor novel hormonal agent NHA next-generation antiandrogen second-generation antiandrogen AR antagonist AR inhibitor antiandrogen anti-androgen AR-V7 AR-targeted AR antagonists","tldr":"The newer prostate cancer hormone pills (abiraterone, enzalutamide, apalutamide, darolutamide) that block the androgen receptor or the last steps of androgen production, used on top of standard testosterone suppression.","tags":"","route":"/terms/arpi/","indications":"prostate"},{"id":"biochemical-recurrence","kind":"term","name":"Biochemical recurrence (BCR)","aka":"","tldr":"PSA rising again after surgery or radiation, usually years before anything shows on a scan.","tags":"","route":"/terms/biochemical-recurrence/","indications":"prostate"},{"id":"bone-marrow","kind":"term","name":"Bone marrow","aka":"marrow bone-marrow marrow suppression myelosuppression myelosuppressive blood counts blood count low blood counts neutropenia neutropenic anaemia anemia thrombocytopenia","tldr":"The soft tissue inside bones where all blood cells are made. Chemotherapy damages it, causing the low blood counts that limit how much treatment a patient can take.","tags":"","route":"/terms/bone-marrow/"},{"id":"bone-metastases","kind":"term","name":"Bone metastases and skeletal-related events","aka":"bone metastasis skeletal metastases skeletal-related events skeletal-related event SRE bone-only bone-predominant osseous metastases pathological fracture spinal cord compression","tldr":"Cancer spread to the bones, most common in prostate, breast, lung, kidney and thyroid cancer and myeloma. It causes pain, fractures and high calcium, and the complications are counted in trials as 'skeletal-related events'.","tags":"","route":"/terms/bone-metastases/","indications":"prostate rcc"},{"id":"complete-response-term","kind":"term","name":"Complete response (CR) and partial response (PR)","aka":"complete response complete responses complete remission complete remissions CR rate CRi CR/CRi complete response rate stringent complete response sCR partial response partial responses partial remission PR rate very good partial response VGPR stable disease best response best overall response deep response deep responses complete response rates","tldr":"A complete response means every measurable trace of the cancer has disappeared on scans or in the marrow; a partial response means it has shrunk by at least 30% (RECIST) but is still there. Neither is the same as cure: microscopic disease can remain.","tags":"","route":"/terms/complete-response-term/"},{"id":"crossover","kind":"term","name":"Crossover in trials","aka":"cross-over crossover-adjusted crossover adjustment adjusted for crossover permitted crossover crossover was permitted crossover rate post-progression therapy subsequent therapy subsequent treatment RPSFT rank-preserving structural failure time IPCW treatment switching unplanned crossover confounded by crossover","tldr":"When patients in a trial's control arm are allowed to switch to the experimental drug after their cancer progresses. It is fair to patients but blurs the survival comparison, because the control group has now had the drug too.","tags":"","route":"/terms/crossover/"},{"id":"curie-siopen-score","kind":"term","name":"MIBG Curie and SIOPEN scores","aka":"Curie score SIOPEN score MIBG score MIBG avidity MIBG-avid MIBG-non-avid semi-quantitative MIBG scoring 123I-MIBG scan MIBG scintigraphy 18F-MFBG PET MFBG PET","tldr":"Neuroblastoma soaks up MIBG, a radioactive cousin of noradrenaline; the Curie and SIOPEN scores count how many body regions still light up on the scan, and a score that has not fallen enough after the first rounds of chemotherapy marks a child who is unlikely to be cured with the standard plan.","tags":"","route":"/terms/curie-siopen-score/","indications":"neuroblastoma neuroblastoma-high-risk"},{"id":"cytopenias","kind":"term","name":"Cytopenias and myelosuppression","aka":"cytopenia cytopenias myelosuppression myelosuppressive bone marrow suppression marrow suppression marrow toxicity haematological toxicity hematological toxicity haematologic toxicity hematologic toxicity pancytopenia bicytopenia lymphopenia lymphocytopenia prolonged cytopenias late cytopenias ICAHT immune effector cell-associated haematotoxicity count recovery blood counts full blood count complete blood count CBC","tldr":"The umbrella term for low blood counts of any kind (white cells, red cells, platelets) when treatment suppresses the bone marrow. Most chemotherapy causes it temporarily; radioligands, CAR-T and some pills cause longer-lasting versions.","tags":"","route":"/terms/cytopenias/"},{"id":"dosimetry","kind":"term","name":"Dosimetry","aka":"","tldr":"Measuring how much radiation dose each organ and tumour actually received from a radioactive drug.","tags":"","route":"/terms/dosimetry/"},{"id":"estimand","kind":"term","name":"Estimands and intercurrent events (ICH E9(R1))","aka":"estimand estimands estimand framework ICH E9(R1) E9(R1) intercurrent event intercurrent events treatment policy strategy treatment policy estimand hypothetical strategy hypothetical estimand composite strategy while on treatment strategy principal stratum principal stratum strategy sensitivity analysis sensitivity analyses missing data missing data handling handling of missing data discontinued treatment treatment discontinuation rescue medication subsequent anticancer therapy what the trial is estimating","tldr":"An estimand is a precise statement of what question a trial is answering, including what to do about patients who switch treatment, stop early or start another drug; the ICH E9(R1) framework makes trials write this down before they start.","tags":"","route":"/terms/estimand/"},{"id":"gray-unit","kind":"term","name":"Gray unit (Gy)","aka":"cGy centigray EQD2 BED biologically effective dose dose escalation dose-escalated radiation dose absorbed dose prescribed dose total dose 60 Gy 70 Gy GBq MBq becquerel","tldr":"The unit of radiation dose absorbed by tissue: one gray is one joule per kilogram. A curative course is typically 50-70 Gy in total; a single bone-pain treatment is 8 Gy. Radiopharmaceuticals are prescribed by activity in becquerels (GBq) instead.","tags":"","route":"/terms/gray-unit/"},{"id":"half-life","kind":"term","name":"Half-life","aka":"half-lives half life plasma half-life elimination half-life pharmacokinetics pharmacokinetic PK cleared from the body drug exposure peak concentration Cmax AUC steady state steady-state","tldr":"The time it takes for the amount of a drug in the blood to fall by half. It sets how often a drug must be given: hours to a day for small molecules such as kinase inhibitors, so they are taken daily, and two to four weeks for antibodies, so they are given every three or six weeks.","tags":"","route":"/terms/half-life/"},{"id":"ligand","kind":"term","name":"Ligand","aka":"ligands binding partner","tldr":"The molecule that fits into a receptor and switches it on: growth factors, hormones and cytokines are all ligands. Cancers make their own ligands or mutate receptors so none is needed, and some drugs act on the ligand itself, as bevacizumab does by soaking up VEGF.","tags":"","route":"/terms/ligand/"},{"id":"mcrpc-mhspc","kind":"term","name":"mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)","aka":"castration-resistant castration resistant castrate-resistant mCRPC nmCRPC CRPC castration-sensitive castration sensitive hormone-sensitive hormone sensitive mHSPC mCSPC HSPC hormone-naive hormone-refractory biochemical recurrence PSA recurrence rising PSA PSA progression rPFS","tldr":"Prostate cancer starts out fed by testosterone (hormone-sensitive) and shrinks when it is removed. When it learns to grow despite castrate testosterone levels it is called castration-resistant, a later and more dangerous stage with its own treatments.","tags":"","route":"/terms/mcrpc-mhspc/","indications":"prostate"},{"id":"medicare-ced","kind":"term","name":"Medicare coverage with evidence development","aka":"coverage with evidence development CED national coverage determination national coverage determinations NCD 90.2 Medicare NGS coverage Medicare coverage of cancer drugs protected classes","tldr":"Medicare's way of paying for a promising but uncertain test or treatment only for patients enrolled in a registry or study, used for PET scans in cancer from 2006 and now the frame for how Medicare covers gene panels and cell therapies.","tags":"law us","route":"/terms/medicare-ced/"},{"id":"net-grade-ki67","kind":"term","name":"Neuroendocrine tumour grade (Ki-67) and WHO classification","aka":"","tldr":"How fast the tumour cells are dividing, measured by Ki-67 staining, separates slow-growing neuroendocrine tumours from aggressive neuroendocrine carcinomas and decides the treatment.","tags":"","route":"/terms/net-grade-ki67/","indications":"neuroendocrine sclc grade-3-net"},{"id":"oligometastatic","kind":"term","name":"Oligometastatic disease","aka":"","tldr":"Cancer that has spread to only a few places, which may still be curable by treating each spot.","tags":"","route":"/terms/oligometastatic/"},{"id":"payload","kind":"term","name":"Payload (ADC)","aka":"","tldr":"The payload is the poison an ADC carries, usually a chemotherapy far too toxic to give on its own.","tags":"","route":"/terms/payload/"},{"id":"pharmacokinetics","kind":"term","name":"Pharmacokinetics (PK), half-life and exposure","aka":"pharmacokinetic pharmacokinetics PK/PD pharmacodynamics half-life half life exposure-response exposure–response drug exposure AUC Cmax steady state steady-state bioavailability oral bioavailability drug-drug interaction CYP3A4 food effect therapeutic drug monitoring TDM flat dosing weight-based dosing body surface area mg/m² mg/kg pharmacodynamic","tldr":"How a drug moves through the body: how much is absorbed, how high the blood level gets, how long it lasts (half-life) and how it is cleared. These numbers decide the dose, the schedule and whether a pill can be taken with food or other medicines.","tags":"","route":"/terms/pharmacokinetics/"},{"id":"prostatectomy","kind":"term","name":"Radical prostatectomy","aka":"prostatectomy robotic prostatectomy robot-assisted prostatectomy prostatectomies","tldr":"Removing the entire prostate gland and seminal vesicles for localised prostate cancer, now almost always with a robot.","tags":"","route":"/terms/prostatectomy/","indications":"prostate"},{"id":"prrt-term","kind":"term","name":"PRRT (peptide receptor radionuclide therapy)","aka":"PRRT peptide receptor radionuclide therapy 177Lu-DOTATATE lutetium DOTATATE DOTATATE DOTATOC somatostatin analogue somatostatin analogues SSA SSAs SSTR-targeted SSTR imaging somatostatin receptor imaging alpha PRRT","tldr":"A radioactive drug for neuroendocrine tumours: a small peptide that homes to the somatostatin receptor on the tumour cells carries lutetium-177, which irradiates them from within. Given four times, two months apart.","tags":"","route":"/terms/prrt-term/","indications":"neuroendocrine"},{"id":"psa-kinetics","kind":"term","name":"PSA kinetics: PSA doubling time and PSA density","aka":"PSA doubling time PSADT PSA velocity PSA density PSAD PSA kinetics PSA rise rising PSA biochemical recurrence PSA threshold PSA nadir PSA response PSA50 PSA90 PSA progression","tldr":"How fast PSA is rising matters more than its level: a doubling time under ten months after surgery or radiotherapy, or under nine months in castration-resistant disease, marks the men whose cancer is moving quickly and who benefit from earlier hormone therapy or a PSMA scan, while PSA density (PSA divided by prostate volume) helps decide who needs a biopsy at all.","tags":"","route":"/terms/psa-kinetics/","indications":"prostate-bcr prostate-nmcrpc prostate-mcrpc"},{"id":"psa50","kind":"term","name":"PSA50 / PSA90 response","aka":"","tldr":"PSA50 is the share of patients whose PSA falls by at least half on treatment, and PSA90 the share whose PSA falls by 90%.","tags":"","route":"/terms/psa50/","indications":"prostate"},{"id":"radiation-necrosis","kind":"term","name":"Radiation necrosis (brain)","aka":"","tldr":"Death of brain tissue months to years after radiosurgery or high-dose brain radiotherapy, which can look exactly like tumour growing back on a scan.","tags":"radiation-wave1","route":"/terms/radiation-necrosis/","indications":"glioblastoma"},{"id":"radioiodine-term","kind":"term","name":"Radioiodine therapy (I-131)","aka":"radioiodine radioactive iodine radioiodine ablation radioiodine therapy I-131 131I iodine-131 RAI-refractory radioiodine-refractory RAI-avid radioiodine-avid iodine-avid iodine uptake redifferentiation recombinant TSH rhTSH","tldr":"Swallowing a capsule of radioactive iodine after thyroid surgery: thyroid cells (including cancer cells) are the only ones that soak up iodine, so the radiation destroys leftover thyroid tissue and metastases while sparing everything else. It was the first targeted radiotherapy, in 1946.","tags":"","route":"/terms/radioiodine-term/","indications":"thyroid"},{"id":"radiotherapy","kind":"term","name":"Radiotherapy","aka":"radiation therapy radiation treatment radiation irradiation irradiated radiotherapy fractions fractionation hypofractionated chemoradiotherapy chemoradiation radiation oncology radiation oncologist radiosensitiser radiosensitizer radiosensitive radioresistant external beam radiation oncologists radiosensitisers","tldr":"Using high-energy X-rays or particles to damage the DNA of cancer cells in a precisely aimed volume of the body. On its own it cures early prostate, larynx, cervix and skin cancers, it is combined with chemotherapy in head and neck, lung, oesophageal and rectal cancers, and about half of all cancer patients receive it.","tags":"","route":"/terms/radiotherapy/"},{"id":"sdh-deficiency","kind":"term","name":"SDH deficiency (SDHB immunohistochemistry loss)","aka":"SDH-deficient SDH-deficient GIST SDHB immunohistochemistry SDHB loss SDHB-negative SDHx SDHx mutation SDHA SDHC epimutation SDHC promoter methylation succinate dehydrogenase deficiency Carney-Stratakis syndrome Carney triad KIT/PDGFRA wild-type GIST hereditary paraganglioma syndrome SDH-deficient renal cell carcinoma","tldr":"Loss of the succinate dehydrogenase enzyme, shown by a negative SDHB stain, marks a small family of tumours (some stomach GISTs, paragangliomas and phaeochromocytomas, a rare kidney cancer) that are often inherited, occur in young people, ignore imatinib and grow slowly; the stain is the trigger for germline testing of the whole family.","tags":"","route":"/terms/sdh-deficiency/"},{"id":"sentinel-lymph-node-biopsy","kind":"term","name":"Sentinel node biopsy","aka":"sentinel lymph node biopsy sentinel lymph node sentinel node sentinel lymph node mapping SLNB","tldr":"Finding and removing the first one or two lymph nodes a tumour drains to, to see whether cancer has spread, instead of removing the whole nodal basin.","tags":"","route":"/terms/sentinel-lymph-node-biopsy/"},{"id":"suv","kind":"term","name":"Standardised uptake value (SUV)","aka":"","tldr":"The standardised uptake value (SUV) is a number for how brightly a spot lights up on a PET scan.","tags":"","route":"/terms/suv/"},{"id":"tare","kind":"term","name":"TARE / SIRT (radioembolisation with yttrium-90)","aka":"TARE SIRT radioembolisation radioembolization Y-90 Y90 yttrium-90 selective internal radiation therapy 90Y microspheres","tldr":"Injecting tiny radioactive glass or resin beads into the liver's artery so they lodge in the tumour and irradiate it from inside.","tags":"","route":"/terms/tare/","indications":"hcc neuroendocrine"},{"id":"theranostics","kind":"term","name":"Theranostics","aka":"theranostic","tldr":"Using the same targeting molecule for a diagnostic scan and a therapy, so you treat exactly what you can see.","tags":"","route":"/terms/theranostics/"},{"id":"thrombocytopenia","kind":"term","name":"Thrombocytopenia","aka":"thrombocytopaenia low platelets platelet count platelet transfusion bleeding risk grade 3-4 thrombocytopenia immune thrombocytopenia ITP thrombopoietin receptor agonist platelet transfusions","tldr":"Too few platelets, the blood cells that form clots, caused by chemotherapy or by the cancer in the marrow. Mild cases cause bruising; severe cases (under 10-20 × 10⁹/L) risk serious bleeding and need platelet transfusions.","tags":"","route":"/terms/thrombocytopenia/"},{"id":"tumour-hypoxia","kind":"term","name":"Tumour hypoxia","aka":"","tldr":"Regions of a tumour that have outgrown their blood supply and are short of oxygen. They resist radiotherapy and some chemotherapy, and drive the tumour to become more aggressive.","tags":"radiation-wave1","route":"/terms/tumour-hypoxia/"},{"id":"action-1","kind":"trial","name":"ACTION-1","aka":"","tldr":"Tests whether an actinium alpha-radioligand rescues neuroendocrine tumours after lutetium therapy fails.","tags":"","route":"/trials/action-1/","status":"active","indications":"neuroendocrine"},{"id":"ahod2131","kind":"trial","name":"AHOD2131 (COG / NCTN)","aka":"","tldr":"Asks whether early-stage Hodgkin lymphoma in children and adults can be treated with immunotherapy instead of some chemotherapy and radiation.","tags":"","route":"/trials/ahod2131/","status":"recruiting"},{"id":"alphabreak","kind":"trial","name":"AlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)","aka":"","tldr":"The actinium-225 PSMA trials that will help decide whether alpha-emitting PSMA drugs become the next step after Pluvicto.","tags":"","route":"/trials/alphabreak/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"alphamedix-02","kind":"trial","name":"ALPHAMEDIX-02","aka":"","tldr":"An alpha-emitting radioligand met all its primary endpoints, with responses in more than half of patients new to radioligand therapy.","tags":"","route":"/trials/alphamedix-02/","status":"positive","indications":"neuroendocrine"},{"id":"alsympca","kind":"trial","name":"ALSYMPCA","aka":"","tldr":"ALSYMPCA is the trial that won approval for the first alpha-emitting drug.","tags":"","route":"/trials/alsympca/","status":"positive","indications":"prostate prostate-mcrpc"},{"id":"anbl1531","kind":"trial","name":"COG ANBL1531","aka":"","tldr":"COG ANBL1531 is the current North American high-risk trial, adding targeted radiation during induction and an ALK pill for children whose tumours carry ALK mutations.","tags":"","route":"/trials/anbl1531/","status":"active","indications":"neuroblastoma neuroblastoma-high-risk"},{"id":"astra","kind":"trial","name":"ASTRA","aka":"","tldr":"Adding a MEK inhibitor to boost iodine uptake before ablation did not improve complete remission rates, cooling the 'redifferentiation for everyone' idea.","tags":"failure lesson:adjuvant-vs-active-disease","route":"/trials/astra/","status":"negative","indications":"thyroid"},{"id":"cabinet","kind":"trial","name":"CABINET (Alliance A021602)","aka":"","tldr":"Cabozantinib tripled the time without progression in neuroendocrine tumours that had outgrown other treatments, leading to a 2025 approval.","tags":"","route":"/trials/cabinet/","status":"positive","indications":"neuroendocrine pancreatic-net small-intestinal-net lung-net"},{"id":"chaarted","kind":"trial","name":"CHAARTED (E3805)","aka":"","tldr":"The first trial to show chemotherapy at the start of hormone therapy prolongs life in metastatic prostate cancer.","tags":"","route":"/trials/chaarted/","status":"positive","indications":"prostate prostate-mhspc"},{"id":"compete","kind":"trial","name":"COMPETE","aka":"","tldr":"The first head-to-head trial of a radioligand against a targeted pill in neuroendocrine tumours; the radioligand won on progression-free survival.","tags":"","route":"/trials/compete/","status":"positive","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"decision-sorafenib","kind":"trial","name":"DECISION","aka":"","tldr":"The first drug approved for thyroid cancers that stopped responding to radioactive iodine.","tags":"","route":"/trials/decision-sorafenib/","status":"positive","indications":"thyroid"},{"id":"eclipse-psma","kind":"trial","name":"ECLIPSE","aka":"","tldr":"Curium's PSMA radioligand met its progression endpoint; survival data and an FDA filing are pending.","tags":"","route":"/trials/eclipse-psma/","status":"positive","indications":"prostate prostate-mcrpc"},{"id":"embark","kind":"trial","name":"EMBARK","aka":"","tldr":"Showed that treating a fast-rising PSA after surgery or radiation with enzalutamide delays spread.","tags":"","route":"/trials/embark/","status":"positive","indications":"prostate prostate-bcr"},{"id":"estimabl2","kind":"trial","name":"ESTIMABL2","aka":"","tldr":"Proved that most people with small, low-risk thyroid cancers can skip radioactive iodine after surgery without any increase in recurrence.","tags":"","route":"/trials/estimabl2/","status":"positive","indications":"thyroid"},{"id":"hd21","kind":"trial","name":"GHSG HD21","aka":"","tldr":"A new brentuximab-based intensive regimen matched Europe's most effective (and most toxic) chemotherapy with far fewer side effects.","tags":"","route":"/trials/hd21/","status":"positive"},{"id":"hilo","kind":"trial","name":"HiLo","aka":"","tldr":"Showed a third of the usual radioactive iodine dose ablates the thyroid remnant just as well, with fewer side effects and less time in isolation.","tags":"","route":"/trials/hilo/","status":"positive","indications":"thyroid"},{"id":"ielsg37","kind":"trial","name":"IELSG37","aka":"","tldr":"IELSG37 showed that people with primary mediastinal B-cell lymphoma whose scan is clear after chemotherapy do not need radiotherapy to the chest, sparing young patients decades of heart and breast cancer risk.","tags":"","route":"/trials/ielsg37/","status":"positive"},{"id":"ion-trial","kind":"trial","name":"IoN","aka":"","tldr":"The UK trial confirming that low-risk thyroid cancer patients can safely avoid radioactive iodine, published in 2025.","tags":"","route":"/trials/ion-trial/","status":"positive","indications":"thyroid"},{"id":"mcrpc","kind":"trial","name":"A Study of Pasritamig With or Without JNJ-87189401 Versus Placebo for Late Line Metastatic Castration-resistant Prostate Cancer (mCRPC)","aka":"","tldr":"A phase 3 trial testing JNJ-87189401 in prostate cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/mcrpc/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct02665065","kind":"trial","name":"Study of Iomab-B vs. Conventional Care in Older Subjects With Active, Relapsed or Refractory Acute Myeloid Leukemia","aka":"SIERRA","tldr":"A phase 3 trial of Iomab-B run by Actinium Pharmaceuticals, active.","tags":"ctgov-ingest","route":"/trials/nct02665065/","status":"active"},{"id":"nct02952508","kind":"trial","name":"Study of Iopofosine I-131 (CLR 131) in Select B-Cell Malignancies (CLOVER-1) With Expansion in Waldenstrom","aka":"CLOVER-1","tldr":"A phase 2 trial of Iopofosine I 131 single dose in waldenström macroglobulinaemia, multiple myeloma, chronic lymphocytic leukaemia, non-Hodgkin lymphoma, mantle cell lymphoma and diffuse large B-cell lymphoma, run by Cellectar Biosciences, Inc., active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct02952508/","status":"active","indications":"dlbcl"},{"id":"nct03444844","kind":"trial","name":"Biodistribution and Dosimetry of Ga-68 P16-093 in Prostate Cancer","aka":"","tldr":"A phase 1/2 trial of Ga-68 P16-093 PET/CT scan in prostate cancer, run by Five Eleven Pharma, Inc., active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct03444844/","status":"active","indications":"prostate prostate-bcr"},{"id":"nct03533283","kind":"trial","name":"An Open-Label Phase lB/II Study of Glofitamab and Atezolizumab or Polatuzumab Vedotin in Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma","aka":"","tldr":"A phase 1/2 trial of Glofitamab, Atezolizumab, Obinutuzumab, Tocilizumab and Polatuzumab vedotin in hodgkin lymphoma, run by Hoffmann-La Roche, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct03533283/","status":"active"},{"id":"nct03690388","kind":"trial","name":"A Study of Cabozantinib Compared With Placebo in Subjects With Radioiodine-refractory Differentiated Thyroid Cancer Who Have Progressed After Prior Va","aka":"","tldr":"A phase 3 trial of Cabozantinib in thyroid cancer, run by Exelixis, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct03690388/","status":"active","indications":"thyroid"},{"id":"nct03972488","kind":"trial","name":"Study to Evaluate the Efficacy and Safety of Lutathera in Patients With Grade 2 and Grade 3 Advanced GEP-NET","aka":"NETTER-2","tldr":"A phase 3 trial of Lutetium-177 dotatate in pancreatic ductal adenocarcinoma, run by Advanced Accelerator Applications, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct03972488/","status":"active","indications":"neuroendocrine small-intestinal-net pancreatic-net grade-3-net"},{"id":"nct03972657","kind":"trial","name":"A Trial to Find Out if REGN5678 (Nezastomig) is Safe and How Well it Works Alone or in Combination With Cemiplimab for Adult Participants With Metasta","aka":"","tldr":"A phase 1/2 trial of Cemiplimab in prostate cancer and renal cell carcinoma, run by Regeneron Pharmaceuticals, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct03972657/","status":"recruiting","indications":"prostate rcc prostate-mcrpc"},{"id":"nct04557059","kind":"trial","name":"A Study of Adding Apalutamide to Radiotherapy and LHRH Agonist in High-Risk Patients With Hormone-Sensitive Prostate Cancer","aka":"PRIMORDIUM","tldr":"A phase 3 trial of Apalutamide in prostate cancer, run by Janssen Pharmaceutica N.V., Belgium, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04557059/","status":"active","indications":"prostate prostate-high-risk"},{"id":"nct04711135","kind":"trial","name":"Study to Evaluate Safety and Dosimetry of Lutathera in Adolescent Patients With GEP-NETs and PPGLs","aka":"NETTER-P","tldr":"A phase 2 trial of Lutetium-177 dotatate in pheochromocytoma and paraganglioma, run by Advanced Accelerator Applications, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct04711135/","status":"active","indications":"pheochromocytoma-paraganglioma"},{"id":"nct04724369","kind":"trial","name":"Open-Label Study of 18F-mFBG for Imaging Neuroblastoma","aka":"","tldr":"A phase 3 trial of 18F-MFBG in neuroblastoma, run by Innervate Radiopharmaceuticals LLC (Formerly: Illumina Radiopharmaceuticals LLC), active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04724369/","status":"active","indications":"neuroblastoma"},{"id":"nct04807257","kind":"trial","name":"Auger Molecular Therapy (AMT) for Malignant Cutaneous Lesions Treatment","aka":"","tldr":"A phase 1/2 trial of Auger Molecular Therapy (AMT) in advanced solid tumours, run by NanoRay Biotech Co., Ltd., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04807257/","status":"recruiting"},{"id":"nct04868604","kind":"trial","name":"64Cu-SAR-bisPSMA and 67Cu-SAR-bisPSMA for Identification and Treatment of PSMA-expressing Metastatic Castrate Resistant Prostate Cancer (SECuRE)","aka":"SECuRE","tldr":"A phase 1/2 trial of 64Cu-SAR-bisPSMA in prostate cancer, run by Clarity Pharmaceuticals Ltd, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04868604/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct04919226","kind":"trial","name":"Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE","aka":"COMPOSE","tldr":"A phase 3 trial of 177Lu-edotreotide, Temozolomide, Capecitabine, Everolimus, Leucovorin (folinic acid) and Oxaliplatin in neuroendocrine tumours, run by ITM Solucin GmbH, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04919226/","status":"active","indications":"neuroendocrine grade-3-net pancreatic-net small-intestinal-net"},{"id":"nct04939610","kind":"trial","name":"A Study of 177Lu-FAP-2286 in Advanced Solid Tumors","aka":"LuMIERE","tldr":"A phase 1/2 trial of FAP-2286 (177Lu / 68Ga) in advanced solid tumours, run by Novartis Pharmaceuticals, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct04939610/","status":"recruiting"},{"id":"nct05004285","kind":"trial","name":"Evaluate the Clinical Usefulness of [F-18]Florastamin PET/CT Imaging Diagnosis Compared to MRI Diagnosis","aka":"","tldr":"A phase 3 trial of Florastamin F-18 run by FutureChem, active.","tags":"ctgov-ingest","route":"/trials/nct05004285/","status":"active","indications":"prostate"},{"id":"nct05063565","kind":"trial","name":"TheraSphere With Durvalumab and Tremelimumab for HCC","aka":"ROWAN","tldr":"A phase 2 trial of Durvalumab in hepatocellular carcinoma, run by Boston Scientific Corporation, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct05063565/","status":"active","indications":"hcc"},{"id":"nct05142696","kind":"trial","name":"A Study of [177Lu]Lu-DOTA-TATE in Newly Diagnosed ES-SCLC Patients in Combination With Carboplatin, Etoposide and Atezolizumab","aka":"","tldr":"A phase 1/2 trial of Lutetium-177 dotatate, FAP-2286, Atezolizumab in small-cell lung cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct05142696/","status":"active","indications":"sclc"},{"id":"nct05219500","kind":"trial","name":"Targeted Alpha Therapy With 225Actinium-Prostate Specific Membrane Antigen (PSMA)-I&T of Castration-resISTant Prostate Cancer (TATCIST).","aka":"TATCIST","tldr":"A phase 2 trial of FPI-2265 in prostate cancer, run by Fusion Pharmaceuticals Inc., active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct05219500/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct05381103","kind":"trial","name":"PSMA-PET to Guide Prostatectomy","aka":"","tldr":"A phase 2/3 trial of an investigational treatment in prostate cancer, run by Five Eleven Pharma, Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05381103/","status":"recruiting","indications":"prostate"},{"id":"nct05413850","kind":"trial","name":"Anti-tumour Activity of (177Lu) rhPSMA-10.1 Injection","aka":"","tldr":"A phase 1/2 trial of FAP-2286 in prostate cancer, run by Blue Earth Therapeutics Ltd, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct05413850/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct05459844","kind":"trial","name":"A Study Comparing Treatment With Lutetium[177Lu] Oxodotreotide Injection to Octreotide LAR in Patients With GEP-NETs","aka":"","tldr":"A phase 3 trial of Lutetium[177Lu] Oxodotreotide Injection in neuroendocrine tumours, run by Sinotau Pharmaceutical Group, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05459844/","status":"active","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"nct05547061","kind":"trial","name":"A Phase 1/2 Clinical Trial to Evaluate the Safety, Tolerability, Dosimetry, and Anti-tumor Activity of Ga-68-NGUL / Lu-177-DGUL in Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC) Refractory to Standard Therapy","aka":"","tldr":"A phase 1/2 trial of Lu-177-DGUL in prostate cancer, run by Cellbion Co., Ltd., active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05547061/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct05636618","kind":"trial","name":"Targeted Alpha-Particle Therapy for Advanced Somatostatin Receptor Type 2 (SSTR2) Positive Tumors","aka":"","tldr":"A phase 1/2 trial of [203Pb]VMT-α-NET in neuroendocrine tumours, pancreatic ductal adenocarcinoma and pheochromocytoma and paraganglioma, run by Perspective Therapeutics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05636618/","status":"recruiting","indications":"neuroendocrine pheochromocytoma-paraganglioma"},{"id":"nct05655312","kind":"trial","name":"MC1R-targeted Alpha-particle Monotherapy and Combination Therapy Trial With Nivolumab in Adults With Advanced Melanoma","aka":"","tldr":"A phase 1/2 trial of Nivolumab in melanoma, run by Perspective Therapeutics, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct05655312/","status":"recruiting"},{"id":"nct05658003","kind":"trial","name":"A Study Evaluating [177Lu]Lu-PSMA-617 vs. a Change of Androgen Receptor-directed Therapy in Taxane Treatment Naive Chinese Male Patients With Progressive Metastatic Castrate Resistant Prostate Cancer","aka":"","tldr":"A phase 2 trial of [177Lu]Lu-PSMA-617 in prostate cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05658003/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct05682443","kind":"trial","name":"ONC-392 Plus Lutetium Lu 177 Vipivotide Tetraxetan in Patients With mCRPC","aka":"PRESERVE-006","tldr":"A phase 1/2 trial of Gotistobart, Lutetium-177 vipivotide tetraxetan in prostate cancer, run by OncoC4, Inc., active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct05682443/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct05706129","kind":"trial","name":"A Study to Assess Safety, Tolerability and Imaging Characteristics of [68Ga]Ga-DPI-4452 and to Assess Safety, Tolerability, and Efficacy of [177Lu]Lu-DPI-4452 in Participants With Unresectable Locally Advanced or Metastatic Solid Tumors","aka":"","tldr":"A phase 1/2 trial of [68Ga]Ga-DPI-4452 in renal cell carcinoma, pancreatic ductal adenocarcinoma, colorectal cancer, bladder & urothelial cancer, head and neck squamous cell carcinoma and triple-negative breast cancer, run by Lumara Bio Oncologics GmbH, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05706129/","status":"recruiting","indications":"rcc"},{"id":"nct05849298","kind":"trial","name":"A Phase II Study of AAA617 Alone and AAA617 in Combination With ARPI in Patients With PSMA PET Scan Positive CRPC","aka":"PSMACare","tldr":"A phase 2 trial of AAA617 in prostate cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05849298/","status":"active","indications":"prostate"},{"id":"nct05884255","kind":"trial","name":"An Open-label Phase 3 Study of Lutetium (177Lu) Oxodotreotide Injection in Subjects With Advanced Gastrointestinal Pancreatic Neuroendocrine Tumors.","aka":"","tldr":"A phase 3 trial of Lutetium (177Lu) Oxodotreotide Injection；long-acting Octreotide in pancreatic ductal adenocarcinoma, run by Jiangsu HengRui Medicine Co., Ltd., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct05884255/","status":"recruiting"},{"id":"nct05936658","kind":"trial","name":"[18F]Florastamin PET/CT Imaging Examination in Patients With Suspected Recurrent or Metastatic Prostate Cancer","aka":"","tldr":"A phase 3 trial of Florastamin F-18 run by FutureChem, active.","tags":"ctgov-ingest","route":"/trials/nct05936658/","status":"active","indications":"prostate"},{"id":"nct05939414","kind":"trial","name":"An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan Versus Observation in PSMA Positive OMPC.","aka":"","tldr":"A phase 3 trial of FAP-2286 in prostate cancer, run by Novartis Pharmaceuticals, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct05939414/","status":"recruiting","indications":"prostate"},{"id":"nct06004661","kind":"trial","name":"Study of Lutetium (177Lu) Vipivotide Tetraxetan in mCRPC Participants With Moderately and Severely Impaired and With Normal Renal Function","aka":"","tldr":"A phase 2 trial of Lutetium-177 vipivotide tetraxetan in prostate cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct06004661/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct06040099","kind":"trial","name":"A US Study to Evaluate Transarterial Radioembolization (TARE) in Combination With Durvalumab and Bevacizumab Therapy in People With Unresectable Hepat","aka":"EMERALD-Y90","tldr":"A phase 2 trial of Durvalumab, Bevacizumab in hepatocellular carcinoma, run by AstraZeneca, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct06040099/","status":"active","indications":"hcc"},{"id":"nct06084806","kind":"trial","name":"Test-retest Evaluation of [18F]F-AraG PET","aka":"","tldr":"A phase 2 trial of [18F]F-ARAG PET in non-small-cell lung cancer, run by CellSight Technologies, Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06084806/","status":"recruiting"},{"id":"nct06107374","kind":"trial","name":"Imaging Advanced NSCLC Patients Undergoing PD-1/PD-L1 Directed Therapy Using [18F]-FARAG","aka":"","tldr":"A phase 2 trial of [18F]F-AraG in non-small-cell lung cancer, run by CellSight Technologies, Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06107374/","status":"recruiting","indications":"nsclc"},{"id":"nct06122584","kind":"trial","name":"Diagnostic Performance of [18F]PSMA-1007 PET/CT Imaging in Patients With Newly-Diagnosed Prostate Cancer","aka":"","tldr":"A phase 3 trial of PSMA-1007 F-18 run by ABX advanced biochemical compounds GmbH in prostate cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06122584/","status":"recruiting","indications":"prostate prostate-high-risk"},{"id":"nct06139575","kind":"trial","name":"Phase 1/2 Clinical Study of Lutetium Lu 177 JH020002 Injection in Patients With Advanced Prostate Cancer","aka":"","tldr":"A phase 1/2 trial of Lutetium Lu 177 JH020002 Injection in prostate cancer, run by Bivision Pharmaceuticals, Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06139575/","status":"recruiting","indications":"prostate"},{"id":"nct06184035","kind":"trial","name":"A Dose Escalation and Expansion Study of [177Lu]Lu-SN201 in Participants With Advanced Cancer","aka":"","tldr":"A phase 1/2 trial of [177Lu]Lu-SN201 in advanced solid tumours, run by Spago Nanomedical AB, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06184035/","status":"recruiting"},{"id":"nct06235151","kind":"trial","name":"Copper Cu 64 PSMA I&T PET Imaging in Men With Newly Diagnosed Prostate Cancer","aka":"","tldr":"A phase 3 trial of Copper Cu 64 PSMA I&T in prostate cancer, run by Curium US LLC, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06235151/","status":"active","indications":"prostate prostate-high-risk"},{"id":"nct06247995","kind":"trial","name":"A Phase I/II, Dose Finding and Optimization Study of [177Lu]Lu-NeoB in Combination With Capecitabine in Patients With GRPR+, ER+, HER2- Metastatic Breast Cancer After Progression on Previous Endocrine Therapy in Combination With a CDK4/6 Inhibitor.","aka":"NeoB-Cap1","tldr":"A phase 1/2 trial of Capecitabine in advanced solid tumours, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06247995/","status":"active"},{"id":"nct06298916","kind":"trial","name":"64Cu-LNTH-1363S in Patients With Sarcoma or Gastrointestinal Tract Cancer","aka":"PHANTOM","tldr":"A phase 1/2 trial of 64Cu-LNTH-1363S in sarcomas, oesophageal cancer, gastric & gastro-oesophageal junction cancer, pancreatic ductal adenocarcinoma and colorectal cancer, run by Lantheus Medical Imaging, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06298916/","status":"recruiting"},{"id":"nct06359847","kind":"trial","name":"Study of ST-1898 in Locally Advanced or Metastatic Radioiodine-Refractory Differentiated Thyroid Cancer","aka":"","tldr":"A phase 2 trial of ST-1898 tablets in thyroid cancer, run by Beijing Scitech-Mq Pharmaceuticals Limited, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06359847/","status":"recruiting","indications":"thyroid"},{"id":"nct06369831","kind":"trial","name":"HER2 Targeted Molecular Imaging in mBC and Other Metastatic Solid Carcinomas Using 68Ga-ABS011","aka":"HERMIA","tldr":"A phase 2 trial of an investigational treatment in advanced solid tumours, run by Abscint NV/SA, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06369831/","status":"recruiting"},{"id":"nct06383052","kind":"trial","name":"A Phase 1/2 Study of 177Lu-NYM032 Injection in mCRPC","aka":"","tldr":"A phase 1/2 trial of 177Lu-NYM032 injection in prostate cancer, run by Norroy Bioscience Co., LTD, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06383052/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct06398444","kind":"trial","name":"A Clinical Study of Lutetium[177Lu] Oxodotreotide Injection in Patients With Advanced Neuroendocrine Neoplasms","aka":"","tldr":"A phase 2/3 trial of Lutetium[177Lu] Oxodotreotide Injection in neuroendocrine tumours, run by Sinotau Pharmaceutical Group, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06398444/","status":"recruiting","indications":"neuroendocrine"},{"id":"nct06474806","kind":"trial","name":"Safety and Diagnostic Performance of uPAR PET Imaging in Localised, Untreated Prostate Cancer","aka":"uTRACE-101","tldr":"A phase 2 trial of 64Cu-DOTA-AE105 in prostate cancer, run by Curasight, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06474806/","status":"recruiting","indications":"prostate"},{"id":"nct06504147","kind":"trial","name":"A Study of Radspherin® in Patients With Primary Advanced Epithelial Cancer, With Peritoneal Metastasis That Are Homologous Recombination Proficient Scheduled to Undergo Neoadjuvant Chemotherapy and Interval Debulking Surgery","aka":"","tldr":"A phase 2 trial of Radspherin in ovarian cancer, run by Oncoinvent Solutions AS, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06504147/","status":"recruiting"},{"id":"nct06505395","kind":"trial","name":"A Trial to Assess Efficacy, Safety, Pharmacokinetics of Octreotide Subcutaneous Injection in Patients With Gastroentero-pancreatic Neuroendocrine Tumor (GEP-NET)","aka":"","tldr":"A phase 2 trial of SYHX2008 injection in pancreatic ductal adenocarcinoma, run by CSPC ZhongQi Pharmaceutical Technology Co., Ltd., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06505395/","status":"recruiting"},{"id":"nct06520345","kind":"trial","name":"The Study of 177Lu-TLX591 Plus SOC Versus SOC Alone in Patients With mCRPC (ProstACT Global)","aka":"","tldr":"A phase 3 trial of FAP-2286, Enzalutamide, Abiraterone acetate in prostate cancer, run by Telix Pharmaceuticals (Innovations) Pty Limited, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06520345/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct06549465","kind":"trial","name":"Study Evaluating Dosimetry, Randomized Dose Optimization, Dose Escalation and Efficacy of Ac-225 Rosopatamab Tetraxetan in Participants With PSMA PET-Positive Castration-Resistant Prostate Cancer (CRPC)","aka":"","tldr":"A phase 2 trial of the actinium-225 antibody rosopatamab tetraxetan (with an indium-111 version for dosimetry) in prostate cancer, run by Convergent Therapeutics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06549465/","status":"recruiting","indications":"prostate"},{"id":"nct06569420","kind":"trial","name":"Study Of Comparing SAF-189s With Crizotinib In First Line ALK-Positive Advanced and Metastatic NSCLC","aka":"","tldr":"A phase 3 trial of an investigational treatment in non-small-cell lung cancer, run by Shanghai Fosun Pharmaceutical Industrial Development Co. Ltd., active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06569420/","status":"active","indications":"nsclc"},{"id":"nct06590857","kind":"trial","name":"Trial of 225Ac-DOTATATE (RYZ101) in Subjects With ER+, HER2-negative Unresectable or Metastatic Breast Cancer Expressing SSTRs.","aka":"TRACY-1","tldr":"A phase 1/2 trial of Actinium-225 DOTATATE in HR-positive / HER2-negative breast cancer, run by RayzeBio, Inc., active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06590857/","status":"active"},{"id":"nct06710756","kind":"trial","name":"Lead-212 PSV359 Therapy for Patients With Solid Tumors","aka":"","tldr":"A phase 1/2 trial of [203Pb]Pb-PSV359 in pancreatic ductal adenocarcinoma, gastric & gastro-oesophageal junction cancer, oesophageal cancer, colorectal cancer, ovarian cancer and head and neck squamous cell carcinoma, run by Perspective Therapeutics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06710756/","status":"recruiting"},{"id":"nct06726161","kind":"trial","name":"Study of the Theranostic Pair RYZ811 (Diagnostic) and RYZ801 (Therapeutic) to Identify and Treat Subjects With GPC3+ (Glypican-3) Unresectable HCC","aka":"","tldr":"A phase 1/2 trial of RYZ801 in hepatocellular carcinoma, run by RayzeBio, Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06726161/","status":"recruiting","indications":"hcc"},{"id":"nct06750419","kind":"trial","name":"89Zr-TLX250 for PET/CT Imaging of ccRCC - ZIRCON-CP Study","aka":"ZIRCON-CP","tldr":"A phase 3 trial of Zirconium-89 girentuximab run by Telix Pharmaceuticals (Innovations) Pty Limited in renal cell carcinoma, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06750419/","status":"recruiting","indications":"rcc"},{"id":"nct06754085","kind":"trial","name":"Study of 18F-Florastamin PET/CT Imaging in Patients With Suspected Recurrence of Prostate Cancer","aka":"","tldr":"A phase 3 trial of Florastamin[18F] Injection in prostate cancer, run by HTA Co., Ltd., completed in June 2026 with no results posted yet.","tags":"pipeline ctgov-ingest","route":"/trials/nct06754085/","status":"completed","indications":"prostate"},{"id":"nct06777433","kind":"trial","name":"Phase 2b Imaging Study of RAD101 in Participants With Suspected Recurrent Brain Metastases","aka":"","tldr":"A phase 2 trial of RAD101 (18F-FPIA) in brain and spinal cord tumours, run by Radiopharm Theranostics, Ltd, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06777433/","status":"active"},{"id":"nct06780670","kind":"trial","name":"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","aka":"PSMAcTION","tldr":"A phase 2/3 trial testing AAA817 in prostate cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06780670/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct06784752","kind":"trial","name":"Study to Evaluate the Efficacy and Safety of [177Lu]Lu-DOTA-TATE in Patients With Grade 1 and Grade 2 Advanced GEP-NET","aka":"NETTER-3","tldr":"A phase 3 trial of [177Lu]Lu-DOTA-TATE in pancreatic ductal adenocarcinoma, run by Novartis Pharmaceuticals, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06784752/","status":"recruiting"},{"id":"nct06855277","kind":"trial","name":"Study Comparing AAA817+ARPI Versus Standard of Care in Adult Participants With PSMA-positive mCRPC","aka":"AcTFirst","tldr":"A phase 3 trial testing AAA817 in prostate cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06855277/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct06860971","kind":"trial","name":"A Study of AL2846 Capsule Versus Placebo in the Treatment of Advanced Radioiodine-Refractory Differentiated Thyroid Carcinoma","aka":"","tldr":"A phase 3 trial testing AL2846 in thyroid cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct06860971/","status":"recruiting","indications":"thyroid"},{"id":"nct06894511","kind":"trial","name":"An Open-label Study of Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI Versus AAA617 in PSMA Positive First-line mCRPC","aka":"PSMAndARPI","tldr":"A phase 2 trial of FAP-2286, Lutetium-177 vipivotide tetraxetan in prostate cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct06894511/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct06906471","kind":"trial","name":"A Single-Arm, Blinded, Fluorescent PSMA Histopathology Trial of AS1986NS","aka":"","tldr":"A phase 1/2 trial of AS1986NS in prostate cancer, run by Antelope Surgical Solutions, Inc, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06906471/","status":"recruiting","indications":"prostate"},{"id":"nct06909825","kind":"trial","name":"FPI-2265 (225Ac-PSMA-I&T) and Olaparib for Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC)","aka":"","tldr":"A phase 2 trial of FPI-2265, Olaparib in prostate cancer, run by Fusion Pharmaceuticals Inc., active and no longer recruiting.","tags":"ctgov-ingest","route":"/trials/nct06909825/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct06925581","kind":"trial","name":"A Trial of HRS-6768 in Patients With Advanced Solid Tumors","aka":"","tldr":"A phase 1/2 trial of HRS-6768 in advanced solid tumours, run by Jiangsu HengRui Medicine Co., Ltd., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06925581/","status":"recruiting"},{"id":"nct06990880","kind":"trial","name":"A Study of GSK5458514 Administered Alone or In Combination With Other Anti-Cancer Agents in Participants With Prostate Cancer","aka":"","tldr":"A phase 1/2 trial of GSK5458514 in prostate cancer, run by GlaxoSmithKline, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct06990880/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07047118","kind":"trial","name":"A Study of JSB462 (Luxdegalutamide) Plus Lutetium (177Lu) Vipivotide Tetraxetan in Patients With Metastatic Castration Resistant Prostate Cancer (mCRPC)","aka":"","tldr":"A phase 2 trial of JSB462 in prostate cancer, run by Novartis Pharmaceuticals, active and no longer recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07047118/","status":"active","indications":"prostate prostate-mcrpc"},{"id":"nct07052214","kind":"trial","name":"PSMA PET Combined With MRI for the Detection of PCa","aka":"BiPASS","tldr":"A phase 3 trial of Gallium-68 gozetotide in prostate cancer, run by Telix Pharmaceuticals (Innovations) Pty Limited, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07052214/","status":"recruiting","indications":"prostate"},{"id":"nct07070349","kind":"trial","name":"A Trial of HRS-6213 in Healthy Subjects and Patients With Solid Tumors","aka":"","tldr":"A phase 1/2 trial of HRS-6213 in advanced solid tumours, run by Jiangsu HengRui Medicine Co., Ltd., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07070349/","status":"recruiting"},{"id":"nct07129252","kind":"trial","name":"A Study to Investigate Safety and Effectiveness of CRN09682 in Participants With SST2-Expressing NENs and Other Solid Tumors","aka":"BRAVESST2","tldr":"A phase 1/2 trial of CRN09682 in neuroendocrine tumours, run by Crinetics Pharmaceuticals Inc., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07129252/","status":"recruiting","indications":"neuroendocrine"},{"id":"nct07189871","kind":"trial","name":"177Lu-BetaBart in Patients With Relapsed/Refractory, Locally Advanced Inoperable, or Metastatic Solid Tumors","aka":"","tldr":"A phase 1/2 trial of 177Lu-BetaBart in prostate cancer, colorectal cancer, non-small-cell lung cancer, ovarian cancer, cervical cancer and endometrial cancer, run by Radiopharm Theranostics, Ltd, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07189871/","status":"recruiting","indications":"prostate"},{"id":"nct07197580","kind":"trial","name":"Phase 3 Study to Assess Safety and Efficacy of 177Lu-TLX250 in Advanced Relapsed or Recurrent ccRCC","aka":"LUTEON","tldr":"A phase 3 trial of 177Lu-TLX250 in renal cell carcinoma, run by Telix Pharmaceuticals (Innovations) Pty Limited, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07197580/","status":"recruiting","indications":"rcc"},{"id":"nct07217704","kind":"trial","name":"Using 18F-FAPI PET to Detect Metastatic Disease in Patients That Have Gastric or Esophageal Cancer.","aka":"","tldr":"A phase 3 trial of [18F]FAPI-74 PET/CT in oesophageal cancer and gastric & gastro-oesophageal junction cancer, run by SOFIE, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07217704/","status":"recruiting"},{"id":"nct07219238","kind":"trial","name":"Study to Evaluate the Diagnostic Performance of GEH300079 (68Ga) Injection PET/CT for Detection of PC in Patients With Colorectal, Gastric, Ovarian, o","aka":"PERISCOPE","tldr":"A phase 2/3 trial of FAP-2286 in colorectal cancer and ovarian cancer, run by GE Healthcare, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07219238/","status":"recruiting"},{"id":"nct07226986","kind":"trial","name":"A Phase Ib/II Open-label Study of AMO959 With Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI in Adult Participants With PSMA","aka":"","tldr":"A phase 1/2 trial of Enzalutamide, Abiraterone acetate in prostate cancer, run by Novartis Pharmaceuticals, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07226986/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07258407","kind":"trial","name":"A Clinical Trial Evaluating the Safety of TD001 In Patients With PSMA-Expressing Metastatic Prostate Cancer","aka":"","tldr":"A phase 1/2 trial of TD001 in prostate cancer, run by T.O.A.D. Oncology SA, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07258407/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07259213","kind":"trial","name":"A Study of Terbium 161 (161Tb)-RAD402 in Participants With CRPC","aka":"","tldr":"A phase 1/2 trial of 161Tb RAD402 in prostate cancer, run by Radiopharm Theranostics, Ltd, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07259213/","status":"recruiting","indications":"prostate"},{"id":"nct07276789","kind":"trial","name":"Efficacy and Safety of a Single Dose of LS301-IT for Fluorescence Intraoperative Molecular Imaging (IMI) for Patients Undergoing Lung Cancer Resection for Non Small Cell Lung Cancer","aka":"","tldr":"A phase 2 trial of LS301-IT 0.1 mg/kg in non-small-cell lung cancer, run by Integro Theranostics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07276789/","status":"recruiting","indications":"nsclc"},{"id":"nct07278479","kind":"trial","name":"Study of [212Pb]Pb-DOTAM-MAM279 ([212Pb]Pb-MP0712) in Patients With Small Cell Lung Cancer and Other DLL3 Expressing Solid Tumors","aka":"","tldr":"A phase 1/2 trial of [212Pb]Pb-MP0712 in neuroendocrine tumours, small-cell lung cancer, pancreatic ductal adenocarcinoma and bladder & urothelial cancer, run by Molecular Partners AG, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07278479/","status":"recruiting","indications":"neuroendocrine sclc"},{"id":"nct07311694","kind":"trial","name":"A Phase III Study Comparing HRS-4357 With Novel Androgen Receptor Pathway Inhibitors in Patients With Progressive, PSMA-Positive Metastatic Castration-Resistant Prostate Cancer","aka":"","tldr":"A phase 3 trial testing HRS-4357 in prostate cancer, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07311694/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07357519","kind":"trial","name":"Lu-TARGO (177Lu-TARGeted Osteosarcoma Therapy)","aka":"","tldr":"A phase 1/2 trial of LNTH2403 Phase 1 dose in osteosarcoma, run by Lantheus Medical Imaging, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07357519/","status":"recruiting","indications":"osteosarcoma"},{"id":"nct07432633","kind":"trial","name":"[18F]FPyQCP PET Imaging of Fibroblast Activation Protein in Selected Oncology Indications","aka":"","tldr":"A phase 1/2 trial of [18F]FPyQCP in colorectal cancer, ovarian cancer, gastric & gastro-oesophageal junction cancer and pancreatic ductal adenocarcinoma, run by Blue Earth Diagnostics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07432633/","status":"recruiting"},{"id":"nct07567521","kind":"trial","name":"A Study of TRC003 in the Treatment of Patients With Progressive PSMA-positive mCRPC","aka":"","tldr":"A phase 1/2 trial of Radiopharmaceuticals in prostate cancer, run by C Ray Therapeutics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07567521/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07590934","kind":"trial","name":"Phase Ib/II Platform Study of Multiple Anti-Cancer Agents in Participants With Metastatic Prostate Cancer","aka":"PROSPECTOR","tldr":"A phase 1/2 trial of FPI-2265, Actinium-225 PSMA agents, Palacaparib in prostate cancer, run by AstraZeneca, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07590934/","status":"recruiting","indications":"prostate"},{"id":"nct07611110","kind":"trial","name":"AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01)","aka":"VECTRA-01","tldr":"A phase 3 trial of FPI-2265, Cabazitaxel, Abiraterone acetate in prostate cancer, run by AstraZeneca, now recruiting.","tags":"ctgov-ingest","route":"/trials/nct07611110/","status":"recruiting","indications":"prostate prostate-mcrpc"},{"id":"nct07615101","kind":"trial","name":"Investigating the Safety and Diagnostic Performance of 68Ga-NYM032 Injection PET/CT in Men With Newly Diagnosed Prostate Cancer.","aka":"","tldr":"A phase 3 trial of 68-Ga-NYM032 in prostate cancer, run by Norroy Bioscience Co., LTD, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07615101/","status":"recruiting","indications":"prostate"},{"id":"nct07649122","kind":"trial","name":"This Study Evaluates the Diagnostic Performance and Safety of 68Ga-NYM032 PET/CT Imaging in Patients With Suspected Recurrence of Prostate Cancer.","aka":"","tldr":"A phase 3 trial of an investigational treatment in prostate cancer, run by Norroy Bioscience Co., LTD, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07649122/","status":"recruiting","indications":"prostate"},{"id":"nct07691775","kind":"trial","name":"A Study to Evaluate the Safety and Diagnostic Performance of F18 FBPA PET/CT Imaging in Solid Tumors","aka":"","tldr":"A phase 1/2 trial of F18 FBPA Injection in advanced solid tumours, run by Heron Neutron Medical Corp., now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07691775/","status":"recruiting"},{"id":"nct07702292","kind":"trial","name":"[68Ga]BED003 PET Imaging of Fibroblast Activation Protein in Selected Oncology Indications","aka":"","tldr":"A phase 2 trial of [68Ga]BED003 in colorectal cancer, ovarian cancer, gastric & gastro-oesophageal junction cancer and pancreatic ductal adenocarcinoma, run by Blue Earth Diagnostics, now recruiting.","tags":"pipeline ctgov-ingest","route":"/trials/nct07702292/","status":"recruiting"},{"id":"netter-1","kind":"trial","name":"NETTER-1","aka":"","tldr":"The trial that made radioligand therapy a standard: a radioactive drug homing to the somatostatin receptor held midgut neuroendocrine tumours in check far longer than high-dose octreotide, and it underpins Lutathera's approvals.","tags":"","route":"/trials/netter-1/","status":"positive","indications":"neuroendocrine small-intestinal-net"},{"id":"phergain","kind":"trial","name":"PHERGain","aka":"","tldr":"Using an early PET scan to spot responders let a third of women be cured of HER2-positive breast cancer without any chemotherapy.","tags":"","route":"/trials/phergain/","status":"positive","indications":"breast-her2-positive"},{"id":"pop-rt","kind":"trial","name":"POP-RT","aka":"","tldr":"POP-RT, from Mumbai, showed that treating the pelvic lymph nodes as well as the prostate improves disease control in high-risk prostate cancer, reviving a question earlier trials had left unanswered.","tags":"radiation-wave4","route":"/trials/pop-rt/","status":"positive","indications":"prostate"},{"id":"propsma","kind":"trial","name":"proPSMA","aka":"","tldr":"Proved PSMA PET is far more accurate than conventional scans for staging, with less radiation.","tags":"","route":"/trials/propsma/","status":"positive","indications":"prostate prostate-high-risk"},{"id":"prosper","kind":"trial","name":"PROSPER","aka":"","tldr":"PROSPER showed that enzalutamide delayed the appearance of metastases by about two years, and later helped men live longer, when given at the point where prostate cancer is rising on hormone therapy but has not yet spread on scans.","tags":"subtype-trials","route":"/trials/prosper/","status":"positive","indications":"prostate-nmcrpc prostate"},{"id":"psmaddition","kind":"trial","name":"PSMAddition","aka":"","tldr":"PSMAddition moved the radioligand Pluvicto into the first treatment of metastatic hormone-sensitive prostate cancer, given alongside hormone therapy, and the FDA approved this use on 31 July 2026. It delayed progression on scans, but severe side effects were more common and whether it lengthens life is not yet known.","tags":"","route":"/trials/psmaddition/","status":"positive","indications":"prostate prostate-mhspc"},{"id":"psmafore","kind":"trial","name":"PSMAfore","aka":"","tldr":"PSMAfore moved Pluvicto before chemotherapy in prostate cancer.","tags":"","route":"/trials/psmafore/","status":"positive","indications":"prostate prostate-mcrpc"},{"id":"radiant-3-4","kind":"trial","name":"RADIANT-3 and RADIANT-4","aka":"","tldr":"The two trials that made everolimus a standard pill for pancreatic, lung and gut neuroendocrine tumours.","tags":"","route":"/trials/radiant-3-4/","status":"positive","indications":"neuroendocrine pancreatic-net small-intestinal-net lung-net"},{"id":"rathl","kind":"trial","name":"RATHL","aka":"","tldr":"Showed that patients whose PET scan is clear after two cycles can safely drop bleomycin and its lung toxicity.","tags":"","route":"/trials/rathl/","status":"positive"},{"id":"sarah-sirvenib","kind":"trial","name":"SARAH and SIRveNIB","aka":"","tldr":"Two large trials found radioactive beads were gentler than sorafenib but did not help patients live longer.","tags":"failure lesson:patient-selection","route":"/trials/sarah-sirvenib/","status":"negative","indications":"hcc"},{"id":"select-lenvatinib","kind":"trial","name":"SELECT","aka":"","tldr":"Turned lenvatinib into the main drug for thyroid cancers that no longer take up radioactive iodine, quadrupling the time before the disease grew.","tags":"","route":"/trials/select-lenvatinib/","status":"positive","indications":"thyroid"},{"id":"splash","kind":"trial","name":"SPLASH","aka":"","tldr":"In SPLASH, a second PSMA radioligand improved progression-free survival but not, so far, survival.","tags":"","route":"/trials/splash/","status":"mixed","indications":"prostate prostate-mcrpc"},{"id":"stampede","kind":"trial","name":"STAMPEDE","aka":"STAMPEDE trial MRC PR08 Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy STAMPEDE platform","tldr":"STAMPEDE is the longest-running platform trial in oncology, and showed that both docetaxel and abiraterone extend life when started at first diagnosis of metastatic disease.","tags":"","route":"/trials/stampede/","status":"positive","indications":"prostate prostate-mhspc prostate-high-risk"},{"id":"therap","kind":"trial","name":"TheraP (ANZUP 1603)","aka":"","tldr":"The randomised trial that first pitted a radioligand against chemotherapy and won on response, with fewer side effects.","tags":"","route":"/trials/therap/","status":"positive","indications":"prostate prostate-mcrpc"},{"id":"vision","kind":"trial","name":"VISION","aka":"","tldr":"VISION was the trial that established radioligand therapy in prostate cancer.","tags":"","route":"/trials/vision/","status":"positive","indications":"prostate prostate-mcrpc"},{"id":"beta-then-alpha","kind":"pairing","name":"Beta radioligand → alpha radioligand","aka":"","tldr":"After lutetium therapy stops working, an actinium version of the same drug can still produce responses.","tags":"","route":"/pairings/beta-then-alpha/","indications":"prostate neuroendocrine"},{"id":"prrt-then-alpha-net","kind":"pairing","name":"Beta PRRT → alpha PRRT","aka":"","tldr":"When lutetium radioligand therapy stops working, alpha-emitting versions can still control the disease.","tags":"","route":"/pairings/prrt-then-alpha-net/","indications":"neuroendocrine"},{"id":"psma-pet-to-rlt","kind":"pairing","name":"PSMA PET → PSMA radioligand therapy","aka":"","tldr":"The scan shows whether the target is there; the treatment uses the same address. Only patients whose tumours light up are treated.","tags":"","route":"/pairings/psma-pet-to-rlt/","indications":"prostate"},{"id":"sstr-pet-to-prrt","kind":"pairing","name":"SSTR PET → PRRT","aka":"","tldr":"SSTR PET followed by PRRT is the original theranostic pair: the scan with the diagnostic isotope decides who gets the same molecule with the therapeutic isotope.","tags":"","route":"/pairings/sstr-pet-to-prrt/","indications":"neuroendocrine"},{"id":"molecular-imaging-roadmap","kind":"roadmap","name":"Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET","aka":"","tldr":"From a sugar tracer that lights up most cancers to tracers that show a single protein, a stromal cell type, or the immune cells inside a tumour.","tags":"","route":"/roadmaps/molecular-imaging-roadmap/"},{"id":"radiopharma-roadmap","kind":"roadmap","name":"Radiopharmaceutical roadmap: iodine → lutetium → actinium","aka":"","tldr":"The radiopharmaceutical roadmap runs eighty years from radioactive iodine for thyroid cancer to alpha-emitting drugs for prostate and neuroendocrine cancers, with isotope supply as the limiting factor.","tags":"","route":"/roadmaps/radiopharma-roadmap/"},{"id":"idea-alpha-after-adc","kind":"idea","name":"Alpha radioligands after ADC failure","aka":"","tldr":"When ADCs against a surface protein stop working because the payload no longer kills, use the same protein to deliver radiation instead.","tags":"","route":"/ideas/idea-alpha-after-adc/"},{"id":"idea-alpha-first-mhspc","kind":"idea","name":"Alpha-emitting PSMA therapy at first metastatic diagnosis","aka":"","tldr":"If Pluvicto helps at first diagnosis, an alpha version might do more against microscopic disease, when tumour burden is smallest.","tags":"","route":"/ideas/idea-alpha-first-mhspc/","indications":"prostate"},{"id":"idea-caix-theranostics","kind":"idea","name":"CAIX theranostics: 89Zr-girentuximab PET and 177Lu/225Ac-girentuximab therapy","aka":"","tldr":"Almost every clear-cell kidney cancer carries the CAIX protein. Image it with one radioactive antibody, then treat with the same antibody carrying a therapeutic isotope.","tags":"","route":"/ideas/idea-caix-theranostics/","indications":"rcc"},{"id":"idea-cd8-pet-io","kind":"idea","name":"CD8 PET to stop or switch immunotherapy early","aka":"","tldr":"Scan for T cells inside the tumour a few weeks after starting immunotherapy. If they have not arrived, change course.","tags":"","route":"/ideas/idea-cd8-pet-io/"},{"id":"idea-fap-theranostics-pancancer","kind":"idea","name":"FAP theranostics as a pan-cancer stromal strategy","aka":"","tldr":"Instead of finding a different target for each cancer, hit the scaffolding cells that almost all solid tumours share.","tags":"","route":"/ideas/idea-fap-theranostics-pancancer/"},{"id":"idea-fund-academic-radiopharma-pipeline","kind":"idea","name":"A university cyclotron network with shared regulatory files for new tracers","aka":"","tldr":"Most new cancer imaging agents and radioactive drugs start in university hospitals. A network sharing production, quality files and regulatory paperwork would get them into multi-centre trials years faster.","tags":"","route":"/ideas/idea-fund-academic-radiopharma-pipeline/"},{"id":"idea-mced-plus-fapi","kind":"idea","name":"FAPI PET as the workup for MCED positives","aka":"","tldr":"When a blood test says 'cancer signal, origin unclear', a FAPI PET scan may find it where FDG cannot.","tags":"","route":"/ideas/idea-mced-plus-fapi/"},{"id":"idea-mfbg-pet-replaces-mibg","kind":"idea","name":"18F-MFBG PET replacing 123I-MIBG scintigraphy","aka":"","tldr":"A same-day PET tracer could replace the two-day, low-resolution MIBG scan children now undergo repeatedly.","tags":"","route":"/ideas/idea-mfbg-pet-replaces-mibg/","indications":"neuroblastoma"},{"id":"idea-net-antagonist-ligands","kind":"idea","name":"SSTR antagonist radioligands to increase tumour dose","aka":"","tldr":"Radioligand therapy for neuroendocrine tumours built on somatostatin receptor antagonists rather than the agonists used today: antagonists bind the receptor in every state and are not internalised, so they occupy several times more sites per cell and deliver more radiation per dose. The test is a randomised phase 2 against agonist lutetium therapy.","tags":"","route":"/ideas/idea-net-antagonist-ligands/","indications":"neuroendocrine"},{"id":"idea-net-dosimetry-prrt","kind":"idea","name":"Dosimetry-personalised PRRT instead of four fixed cycles","aka":"","tldr":"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 cycles.","tags":"","route":"/ideas/idea-net-dosimetry-prrt/","indications":"neuroendocrine"},{"id":"idea-psma-pet-guided-mdt","kind":"idea","name":"PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer","aka":"","tldr":"When PSMA PET finds only a few spots after surgery, zap each spot with focused radiation and delay or avoid lifelong hormone therapy.","tags":"","route":"/ideas/idea-psma-pet-guided-mdt/","indications":"prostate"},{"id":"idea-reg-ac225-accelerator-pharmacopoeia","kind":"idea","name":"Regional cyclotron hubs for actinium-225 with an agreed actinium-227 impurity limit","aka":"","tldr":"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. Settle the limit and build the hubs.","tags":"","route":"/ideas/idea-reg-ac225-accelerator-pharmacopoeia/"},{"id":"idea-reg-alpha-emitter-portfolio","kind":"idea","name":"Fund alpha emitters beyond actinium-225: lead-212, terbium-149 and astatine-211","aka":"","tldr":"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.","tags":"","route":"/ideas/idea-reg-alpha-emitter-portfolio/"},{"id":"idea-reg-isotope-supply-observatory","kind":"idea","name":"A global medical isotope supply observatory with forecasts and shortage alerts","aka":"","tldr":"Nobody publishes how much cancer isotope is made, where, or when supply will fall short. A public observatory would let hospitals and investors plan.","tags":"","route":"/ideas/idea-reg-isotope-supply-observatory/"},{"id":"idea-reg-legacy-radium-recovery-ac225","kind":"idea","name":"Recover legacy radium-226 sources worldwide as the feedstock for actinium-225","aka":"","tldr":"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 isotope.","tags":"","route":"/ideas/idea-reg-legacy-radium-recovery-ac225/"},{"id":"idea-reg-medical-isotope-reactor-reserve","kind":"idea","name":"A coordinated reserve and shared schedule for the world's medical isotope reactors","aka":"","tldr":"A handful of ageing research reactors make most cancer isotopes. Coordinating their maintenance and funding reserve capacity would prevent the shortages that stop treatments.","tags":"","route":"/ideas/idea-reg-medical-isotope-reactor-reserve/"},{"id":"idea-reg-regional-radiopharmacy-hubs","kind":"idea","name":"Regional radiopharmacy hubs and harmonised transport rules for short-lived isotopes","aka":"","tldr":"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 time.","tags":"","route":"/ideas/idea-reg-regional-radiopharmacy-hubs/"},{"id":"idea-reg-yb176-enrichment-capacity","kind":"idea","name":"Build Western ytterbium-176 enrichment so lutetium-177 has more than one supplier","aka":"","tldr":"The lutetium used in approved prostate and neuroendocrine cancer treatments is made from an enriched metal that comes mostly from Russia. Making it elsewhere would secure supply.","tags":"","route":"/ideas/idea-reg-yb176-enrichment-capacity/"},{"id":"idea-total-body-pet-dosimetry","kind":"idea","name":"Total-body PET for personalised radioligand dosing","aka":"","tldr":"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 tailored.","tags":"","route":"/ideas/idea-total-body-pet-dosimetry/","indications":"prostate"},{"id":"idea-tr2-psma-volume-qualification","kind":"idea","name":"Qualify PSMA PET tumour volume as a validated imaging biomarker","aka":"","tldr":"PSMA scans could measure prostate cancer burden and response far better than PSA, but no one has done the standardisation work to make the measurement trustworthy across scanners.","tags":"","route":"/ideas/idea-tr2-psma-volume-qualification/","indications":"prostate"},{"id":"idea-trop2-pet-selection","kind":"idea","name":"TROP2 PET to choose and sequence TROP2 ADCs","aka":"","tldr":"Use a whole-body TROP2 scan instead of a single tissue stain to decide which patients get a TROP2 ADC, which one, and when to switch.","tags":"","route":"/ideas/idea-trop2-pet-selection/"},{"id":"clinicaltrials-gov","kind":"collection","name":"ClinicalTrials.gov","aka":"","tldr":"ClinicalTrials.gov is the master list of clinical trials. Every trial on this site links to its record.","tags":"","route":"/collections/clinicaltrials-gov/"},{"id":"prostate-cancer-foundation","kind":"collection","name":"Prostate Cancer Foundation (PCF)","aka":"","tldr":"Michael Milken's prostate cancer foundation, which funded the science behind abiraterone, enzalutamide and PSMA therapy and runs a precision-oncology network in US veterans' hospitals.","tags":"gap-fill patient-org","route":"/collections/prostate-cancer-foundation/"},{"id":"src-snmmi","kind":"collection","name":"SNMMI Annual Meeting","aka":"","tldr":"The SNMMI Annual Meeting, held each June by the Society of Nuclear Medicine and Molecular Imaging, is where new PET tracers, radioligand therapy results and dosimetry work are first presented. Abstracts are free as a Journal of Nuclear Medicine supplement, and that journal carries the field's papers through the rest of the year.","tags":"source congress","route":"/collections/src-snmmi/"},{"id":"src-urotoday","kind":"collection","name":"UroToday","aka":"","tldr":"UroToday is the prostate, bladder, and kidney cancer feed, including PSMA and radioligand news.","tags":"source news","route":"/collections/src-urotoday/"},{"id":"tcia","kind":"collection","name":"The Cancer Imaging Archive (TCIA)","aka":"","tldr":"The public archive of cancer scans that most radiology AI is trained and tested on.","tags":"data","route":"/collections/tcia/"},{"id":"chris-parker","kind":"person","name":"Chris C. Parker","aka":"","tldr":"London radiation oncologist who led ALSYMPCA, the trial that showed radium-223 lengthens survival in prostate cancer that has spread to bone, and RADICALS-RT, which showed radiotherapy after prostatectomy can safely wait until the PSA rises.","tags":"prostate radiotherapy trialist","route":"/people/chris-parker/","indications":"prostate-mcrpc prostate-bcr prostate"},{"id":"clemens-kratochwil","kind":"person","name":"Clemens Kratochwil","aka":"","tldr":"Clemens Kratochwil reported the first patients treated with actinium-225 PSMA therapy.","tags":"","route":"/people/clemens-kratochwil/","indications":"prostate"},{"id":"declan-murphy","kind":"person","name":"Declan G. Murphy","aka":"","tldr":"Urologist who co-led proPSMA, the trial that showed PSMA PET should replace CT and bone scan for staging prostate cancer.","tags":"prostate imaging surgery","route":"/people/declan-murphy/","indications":"prostate"},{"id":"ebrahim-delpassand","kind":"person","name":"Ebrahim S. Delpassand","aka":"","tldr":"The nuclear medicine physician who founded and leads Excel Diagnostics in Houston, a radiopharmaceutical therapy centre that also runs early trials of new radioligands.","tags":"leadership","route":"/people/ebrahim-delpassand/"},{"id":"emily-bergsland","kind":"person","name":"Emily K. Bergsland","aka":"","tldr":"Neuroendocrine tumour specialist who helps design the trials that set treatment for these rare cancers.","tags":"","route":"/people/emily-bergsland/","indications":"neuroendocrine"},{"id":"frederik-giesel","kind":"person","name":"Frederik Giesel","aka":"","tldr":"Frederik Giesel co-developed FAPI PET imaging and now leads nuclear medicine in Düsseldorf.","tags":"","route":"/people/frederik-giesel/"},{"id":"hofman-michael","kind":"person","name":"Michael Hofman","aka":"","tldr":"Led proPSMA and TheraP, the trials that proved PSMA PET beats conventional imaging and that lutetium-PSMA beats chemotherapy.","tags":"","route":"/people/hofman-michael/","indications":"prostate"},{"id":"jason-lewis","kind":"person","name":"Jason S. Lewis","aka":"","tldr":"Radiochemist who built the zirconium-89 immuno-PET platform and MSKCC's radiopharmaceutical pipeline.","tags":"radiochemistry immuno-pet theranostics","route":"/people/jason-lewis/"},{"id":"jeremie-calais","kind":"person","name":"Jeremie Calais","aka":"","tldr":"Runs the UCLA theranostics trials that test PSMA imaging against conventional scans and lutetium against chemotherapy.","tags":"","route":"/people/jeremie-calais/","indications":"prostate"},{"id":"johannes-czernin","kind":"person","name":"Johannes Czernin","aka":"","tldr":"Nuclear medicine leader who helped bring PSMA PET and radioligand therapy to the United States.","tags":"","route":"/people/johannes-czernin/","indications":"prostate"},{"id":"jonathan-strosberg","kind":"person","name":"Jonathan R. Strosberg","aka":"","tldr":"Led NETTER-1, the trial that made lutetium dotatate the first approved radioligand therapy for neuroendocrine tumours.","tags":"neuroendocrine radioligand trialist","route":"/people/jonathan-strosberg/","indications":"neuroendocrine"},{"id":"karim-fizazi","kind":"person","name":"Karim Fizazi","aka":"","tldr":"Led LATITUDE and PEACE-1, which put abiraterone into first-line metastatic prostate cancer.","tags":"","route":"/people/karim-fizazi/","indications":"prostate"},{"id":"katherine-matthay","kind":"person","name":"Katherine K. Matthay","aka":"","tldr":"Paediatric oncologist whose trials established transplant and 13-cis-retinoic acid for high-risk neuroblastoma.","tags":"","route":"/people/katherine-matthay/","indications":"neuroblastoma"},{"id":"ken-herrmann","kind":"person","name":"Ken Herrmann","aka":"","tldr":"Nuclear medicine leader who co-led VISION and runs one of the world's largest theranostics programmes.","tags":"radioligand nuclear-medicine germany","route":"/people/ken-herrmann/","indications":"prostate neuroendocrine"},{"id":"louise-emmett","kind":"person","name":"Louise Emmett","aka":"","tldr":"Nuclear medicine physician who leads ENZA-p and the PSMA imaging trials shaping Australian theranostics.","tags":"prostate radioligand australia","route":"/people/louise-emmett/","indications":"prostate"},{"id":"michael-morris","kind":"person","name":"Michael J. Morris","aka":"","tldr":"Principal investigator of the VISION trial that made lutetium-PSMA a standard prostate cancer treatment.","tags":"","route":"/people/michael-morris/","indications":"prostate"},{"id":"oliver-sartor","kind":"person","name":"A. Oliver Sartor","aka":"","tldr":"Led VISION, the trial that made lutetium-PSMA the first radioligand therapy for prostate cancer.","tags":"prostate radioligand trialist","route":"/people/oliver-sartor/","indications":"prostate"},{"id":"paola-anna-erba","kind":"person","name":"Paola Anna Erba","aka":"","tldr":"Italian nuclear medicine physician serving as President of the European Association of Nuclear Medicine.","tags":"leadership clinician-scientist nuclear medicine theranostics","route":"/people/paola-anna-erba/","indications":"neuroendocrine prostate"},{"id":"peter-bartenstein","kind":"person","name":"Peter Bartenstein","aka":"","tldr":"Peter Bartenstein is a nuclear medicine head whose department is a leading European PSMA theranostics centre.","tags":"","route":"/people/peter-bartenstein/","indications":"prostate"},{"id":"pierre-vera","kind":"person","name":"Pierre Vera","aka":"","tldr":"Nuclear medicine physician who directs Centre Henri Becquerel, the comprehensive cancer centre for the Rouen area in Normandy.","tags":"leadership clinician-scientist comprehensive-cancer-centre","route":"/people/pierre-vera/"},{"id":"rafael-mariano-grossi","kind":"person","name":"Rafael Mariano Grossi","aka":"","tldr":"Argentine diplomat leading the IAEA since 2019, whose Rays of Hope initiative expands radiotherapy and nuclear medicine access in low- and middle-income countries.","tags":"leadership radiotherapy global health","route":"/people/rafael-mariano-grossi/"},{"id":"rahul-aggarwal","kind":"person","name":"Rahul Aggarwal","aka":"","tldr":"Prostate oncologist studying how tumours transform to escape hormone therapy and how to target them with radioligands.","tags":"","route":"/people/rahul-aggarwal/","indications":"prostate"},{"id":"richard-baum","kind":"person","name":"Richard P. Baum","aka":"","tldr":"One of the pioneers of peptide receptor radionuclide therapy for neuroendocrine tumours, now practising at the Curanosticum theranostics centre in Wiesbaden.","tags":"leadership","route":"/people/richard-baum/","indications":"neuroendocrine prostate"},{"id":"robert-mach","kind":"person","name":"Robert H. Mach","aka":"","tldr":"Robert Mach invented the PARP PET tracer FluorThanatrace that images DNA repair capacity in tumours.","tags":"","route":"/people/robert-mach/"},{"id":"sandhu-shahneen","kind":"person","name":"Shahneen Sandhu","aka":"","tldr":"Runs the medical oncology side of Peter Mac's theranostics programme, combining lutetium-PSMA with hormonal and immune therapies.","tags":"","route":"/people/sandhu-shahneen/","indications":"prostate"},{"id":"silke-gillessen","kind":"person","name":"Silke Gillessen","aka":"","tldr":"Founder and chair of the APCCC consensus conference that guides advanced prostate cancer management worldwide.","tags":"prostate guidelines switzerland","route":"/people/silke-gillessen/","indications":"prostate"},{"id":"simron-singh","kind":"person","name":"Simron Singh","aka":"","tldr":"Led NETTER-2, which moved lutetium dotatate into first-line treatment of higher-grade neuroendocrine tumours.","tags":"neuroendocrine radioligand canada","route":"/people/simron-singh/","indications":"neuroendocrine"},{"id":"song-shaoli","kind":"person","name":"Shaoli Song","aka":"","tldr":"Leads the nuclear medicine group behind the first human TROP2 PET imaging, aiming to pick patients for TROP2 ADCs with a scan.","tags":"","route":"/people/song-shaoli/"},{"id":"thomas-hope","kind":"person","name":"Thomas A. Hope","aka":"","tldr":"Nuclear medicine physician who led the trials that got PSMA PET approved in the United States.","tags":"","route":"/people/thomas-hope/","indications":"prostate"},{"id":"uwe-haberkorn","kind":"person","name":"Uwe Haberkorn","aka":"","tldr":"Nuclear medicine physician whose group invented FAPI PET tracers and pioneered PSMA and FAP radioligand therapy.","tags":"","route":"/people/uwe-haberkorn/"},{"id":"virginia-pappas","kind":"person","name":"Virginia Pappas","aka":"","tldr":"Long-serving CEO of the Society of Nuclear Medicine and Molecular Imaging.","tags":"leadership nuclear medicine","route":"/people/virginia-pappas/"},{"id":"wolfgang-weber","kind":"person","name":"Wolfgang A. Weber","aka":"","tldr":"Nuclear medicine physician who established PET response criteria and leads Munich's radiopharmaceutical development pipeline.","tags":"nuclear-medicine imaging theranostics","route":"/people/wolfgang-weber/"},{"id":"b-dose-optimisation","kind":"bottleneck","name":"Wrong doses","aka":"","tldr":"Most drug doses were chosen as the highest a person can tolerate, which is often more than they need.","tags":"","route":"/bottlenecks/b-dose-optimisation/","indications":"breast-her2-positive neuroendocrine"},{"id":"b-manufacturing-cell-therapy","kind":"bottleneck","name":"Manufacturing cost and time for living and radioactive medicines","aka":"","tldr":"Cell therapies take weeks to make for one patient and cost hundreds of thousands of dollars. Isotopes run short.","tags":"","route":"/bottlenecks/b-manufacturing-cell-therapy/","indications":"dlbcl prostate neuroendocrine"},{"id":"paper-alsympca-radium-223-nejm-2013","kind":"paper","name":"ALSYMPCA: alpha emitter radium-223 and survival in metastatic prostate cancer with bone metastases","aka":"","tldr":"Radium-223, an injected alpha-emitting radioisotope that homes to bone, lengthened survival and delayed skeletal complications in men with castration-resistant prostate cancer that had spread to bone but not to organs.","tags":"","route":"/key-papers/paper-alsympca-radium-223-nejm-2013/","indications":"prostate-mcrpc"},{"id":"paper-cabinet-cabozantinib-nejm-2024","kind":"paper","name":"CABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours","aka":"","tldr":"Cabozantinib delayed progression in previously treated advanced neuroendocrine tumours of both pancreatic and extra-pancreatic origin compared with placebo, adding a new option after somatostatin analogues, everolimus or radioligand therapy.","tags":"","route":"/key-papers/paper-cabinet-cabozantinib-nejm-2024/","indications":"lung-net pancreatic-net small-intestinal-net"},{"id":"paper-clarinet-lanreotide-nejm-2014","kind":"paper","name":"CLARINET: lanreotide in metastatic enteropancreatic neuroendocrine tumours","aka":"","tldr":"The long-acting somatostatin analogue lanreotide roughly halved the risk of progression in non-functioning gut and pancreatic neuroendocrine tumours, extending the use of these drugs from symptom control to slowing tumour growth.","tags":"","route":"/key-papers/paper-clarinet-lanreotide-nejm-2014/","indications":"pancreatic-net small-intestinal-net"},{"id":"paper-detect-a-science-2020","kind":"paper","name":"DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms","aka":"","tldr":"The first prospective interventional study of a multi-analyte blood test (CancerSEEK) in asymptomatic people: 26 cancers were first detected by the blood test, most of them localised, and the test roughly doubled the number of cancers caught by standard screening.","tags":"","route":"/key-papers/paper-detect-a-science-2020/"},{"id":"paper-netter-1-nejm-2017","kind":"paper","name":"NETTER-1: 177Lu-Dotatate for midgut neuroendocrine tumours progressing on octreotide","aka":"","tldr":"Radioligand therapy with lutetium-177 dotatate reduced the risk of progression or death by nearly 80 percent compared with high-dose octreotide in midgut neuroendocrine tumours, the first randomised proof that targeted radiation works in these cancers.","tags":"","route":"/key-papers/paper-netter-1-nejm-2017/","indications":"small-intestinal-net"},{"id":"paper-netter-2-lancet-2024","kind":"paper","name":"NETTER-2: lutetium-177 dotatate as first treatment for higher-grade gastroenteropancreatic neuroendocrine tumours","aka":"","tldr":"Using the radioactive drug lutetium dotatate as the first treatment for faster-growing neuroendocrine tumours, rather than saving it for later, nearly tripled the time without progression compared with high-dose octreotide.","tags":"","route":"/key-papers/paper-netter-2-lancet-2024/","indications":"neuroendocrine"},{"id":"paper-propsma-hofman-lancet-2020","kind":"paper","name":"proPSMA: PSMA PET-CT versus conventional imaging for staging high-risk prostate cancer","aka":"","tldr":"PSMA PET-CT was 27 percentage points more accurate than CT and bone scan for finding spread in men with high-risk prostate cancer before treatment, with less radiation and more influence on management, and it has replaced conventional imaging where available.","tags":"","route":"/key-papers/paper-propsma-hofman-lancet-2020/","indications":"prostate-bcr prostate-high-risk"},{"id":"paper-pryma-high-specific-activity-i131-mibg-ppgl-jnm-2019","kind":"paper","name":"Efficacy and safety of high-specific-activity 131I-MIBG therapy in advanced pheochromocytoma or paraganglioma","aka":"","tldr":"A purified radioactive form of MIBG, taken up by adrenaline-producing tumour cells, let a quarter of patients halve their blood pressure medication for at least six months and shrank tumours in about one in five, leading to the first approved radiopharmaceutical for these tumours.","tags":"","route":"/key-papers/paper-pryma-high-specific-activity-i131-mibg-ppgl-jnm-2019/","indications":"metastatic-ppgl"},{"id":"paper-rathl-interim-pet-adapted-abvd-advanced-hodgkin-nejm-2016","kind":"paper","name":"RATHL: adapted treatment guided by interim PET-CT in advanced Hodgkin lymphoma","aka":"","tldr":"Using a PET scan after two cycles to decide the rest of treatment let patients with a clear scan drop bleomycin, sparing their lungs without losing cure, while those with a positive scan were escalated to stronger chemotherapy.","tags":"","route":"/key-papers/paper-rathl-interim-pet-adapted-abvd-advanced-hodgkin-nejm-2016/"},{"id":"paper-sempet-de-santis-jco-2004","kind":"paper","name":"SEMPET: FDG-PET as a predictor of viable tumour in post-chemotherapy seminoma residuals","aka":"","tldr":"A PET scan reliably told apart residual masses that still contained living seminoma from scar tissue after chemotherapy, allowing surgeons to leave PET-negative masses alone rather than operating on all masses over 3 cm.","tags":"","route":"/key-papers/paper-sempet-de-santis-jco-2004/"},{"id":"paper-vision-nejm-2021","kind":"paper","name":"VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer","aka":"","tldr":"A radioactive drug that homes to the PSMA protein on prostate cancer cells helped men with heavily pretreated metastatic prostate cancer live about four months longer, launching radioligand therapy as a mainstream treatment.","tags":"","route":"/key-papers/paper-vision-nejm-2021/","indications":"prostate"},{"id":"annals-of-oncology","kind":"journal","name":"Annals of Oncology","aka":"Ann Oncol src-annals-oncology","tldr":"Annals of Oncology is ESMO's flagship journal, publishing European phase 3 trials, the ESMO Clinical Practice Guidelines and the abstract books for the ESMO Congress.","tags":"","route":"/journals/annals-of-oncology/"},{"id":"cancer-biotherapy-and-radiopharmaceuticals","kind":"journal","name":"Cancer biotherapy & radiopharmaceuticals","aka":"Cancer Biotherapy & Radiopharmaceuticals Cancer Biotherapy and Radiopharmaceuticals Cancer Biother Radiopharm","tldr":"Cancer Biotherapy and Radiopharmaceuticals covers immunotherapy, targeted biological agents and radiolabelled drugs for cancer imaging and treatment, read by nuclear medicine and biotherapy researchers.","tags":"","route":"/journals/cancer-biotherapy-and-radiopharmaceuticals/"},{"id":"cancer-imaging","kind":"journal","name":"Cancer imaging","aka":"Cancer imaging : the official publication of the International Cancer Imaging Society Cancer Imaging","tldr":"Cancer Imaging is the open-access journal of the International Cancer Imaging Society, covering CT, MRI, PET and other imaging of cancer. Read by radiologists and nuclear medicine specialists working in oncology.","tags":"","route":"/journals/cancer-imaging/"},{"id":"clinical-cancer-research","kind":"journal","name":"Clinical Cancer Research","aka":"Clin Cancer Res CCR src-clinical-cancer-research","tldr":"AACR's clinical journal: phase 1 dose-escalation trials, biomarker studies, pharmacodynamics and the FDA approval summaries written by agency reviewers.","tags":"","route":"/journals/clinical-cancer-research/"},{"id":"european-urology","kind":"journal","name":"European Urology","aka":"Eur Urol","tldr":"European Urology is the European Association of Urology's journal and the most cited urology title, publishing prostate, bladder and kidney cancer trials, the EAU guidelines and PSMA imaging studies.","tags":"","route":"/journals/european-urology/","indications":"prostate"},{"id":"jama","kind":"journal","name":"JAMA","aka":"Journal of the American Medical Association JAMA","tldr":"JAMA is the American Medical Association's flagship journal. It is strong on cancer screening, prevention, health-services and patient-reported-outcome research, and on the USPSTF recommendations.","tags":"","route":"/journals/jama/"},{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","aka":"JCO J Clin Oncol src-jco","tldr":"The Journal of Clinical Oncology is ASCO's flagship journal and the workhorse of clinical oncology, publishing trials, ASCO guidelines, and the abstract supplements for the ASCO Annual Meeting.","tags":"","route":"/journals/jco/"},{"id":"journal-of-medical-imaging-and-radiation-oncology","kind":"journal","name":"Journal of medical imaging and radiation oncology","aka":"J Med Imaging Radiat Oncol JMIRO","tldr":"The journal of the Australian and New Zealand college for radiologists and radiation oncologists, covering diagnostic imaging, nuclear medicine and radiotherapy. Read by radiologists and radiation oncologists in Australasia and beyond.","tags":"","route":"/journals/journal-of-medical-imaging-and-radiation-oncology/"},{"id":"journal-of-nuclear-medicine","kind":"journal","name":"Journal of Nuclear Medicine","aka":"JNM J Nucl Med","tldr":"The Journal of Nuclear Medicine is the SNMMI's journal and the core venue for PET tracers and radioligand therapy: PSMA and somatostatin imaging, lutetium and actinium dosimetry, and theranostics trials.","tags":"","route":"/journals/journal-of-nuclear-medicine/"},{"id":"lancet","kind":"journal","name":"The Lancet","aka":"Lancet","tldr":"The Lancet is Britain's leading general medical journal and the other main home of practice-changing cancer trials, with a stronger global-health and policy voice than NEJM.","tags":"","route":"/journals/lancet/"},{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","aka":"Lancet Oncol src-lancet-oncology","tldr":"The Lancet Oncology is the leading specialist cancer journal for clinical trials. It publishes phase 2 and 3 trials, long-term follow-up, quality-of-life analyses and global-oncology policy Commissions.","tags":"","route":"/journals/lancet-oncology/"},{"id":"nature-medicine","kind":"journal","name":"Nature Medicine","aka":"Nat Med src-nature-medicine","tldr":"Nature Medicine is Nature's clinical journal and now a top venue for early-phase and biomarker-rich cancer trials, medical AI studies and cell-therapy reports.","tags":"","route":"/journals/nature-medicine/"},{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","aka":"NEJM N Engl J Med src-nejm","tldr":"NEJM is the most influential medical journal. When a cancer drug trial changes how patients are treated, the paper is usually here, often published the same day it is presented at ASCO, ESMO or ASH.","tags":"","route":"/journals/nejm/"},{"id":"radiology","kind":"journal","name":"Radiology","aka":"Radiology (RSNA)","tldr":"Radiology is the RSNA's flagship journal, publishing imaging research including cancer screening performance, AI image analysis and response assessment.","tags":"","route":"/journals/radiology/"},{"id":"science-translational-medicine","kind":"journal","name":"Science Translational Medicine","aka":"Sci Transl Med","tldr":"Science Translational Medicine is AAAS's translational journal, publishing the bench-to-bedside cancer papers on liquid biopsy, CAR-T engineering, tumour-immune biology and new imaging agents.","tags":"","route":"/journals/science-translational-medicine/"},{"id":"coronary-artery-disease","kind":"indication","name":"Coronary artery disease","aka":"","tldr":"The arteries that feed the heart muscle narrow with fatty plaque, so parts of the heart can be starved of blood, especially during exercise or stress.","tags":"","route":"/indications/coronary-artery-disease/"},{"id":"cardiac-amyloidosis-attr","kind":"indication","name":"Cardiac amyloidosis (transthyretin, ATTR-CM)","aka":"","tldr":"A misfolded blood protein called transthyretin builds up as stiff deposits inside the heart muscle, making it thicken and stop relaxing properly. A bone-scanning tracer that also sticks to these deposits can diagnose it without a heart biopsy.","tags":"","route":"/indications/cardiac-amyloidosis-attr/"},{"id":"cardiac-sarcoidosis","kind":"indication","name":"Cardiac sarcoidosis","aka":"","tldr":"Sarcoidosis is patches of inflammation that can form in the heart as well as the lungs and other organs, and it can trigger dangerous heart rhythms or heart failure. A PET scan that shows heart inflammation, paired with a separate scan of blood flow, helps find and track it.","tags":"","route":"/indications/cardiac-sarcoidosis/"},{"id":"tc-99m-sestamibi","kind":"drug","name":"Technetium Tc-99m sestamibi","aka":"Sestamibi MIBI Miraluma (breast imaging)","tldr":"A radioactive tracer injected into a vein that lodges inside heart muscle cells in proportion to blood flow, so a gamma camera picture taken after exercise or a stress drug shows which parts of the heart are not getting enough blood.","tags":"SPECT myocardial perfusion technetium","route":"/drugs/tc-99m-sestamibi/","indications":"coronary-artery-disease cardiac-sarcoidosis"},{"id":"tc-99m-tetrofosmin","kind":"drug","name":"Technetium Tc-99m tetrofosmin","aka":"Tetrofosmin","tldr":"A radioactive tracer, chemically similar to Cardiolite, injected into a vein and taken up by heart muscle in proportion to blood flow; a gamma camera scan after rest and after exercise or a stress drug shows areas with reduced blood supply.","tags":"SPECT myocardial perfusion technetium","route":"/drugs/tc-99m-tetrofosmin/","indications":"coronary-artery-disease cardiac-sarcoidosis"},{"id":"tl-201-chloride","kind":"drug","name":"Thallous chloride Tl-201","aka":"Thallium-201 Tl-201 chloride","tldr":"The original heart-blood-flow tracer: a radioactive form of the metal thallium that heart muscle cells pull in almost like potassium, so a scan straight after exercise and a second scan hours later can tell a starved-but-alive muscle from permanently dead muscle without a second injection.","tags":"SPECT myocardial perfusion viability","route":"/drugs/tl-201-chloride/","indications":"coronary-artery-disease"},{"id":"rb-82-chloride","kind":"drug","name":"Rubidium Rb-82 chloride","aka":"Rb-82 82Rb","tldr":"A generator-produced radioactive form of the metal rubidium, chemically similar to potassium, given as a fast intravenous infusion; because it decays away in about a minute and a half it can be produced on site without a cyclotron, letting a PET scan of heart blood flow be done in around half an hour.","tags":"PET myocardial perfusion generator","route":"/drugs/rb-82-chloride/","indications":"coronary-artery-disease cardiac-sarcoidosis"},{"id":"n-13-ammonia","kind":"drug","name":"Ammonia N-13","aka":"13N-ammonia N-13 ammonia","tldr":"A radioactive form of ammonia gas, made fresh on site in a cyclotron and injected into a vein; heart muscle cells trap it in proportion to how much blood is flowing through, so a PET scan maps blood flow to the heart very precisely.","tags":"PET myocardial perfusion cyclotron","route":"/drugs/n-13-ammonia/","indications":"coronary-artery-disease cardiac-sarcoidosis"},{"id":"f-18-flurpiridaz","kind":"drug","name":"Flurpiridaz F-18","aka":"18F-flurpiridaz BMS-747158-02","tldr":"The newest heart PET tracer, approved in the US in September 2024. It sticks tightly to a protein inside heart-muscle mitochondria in proportion to blood flow, lasts long enough to be made off site and shipped like a hospital's regular PET drug, and is the first cardiac PET tracer practical to pair with a treadmill exercise test.","tags":"PET myocardial perfusion mitochondrial complex I","route":"/drugs/f-18-flurpiridaz/","indications":"coronary-artery-disease"},{"id":"tc-99m-pyrophosphate","kind":"drug","name":"Technetium Tc-99m pyrophosphate","aka":"Tc-99m PYP PYP","tldr":"A bone-scanning radioactive tracer that also sticks to stray protein deposits that build up in a stiffened heart in transthyretin amyloidosis. Comparing how brightly the heart lights up against the ribs on the same scan tells doctors whether this specific, now-treatable type of heart disease is present, usually without needing a heart biopsy.","tags":"SPECT cardiac amyloidosis bone-avid tracer","route":"/drugs/tc-99m-pyrophosphate/","indications":"cardiac-amyloidosis-attr"},{"id":"i-123-mibg-cardiac","kind":"drug","name":"Iobenguane I-123 (cardiac use)","aka":"I-123 MIBG 123I-mIBG","tldr":"A radioactive tracer that mimics the body's own \"fight or flight\" nerve chemical and is taken up by the nerve endings in heart muscle. In people with heart failure, comparing how much of it the heart holds onto against the surrounding chest tissue gives a read on how damaged the heart's nerve supply is, which relates to future risk.","tags":"SPECT sympathetic innervation heart failure","route":"/drugs/i-123-mibg-cardiac/"},{"id":"technegas","kind":"drug","name":"Technegas (technetium Tc-99m labelled carbon inhalation aerosol)","aka":"Technegas Tc-99m carbon nanoparticle aerosol 99mTc-CNP","tldr":"A puff of radioactive carbon particles so fine they travel with the breath into the depths of the lung, where they stick. A gamma camera then photographs which parts of the lung are getting air, which is compared with a second scan showing which parts are getting blood.","tags":"ventilation V/Q technetium inhaled","route":"/drugs/technegas/","status":"approved","indications":"pulmonary-embolism-vq"},{"id":"tc-99m-maa","kind":"drug","name":"Technetium Tc-99m albumin aggregated (MAA)","aka":"99mTc-MAA Tc-99m macroaggregated albumin MAA Pulmotech MAA DraxImage MAA","tldr":"Tiny clumps of albumin, a normal blood protein, tagged with a radioactive marker and injected into a vein. They wedge briefly in the smallest blood vessels of the lung wherever blood is flowing, so the scan maps the lung's blood supply; the clumps then break up and clear.","tags":"perfusion V/Q technetium radioembolisation work-up","route":"/drugs/tc-99m-maa/","status":"approved","indications":"pulmonary-embolism-vq"},{"id":"pb-212-psv359","kind":"drug","name":"Lead-212 PSV359","aka":"[212Pb]PSV359 PSV359 PSV377 (imaging analogue)","tldr":"A drug that homes to the scaffolding cells tumours build around themselves, carrying a radioactive metal that fires alpha particles over a very short range. A matching scan version shows first whether a patient's tumour has the target.","tags":"FAP lead-212 alpha NSCLC","route":"/drugs/pb-212-psv359/","status":"phase-1","indications":"nsclc"},{"id":"nct03054870","kind":"trial","name":"CYC-009: Technegas versus xenon-133 ventilation imaging","aka":"","tldr":"The trial that got Technegas approved in the United States: it compared the inhaled carbon aerosol against xenon-133 gas, the agent it was meant to replace.","tags":"ventilation registration trial","route":"/trials/nct03054870/","status":"historic"},{"id":"kr-81m","kind":"isotope","name":"Krypton-81m","aka":"81mKr Kr-81m krypton gas","tldr":"A radioactive gas that a patient simply breathes in and out while the camera runs. It decays in thirteen seconds, so the picture is of ventilation happening now rather than of particles left behind, and it has to be generated in the room from a parent that itself lasts only a few hours.","tags":"ventilation V/Q generator gas","route":"/isotopes/kr-81m/","status":"historic","indications":"pulmonary-embolism-vq"},{"id":"split-function-lung-perfusion","kind":"technology","name":"Split-function perfusion scintigraphy before lung resection","aka":"Quantitative lung perfusion scintigraphy Split lung function study Differential perfusion scan","tldr":"Before a surgeon removes part of a lung, the scan is used as an arithmetic tool rather than a picture: it measures what share of the breathing work that piece of lung is actually doing, so the team can predict the patient's lung function after the operation and decide whether they will tolerate it.","tags":"pulmonary surgical planning quantitative SPECT","route":"/technologies/split-function-lung-perfusion/","status":"standard-of-care","indications":"nsclc"},{"id":"cyclopharm","kind":"company","name":"Cyclopharm","aka":"Cyclomedica Cyclomedica Australia Cyclopharm Limited","tldr":"The Australian company behind Technegas, the inhaled ventilation agent, which spent thirty years as a product the United States could not buy and is now being installed across American hospitals.","tags":"ventilation Australia listed","route":"/companies/cyclopharm/"},{"id":"asnc","kind":"institution","name":"American Society of Nuclear Cardiology","aka":"ASNC","tldr":"The professional society for heart scans that use radioactive tracers. It writes the rules for how those scans are done in the United States and publishes the field's journal.","tags":"","route":"/institutions/asnc/"},{"id":"jsnm","kind":"institution","name":"Japanese Society of Nuclear Medicine","aka":"JSNM Nihon Kaku Igakukai","tldr":"Japan's national society for nuclear medicine: it runs the country's annual nuclear medicine meeting and publishes its journals.","tags":"","route":"/institutions/jsnm/"},{"id":"ksnm","kind":"institution","name":"Korean Society of Nuclear Medicine","aka":"KSNM","tldr":"South Korea's nuclear medicine society, which runs the country's annual meeting and publishes its English-language journal.","tags":"","route":"/institutions/ksnm/"},{"id":"csnm","kind":"institution","name":"Chinese Society of Nuclear Medicine","aka":"CSNM Chinese Medical Association Society of Nuclear Medicine","tldr":"China's national nuclear medicine society, a branch of the Chinese Medical Association, which runs the country's annual nuclear medicine congress.","tags":"","route":"/institutions/csnm/"},{"id":"kirams","kind":"institution","name":"Korea Institute of Radiological and Medical Sciences","aka":"KIRAMS","tldr":"South Korea's government radiation-medicine institute, which runs the national cancer hospital and the cyclotrons that make the country's research isotopes.","tags":"","route":"/institutions/kirams/"},{"id":"brit","kind":"institution","name":"Board of Radiation and Isotope Technology","aka":"BRIT","tldr":"India's government isotope producer: it makes and sells the radioactive medicines used in Indian hospitals.","tags":"","route":"/institutions/brit/"},{"id":"nihon-medi-physics","kind":"company","name":"Nihon Medi-Physics","aka":"Nihon Medi-Physics Co., Ltd. NMP","tldr":"Japan's largest maker of radioactive tracers for scans, now wholly owned by GE HealthCare.","tags":"","route":"/companies/nihon-medi-physics/"},{"id":"pdradiopharma","kind":"company","name":"PDRadiopharma","aka":"PDRadiopharma Inc. PDR","tldr":"The Japanese radiopharmaceutical business that PeptiDream bought from FUJIFILM: it sells most of Japan's radioactive diagnostics and the therapies that go with them.","tags":"","route":"/companies/pdradiopharma/"},{"id":"china-isotope-radiation","kind":"company","name":"China Isotope & Radiation Corporation","aka":"CIRC China Isotope and Radiation Corporation","tldr":"China's state-backed isotope and nuclear medicine group: it makes the radioactive material and the medicines that use it.","tags":"","route":"/companies/china-isotope-radiation/"},{"id":"hta-atom-hi-tech","kind":"company","name":"HTA (Atom Hi-Tech)","aka":"HTA Co., Ltd. Atom Hi-Tech Atom High-Tech","tldr":"The Chinese state group's radiopharmaceutical arm, and the first company to make germanium-68 generators' feedstock at scale in China.","tags":"","route":"/companies/hta-atom-hi-tech/"},{"id":"cellbion","kind":"company","name":"CellBion","aka":"CellBion Co., Ltd. Cellbion","tldr":"A Korean company developing a lutetium-177 prostate cancer therapy of its own, now filed for conditional approval in Korea.","tags":"","route":"/companies/cellbion/"},{"id":"duchembio","kind":"company","name":"DuChemBio","aka":"DuchemBio Co., Ltd. DCB","tldr":"Korea's biggest maker of diagnostic PET tracers, now building the country's first plant for radioactive cancer therapies.","tags":"","route":"/companies/duchembio/"},{"id":"annals-of-nuclear-medicine","kind":"journal","name":"Annals of Nuclear Medicine","aka":"Ann Nucl Med","tldr":"The English-language journal of Japan's nuclear medicine society.","tags":"","route":"/journals/annals-of-nuclear-medicine/"},{"id":"nuclear-medicine-and-molecular-imaging","kind":"journal","name":"Nuclear Medicine and Molecular Imaging","aka":"Nucl Med Mol Imaging","tldr":"The English-language journal of Korea's nuclear medicine society.","tags":"","route":"/journals/nuclear-medicine-and-molecular-imaging/"},{"id":"chinese-journal-of-nuclear-medicine-and-molecular-imaging","kind":"journal","name":"Chinese Journal of Nuclear Medicine and Molecular Imaging","aka":"CJNMMI Zhonghua he yi xue yu fen zi ying xiang za zhi","tldr":"China's main nuclear medicine journal. It publishes in Chinese, which is why most of its content is invisible to the usual English-language trackers.","tags":"","route":"/journals/chinese-journal-of-nuclear-medicine-and-molecular-imaging/"},{"id":"pexiretide-tc99m","kind":"drug","name":"Technetium (99mTc) pexiretide","aka":"99mTc-3PRGD2 technetium [99mTc] pexiretide injection Jilunte 3PRGD2 锝[99mTc]佩昔瑞特加肽注射液","tldr":"A Chinese-invented injection that makes tumours visible on the cheap, widely available type of scanner (SPECT) rather than the expensive one (PET). It was approved in China in April 2026 to check whether lung cancer has spread to the lymph nodes.","tags":"diagnostic china spect integrin","route":"/drugs/pexiretide-tc99m/","status":"approved","indications":"nsclc"},{"id":"nsclc","kind":"indication","name":"Non-small cell lung cancer","aka":"NSCLC lung cancer lung adenocarcinoma lung squamous cell carcinoma large cell lung carcinoma","tldr":"The cancer that kills more people than any other, and the reason most PET scanners are busy. Most cases are found once the disease has already spread, and a scan with radioactive sugar is what decides who can still be cured by surgery.","tags":"lung diagnostic staging","route":"/indications/nsclc/","indications":"sclc lung-net"},{"id":"colorectal-cancer","kind":"indication","name":"Colorectal cancer","aka":"bowel cancer colon cancer rectal cancer CRC","tldr":"The third commonest cancer in the world and the second biggest cancer killer. Most of it is curable if caught before it spreads, which is why so much of the imaging effort goes into finding out whether it has.","tags":"gastrointestinal surveillance recurrence","route":"/indications/colorectal-cancer/"},{"id":"urothelial-cancer","kind":"indication","name":"Urothelial cancer","aka":"bladder cancer transitional cell carcinoma urothelial carcinoma UC","tldr":"Urothelial cancer mostly starts in the bladder lining and ranges from tumours that stay superficial and are managed for years with local treatments to disease that spreads and needs systemic therapy. Survival depends heavily on how early it is caught, which is why so much attention goes into staging it accurately.","tags":"urological staging nodal-staging","route":"/indications/urothelial-cancer/"},{"id":"pancreatic-cancer","kind":"indication","name":"Pancreatic ductal adenocarcinoma","aka":"pancreatic cancer PDAC pancreatic adenocarcinoma","tldr":"Pancreatic cancer is one of the deadliest common cancers because it is usually found only after it has already grown into nearby structures or spread elsewhere. Surgery can cure it, but scans before the operation often cannot tell whether the tumour is truly removable, so some patients are opened up only to find the cancer has already spread too far.","tags":"gastrointestinal staging unresectability","route":"/indications/pancreatic-cancer/"},{"id":"gastric-oesophageal-cancer","kind":"indication","name":"Gastric and gastro-oesophageal junction adenocarcinoma","aka":"stomach cancer gastric cancer GEJ adenocarcinoma oesophagogastric adenocarcinoma","tldr":"Cancer of the stomach or the junction where the gullet meets the stomach is common worldwide and still mostly found late, which is why survival is poor for most patients. Treatment now depends heavily on testing the tumour for a handful of markers that decide which targeted drugs and immunotherapies can be used.","tags":"gastrointestinal biomarker-selected peritoneal staging","route":"/indications/gastric-oesophageal-cancer/"},{"id":"breast-triple-negative","kind":"indication","name":"Triple-negative breast cancer","aka":"TNBC","tldr":"Triple-negative breast cancer lacks the three commonest treatment targets, so hormone therapy and HER2 drugs do not work against it and treatment rests on chemotherapy, immunotherapy and antibody-drug conjugates. It is more aggressive than most breast cancer and harder to treat once it has spread.","tags":"breast immunotherapy trop2","route":"/indications/breast-triple-negative/"},{"id":"primary-aldosteronism","kind":"indication","name":"Primary aldosteronism","aka":"PA primary hyperaldosteronism hyperaldosteronism","tldr":"Primary aldosteronism is a hormonal condition in which one or both adrenal glands make too much of a hormone that raises blood pressure. It is a common but badly under-diagnosed cause of hypertension, usually flagged by a blood test, and curable with surgery when only one gland is overactive.","tags":"endocrine hypertension screening","route":"/indications/primary-aldosteronism/"},{"id":"opp-dll3-imaging-sclc","kind":"opportunity","name":"DLL3 imaging for small-cell lung cancer","aka":"DLL3 PET delta-like ligand 3 imaging","tldr":"A drug that attacks small-cell lung cancer through a protein called DLL3 is already approved, but there is no approved scan that shows whether a patient's tumours still carry that protein. Doctors decide from a single biopsy taken from one place, which cannot show what the rest of the disease is doing.","tags":"theranostic gap companion diagnostic lung neuroendocrine","route":"/opportunities/opp-dll3-imaging-sclc/","indications":"sclc"},{"id":"opp-nectin4-imaging-urothelial","kind":"opportunity","name":"A liver-cleared Nectin-4 tracer for urothelial cancer","aka":"Nectin-4 PET nectin-4 imaging","tldr":"An approved bladder cancer drug works by latching onto a protein called Nectin-4, and half of patients lose that protein as the disease spreads. The one scan built to show it is cleared through the kidneys, so the bladder and the nearby lymph nodes glow with waste tracer and are the hardest places to read.","tags":"theranostic gap bladder clearance pelvic staging","route":"/opportunities/opp-nectin4-imaging-urothelial/","indications":"urothelial-cancer"},{"id":"opp-ceacam5-imaging-colorectal","kind":"opportunity","name":"CEACAM5 imaging for occult colorectal recurrence","aka":"CEA PET CEACAM5 PET","tldr":"After bowel cancer surgery, a rising blood marker often signals that the cancer is back, but scans frequently cannot say where. The one scan ever approved for that exact problem was withdrawn from the market in 2005 and nothing has replaced it.","tags":"unmet need first colorectal recurrence ctDNA","route":"/opportunities/opp-ceacam5-imaging-colorectal/","indications":"colorectal-cancer"},{"id":"opp-her3-imaging-crossover","kind":"opportunity","name":"HER3 imaging, and why three tracers stalled","aka":"HER3 PET","tldr":"HER3 sits on most lung cancers and there are drugs aimed at it, so a scan showing which tumours carry it looks obvious. Three attempts were made and all three stopped, largely because the drug's own trials could not show that how much HER3 a tumour has predicts whether the drug works.","tags":"target crossover worked negative lung companion diagnostic","route":"/opportunities/opp-her3-imaging-crossover/","indications":"nsclc"},{"id":"opp-cldn18-2-imaging-gastric","kind":"opportunity","name":"Claudin-18.2 imaging when one biopsy says negative","aka":"CLDN18.2 PET claudin 18.2 imaging","tldr":"Stomach cancer patients now get a drug only if a biopsy shows a protein called claudin-18.2. One biopsy core finds it only about six times in ten when the whole tumour has it, so patients are being refused a treatment on a test that misses.","tags":"target crossover gastric companion diagnostic sampling error","route":"/opportunities/opp-cldn18-2-imaging-gastric/","indications":"gastric-oesophageal-cancer"},{"id":"opp-trop2-imaging-heterogeneity","kind":"opportunity","name":"TROP2 imaging where no tissue test is required","aka":"TROP2 PET Trop-2 imaging","tldr":"Two approved breast cancer drugs work through a protein called TROP2, and neither requires any test for it before use. Tumours vary a lot in how much they carry, and a quarter of patients lose it over time, so nobody currently knows who is being treated for a target that is no longer there.","tags":"target crossover breast heterogeneity nanobody","route":"/opportunities/opp-trop2-imaging-heterogeneity/","indications":"breast-triple-negative"},{"id":"opp-caix-indeterminate-renal-mass","kind":"opportunity","name":"CAIX imaging of the indeterminate renal mass","aka":"CA9 imaging girentuximab PET","tldr":"Scans find small kidney lumps all the time and cannot tell which are cancer. Up to one in five that are surgically removed turn out to be harmless. A scan that recognises the commonest kidney cancer would spare those operations, and it needs no drug to be useful.","tags":"standalone diagnostic kidney biopsy avoidance","route":"/opportunities/opp-caix-indeterminate-renal-mass/","indications":"rcc"},{"id":"opp-grpr-psma-negative-prostate","kind":"opportunity","name":"GRPR imaging when the PSMA scan is negative","aka":"GRPR PET bombesin receptor imaging","tldr":"Prostate cancer imaging and treatment both rely on one protein, PSMA. In a minority of men the tumour does not carry it, and for those men a negative scan is a dead end. A second receptor, GRPR, is the best-studied alternative, and the honest reading of the head-to-head studies is that it finds fewer lesions overall but different ones.","tags":"unmet need first prostate PSMA-negative second-look imaging","route":"/opportunities/opp-grpr-psma-negative-prostate/","indications":"prostate-mcrpc prostate-bcr"},{"id":"opp-cxcr4-primary-aldosteronism","kind":"opportunity","name":"CXCR4 imaging instead of adrenal vein sampling","aka":"PentixaFor PET CXCR4 PET in primary aldosteronism","tldr":"A common and curable cause of high blood pressure is almost never cured, because finding out which adrenal gland is at fault needs an invasive procedure few hospitals do well. A PET scan can answer the same question, and one is now heading into a registrational trial.","tags":"unmet need first standalone diagnostic non-oncology hypertension","route":"/opportunities/opp-cxcr4-primary-aldosteronism/","indications":"primary-aldosteronism"},{"id":"opp-alpha-synuclein-pet-parkinsons","kind":"opportunity","name":"Alpha-synuclein PET: works for MSA, not for Parkinson's","aka":"a-synuclein PET ACI-12589","tldr":"Parkinson's disease is defined by a protein clumping in the brain, and no scan can see it. The first tracer to reach patients does light up a rarer, related disease but not Parkinson's itself, while a spinal-fluid test already identifies Parkinson's with high accuracy.","tags":"unmet need first neurology worked negative pharmacodynamic marker","route":"/opportunities/opp-alpha-synuclein-pet-parkinsons/","indications":"parkinsonian-syndromes"},{"id":"opp-fap-pancreatic-staging","kind":"opportunity","name":"FAP imaging to stop futile pancreatic surgery","aka":"FAPI PET in PDAC","tldr":"Four in ten pancreatic cancer patients whose scans say the tumour can be removed turn out, once opened up, to have disease that cannot be removed. A scan that lights up the scar tissue around tumour deposits sees more of that hidden disease than the standard one.","tags":"unmet need first pancreas surgical selection stroma","route":"/opportunities/opp-fap-pancreatic-staging/","indications":"pancreatic-cancer"},{"id":"opp-cardiac-sarcoidosis-specific-tracer","kind":"opportunity","name":"An inflammation tracer that does not need a diet","aka":"SSTR PET in cardiac sarcoidosis","tldr":"Deciding whether to put a patient on long-term steroids for heart sarcoidosis depends on a scan that only works if the patient's heart has been starved of sugar for a day, and a biopsy that misses the disease most of the time. A different tracer would not need the diet.","tags":"unmet need first cardiac non-oncology inflammation","route":"/opportunities/opp-cardiac-sarcoidosis-specific-tracer/","indications":"cardiac-sarcoidosis"},{"id":"opp-gpc3-hcc-china","kind":"opportunity","name":"GPC3 imaging of the indeterminate liver nodule, led from China","aka":"GPC3 PET glypican-3 imaging","tldr":"Cirrhotic livers throw up nodules that scans cannot classify, and the usual answer is to wait three to six months to see if they grow. Several Chinese hospital programmes are testing tracers that recognise a protein carried by most liver cancers, and almost none of that work appears in Western pipeline reviews.","tags":"non-US registry liver China indeterminate nodule","route":"/opportunities/opp-gpc3-hcc-china/","indications":"hcc"},{"id":"f-18-naf","kind":"drug","name":"Sodium fluoride F-18","aka":"18F-NaF Na18F Fluoride F-18","tldr":"A radioactive form of fluoride that collects in areas of bone rebuilding. A PET scan after the injection shows those hot spots, which can be cancer that has spread to bone or something harmless like a healed fracture.","tags":"bone imaging PET generic","route":"/drugs/f-18-naf/","status":"approved","indications":"prostate"},{"id":"ga-68-fapi-46","kind":"drug","name":"Gallium-68 FAPI-46","aka":"68Ga-FAPI-46 Ga-68 FAPi-46","tldr":"An experimental PET tracer that lights up the scaffolding cells cancers build around themselves, not the cancer cells directly. It is still being tested, not yet an approved medicine.","tags":"FAP stroma investigational","route":"/drugs/ga-68-fapi-46/","status":"phase-2","indications":"pancreatic-net nsclc"},{"id":"ga-68-pentixafor","kind":"drug","name":"Gallium-68 pentixafor","aka":"68Ga-Pentixafor Gallium (68Ga) boclatixafortide","tldr":"An experimental PET tracer that looks for a specific docking protein (CXCR4) that some blood cancers and a minority of solid tumours carry in excess. It is a research tool, not an approved scan.","tags":"CXCR4 myeloma investigational","route":"/drugs/ga-68-pentixafor/","status":"phase-2"},{"id":"cu-64-dotatate","kind":"drug","name":"Copper-64 dotatate","aka":"64Cu-DOTATATE Detectnet","tldr":"An injectable tracer that sticks to a marker (somatostatin receptor) many neuroendocrine tumours carry. A PET scan afterwards shows where those tumours are, including small deposits that other scans can miss.","tags":"SSTR2 NET imaging copper-64","route":"/drugs/cu-64-dotatate/","status":"approved","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"ga-68-dotatoc","kind":"drug","name":"Gallium-68 edotreotide (DOTATOC)","aka":"68Ga-DOTATOC Ga 68 DOTATOC Injection Edotreotide","tldr":"A cousin of the Ga-68 DOTATATE and Cu-64 DOTATATE scans: it sticks to the same receptor on neuroendocrine tumours and lets PET find them. It is FDA-approved but, unusually, has no brand name and no pharmaceutical-company sponsor.","tags":"SSTR2 NET imaging academic NDA","route":"/drugs/ga-68-dotatoc/","status":"approved","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"in-111-pentetreotide","kind":"drug","name":"Indium-111 pentetreotide","aka":"111In-pentetreotide OctreoScan","tldr":"The original nuclear medicine scan for finding neuroendocrine tumours, used before PET scans like Ga-68 DOTATATE became available. It is still FDA-approved but has largely been superseded because PET gives sharper pictures with less radiation.","tags":"SSTR2 SPECT legacy agent","route":"/drugs/in-111-pentetreotide/","status":"approved","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"i-123-mibg","kind":"drug","name":"Iobenguane I-123","aka":"123I-MIBG AdreView Iobenguane I 123 Injection","tldr":"An injectable tracer that mimics a stress hormone and gets taken up by certain nerve-related tumours, such as pheochromocytoma and childhood neuroblastoma, so a scan afterwards can show where they are.","tags":"MIBG SPECT pheochromocytoma neuroblastoma","route":"/drugs/i-123-mibg/","status":"approved","indications":"pheochromocytoma-paraganglioma neuroblastoma metastatic-ppgl"},{"id":"f-18-fdopa","kind":"drug","name":"Fluorodopa F-18","aka":"18F-FDOPA 6-[18F]fluoro-L-DOPA Fluorodopa F 18 Injection","tldr":"A tracer originally built to look at brain dopamine cells in suspected Parkinson's disease. Because certain hormone-producing tumours use the same chemical machinery, doctors also use it, off-label, to find those tumours -- especially adrenal gland tumours called pheochromocytoma.","tags":"amino acid PET off-label oncology use PPGL","route":"/drugs/f-18-fdopa/","status":"approved","indications":"pheochromocytoma-paraganglioma metastatic-ppgl neuroendocrine glioblastoma"},{"id":"f-18-fet","kind":"drug","name":"Floretyrosine F-18 (FET)","aka":"18F-FET O-(2-[18F]fluoroethyl)-L-tyrosine Pixclara TLX101-Px","tldr":"A brain-tumour PET tracer that shows where active tumour tissue is by how much it grabs a labelled amino acid, which helps tell a true regrowing tumour apart from scan changes caused by past treatment. Approved by the FDA in September 2026, the first scan of its kind cleared for this use in the US.","tags":"amino acid PET glioma newly approved","route":"/drugs/f-18-fet/","status":"approved","indications":"glioblastoma"},{"id":"tc-99m-mdp","kind":"drug","name":"Technetium Tc-99m medronate (MDP)","aka":"99mTc-MDP Technetium Tc 99m Medronate CIS-MDP Draximage MDP-25","tldr":"The standard, decades-old bone scan: a radioactive tracer that sticks to areas of bone rebuilding, so a gamma-camera picture afterwards shows where cancer may have spread to bone, or where a fracture or infection is healing.","tags":"bone scan SPECT cold kit generic","route":"/drugs/tc-99m-mdp/","status":"approved","indications":"prostate"},{"id":"cu-64-sar-bispsma","kind":"drug","name":"Copper-64 SAR-bisPSMA","aka":"64Cu-SAR-bisPSMA 64Cu-bisPSMA","tldr":"An experimental PET tracer for prostate cancer that binds the same target as approved PSMA scans (PSMA) but, because its radioactive tag lasts longer, can be re-imaged a day later to catch small deposits the first picture missed. It is not yet approved for sale.","tags":"PSMA copper-64 theranostic pair investigational","route":"/drugs/cu-64-sar-bispsma/","status":"phase-3","indications":"prostate-high-risk prostate-bcr prostate-mcrpc"},{"id":"tc-99m-psma-imaging","kind":"drug","name":"Technetium Tc-99m PSMA agents (PSMA-I&S)","aka":"99mTc-PSMA-I&S Tc-99m PSMA imaging and surgery","tldr":"A version of the PSMA prostate cancer scan that uses the same cheap, widely available radioactive tag as a standard bone scan instead of the PET tracers. Surgeons can also carry a small radiation detector into the operating room to help find and remove cancerous lymph nodes. It has not been through formal drug approval; it is used as an academic, in-house preparation.","tags":"PSMA SPECT radioguided surgery academic cold kit","route":"/drugs/tc-99m-psma-imaging/","status":"emerging","indications":"prostate prostate-bcr"},{"id":"f-18-fluorothymidine","kind":"drug","name":"Fluorothymidine F-18 (FLT)","aka":"18F-FLT 3'-deoxy-3'-[18F]fluorothymidine","tldr":"An experimental PET tracer that measures how fast tumour cells are dividing, rather than how much sugar they burn. It has been studied in research settings for over 20 years but has never been approved as a medicine.","tags":"proliferation imaging investigational TK1","route":"/drugs/f-18-fluorothymidine/","status":"phase-2","indications":"breast-her2-positive glioblastoma nsclc"},{"id":"ga-67-citrate","kind":"drug","name":"Gallium citrate Ga-67","aka":"67Ga-citrate Gallium Citrate Ga 67","tldr":"One of the oldest cancer-imaging scans still on the market: an injectable form of radioactive gallium that collects in lymphomas and some other tumours (and in infections), imaged one to five days later. It has mostly been replaced by FDG-PET but is still FDA-approved and occasionally used.","tags":"legacy agent lymphoma imaging SPECT","route":"/drugs/ga-67-citrate/","status":"approved"},{"id":"alzheimers-disease","kind":"indication","name":"Alzheimer's disease","aka":"","tldr":"The most common cause of dementia, in which sticky amyloid protein and tangled tau protein build up in the brain and damage memory and thinking over years.","tags":"neurology dementia","route":"/indications/alzheimers-disease/"},{"id":"parkinsonian-syndromes","kind":"indication","name":"Parkinsonian syndromes","aka":"","tldr":"A group of movement disorders, including Parkinson's disease, that cause tremor, stiffness and slow movement because the brain loses nerve cells that make dopamine.","tags":"neurology movement disorder","route":"/indications/parkinsonian-syndromes/"},{"id":"f-18-florbetapir","kind":"drug","name":"Florbetapir F-18","aka":"Amyvid 18F-AV-45","tldr":"A PET scan tracer that shows whether a patient's brain contains the sticky amyloid protein clumps linked to Alzheimer's disease, and whether they qualify for amyloid-lowering drugs.","tags":"amyloid PET diagnostic neurology","route":"/drugs/f-18-florbetapir/","status":"approved"},{"id":"f-18-flutemetamol","kind":"drug","name":"Flutemetamol F-18","aka":"Vizamyl","tldr":"A PET scan tracer used to check whether a patient's brain has amyloid plaques, the hallmark of Alzheimer's disease, and whether they can be treated with amyloid-lowering drugs.","tags":"amyloid PET diagnostic neurology","route":"/drugs/f-18-flutemetamol/","status":"approved"},{"id":"f-18-florbetaben","kind":"drug","name":"Florbetaben F-18","aka":"Neuraceq","tldr":"A PET scan tracer that lights up amyloid plaques in the brain, helping doctors work out whether memory problems are due to Alzheimer's disease and whether the patient can have amyloid-lowering treatment.","tags":"amyloid PET diagnostic neurology","route":"/drugs/f-18-florbetaben/","status":"approved"},{"id":"f-18-flortaucipir","kind":"drug","name":"Flortaucipir F-18","aka":"Tauvid 18F-AV-1451 18F-T807","tldr":"A PET scan tracer that shows the tangled tau protein build-up in the brain seen in Alzheimer's disease, used alongside amyloid testing and clinical assessment, not on its own.","tags":"tau PET diagnostic neurology","route":"/drugs/f-18-flortaucipir/","status":"approved"},{"id":"f-18-florquinitau","kind":"drug","name":"Florquinitau F-18","aka":"Tauklarify florquinitau F 18 injection","tldr":"A new PET scan tracer, approved by the FDA in August 2026, that shows tangled tau protein in the brain of adults with memory or thinking problems who are being assessed for Alzheimer's disease. It is read alongside other tests: a negative scan does not rule tau out and a positive one does not prove it.","tags":"tau PET diagnostic neurology newly approved","route":"/drugs/f-18-florquinitau/","status":"approved"},{"id":"i-123-ioflupane","kind":"drug","name":"Ioflupane I-123","aka":"DaTscan DaTSCAN 123I-FP-CIT","tldr":"A brain scan that shows how many dopamine-releasing nerve endings remain in a part of the brain called the striatum, helping tell shaking from Parkinson's-type disease apart from other kinds of tremor and from Alzheimer's-type memory loss.","tags":"SPECT diagnostic neurology movement disorder","route":"/drugs/i-123-ioflupane/","status":"approved"},{"id":"tc-99m-hmpao-brain","kind":"drug","name":"Technetium-99m exametazime (brain perfusion)","aka":"Ceretec Tc-99m HMPAO HMPAO","tldr":"A cold-kit radioactive tracer that maps blood flow inside the brain on a SPECT scan, used mainly to look for the effects of stroke and, off-label in practice, to help support a diagnosis of brain death.","tags":"SPECT diagnostic neurology perfusion imaging","route":"/drugs/tc-99m-hmpao-brain/","status":"approved"},{"id":"f-18-fdg-brain","kind":"drug","name":"Fludeoxyglucose F-18 (brain metabolism)","aka":"FDG-PET brain 18F-FDG","tldr":"The standard PET tracer for measuring how the brain is using energy; a pattern of low activity in particular brain regions can help doctors work out which type of dementia a patient has.","tags":"FDG PET diagnostic neurology metabolic imaging","route":"/drugs/f-18-fdg-brain/","status":"approved"},{"id":"y-90-resin-microspheres","kind":"drug","name":"Yttrium-90 resin microspheres","aka":"SIR-Spheres Y-90 resin microspheres","tldr":"Tiny radioactive beads are injected through a small tube into the artery that feeds the liver. They lodge in the tumour and give it radiation from the inside, mostly sparing the rest of the liver.","tags":"radioembolisation liver beta emitter","route":"/drugs/y-90-resin-microspheres/","status":"approved","indications":"hcc"},{"id":"y-90-glass-microspheres","kind":"drug","name":"Yttrium-90 glass microspheres","aka":"TheraSphere Y-90 glass microspheres","tldr":"Microscopic glass beads containing a radioactive metal are injected into the artery that supplies a liver tumour. The beads stay in place permanently and give off radiation that fades away within about two weeks.","tags":"radioembolisation liver beta emitter","route":"/drugs/y-90-glass-microspheres/","status":"approved","indications":"hcc"},{"id":"ho-166-microspheres","kind":"drug","name":"Holmium-166 microspheres","aka":"QuiremSpheres 166Ho-PLLA microspheres","tldr":"Tiny plastic beads carrying a radioactive, slightly magnetic metal are injected into the artery feeding a liver tumour. Because the metal shows up on both nuclear scans and MRI, doctors can check exactly where the beads went.","tags":"radioembolisation liver beta emitter CE mark","route":"/drugs/ho-166-microspheres/","status":"approved","indications":"hcc"},{"id":"i-131-tositumomab","kind":"drug","name":"Iodine-131 tositumomab","aka":"Bexxar tositumomab and I-131 tositumomab","tldr":"A cancer-targeting antibody carrying a radioactive form of iodine was used, as a single course, to treat a type of blood cancer called non-Hodgkin lymphoma. The manufacturer stopped selling it in 2014 because too few patients were using it.","tags":"radioimmunotherapy lymphoma withdrawn beta and gamma emitter","route":"/drugs/i-131-tositumomab/","status":"withdrawn","indications":"follicular-lymphoma"},{"id":"sr-89-chloride","kind":"drug","name":"Strontium-89 chloride","aka":"Metastron Strontium89 89SrCl2","tldr":"A radioactive form of strontium is injected into a vein. Because it behaves like calcium, it collects in the damaged, overactive bone around cancer that has spread to bone, and its radiation can relieve bone pain for months.","tags":"bone pain palliation beta emitter calcium mimetic","route":"/drugs/sr-89-chloride/","status":"approved"},{"id":"re-188-sct","kind":"drug","name":"Rhenium-188 skin cancer therapy","aka":"Rhenium-SCT 188Re epidermal radionuclide therapy","tldr":"A radioactive paste is spread over a thin film placed on top of a skin cancer. The radiation only travels a few millimetres, so it treats the visible tumour without surgery, cutting, or affecting deeper tissue.","tags":"brachytherapy skin cancer beta emitter non-invasive","route":"/drugs/re-188-sct/","status":"approved"},{"id":"lu-177-pnt2002","kind":"drug","name":"Lutetium-177 PNT2002","aka":"177Lu-PNT2002 177Lu-PSMA-I&T (POINT/Lantheus)","tldr":"A radioactive drug that homes in on a marker found on most prostate cancer cells, delivering radiation directly to the tumour, is being tested as a treatment for prostate cancer that has stopped responding to hormone therapy.","tags":"PSMA radioligand therapy prostate cancer beta emitter phase 3","route":"/drugs/lu-177-pnt2002/","status":"phase-3","indications":"prostate-mcrpc"},{"id":"tlx-591","kind":"drug","name":"Lutetium-177 rosopatamab tetraxetan","aka":"TLX591 TLX591-Tx 177Lu-rosopatamab tetraxetan","tldr":"A cancer-targeting antibody carrying a radioactive metal is being tested as a two-dose treatment for advanced prostate cancer, on top of the usual hormone or chemotherapy drugs.","tags":"PSMA radio-antibody-drug conjugate prostate cancer phase 3","route":"/drugs/tlx-591/","status":"phase-3","indications":"prostate-mcrpc"},{"id":"pb-212-vmt-alpha-net","kind":"drug","name":"Lead-212 VMT-alpha-NET","aka":"212Pb-VMT-alpha-NET [212Pb]VMT-α-NET 203Pb-VMT-alpha-NET (imaging analogue)","tldr":"A drug that targets a marker on neuroendocrine tumour cells is being tested with two versions of a radioactive metal: one lets doctors see where the tumour is on a scan, and the other delivers a strong, short-range dose of radiation to kill the tumour cells.","tags":"alpha therapy SSTR2 neuroendocrine tumours lead-212 phase 1/2","route":"/drugs/pb-212-vmt-alpha-net/","status":"phase-2","indications":"neuroendocrine"},{"id":"lu-177-dotatate-generic","kind":"drug","name":"Lutetium-177 dotatate (radioligand equivalent)","aka":"Bexlutry generic lutetium Lu 177 dotatate","tldr":"A second, cheaper version of an already-approved radioactive drug for neuroendocrine tumours has been approved, using the same active radioactive ingredient as the original but made by a different company.","tags":"radioligand therapy generic neuroendocrine tumours beta emitter","route":"/drugs/lu-177-dotatate-generic/","status":"approved","indications":"neuroendocrine pancreatic-net small-intestinal-net"},{"id":"i-125-seeds","kind":"drug","name":"Iodine-125 brachytherapy seeds","aka":"I-125 seeds 125I permanent seed implants","tldr":"Tiny metal seeds containing a mildly radioactive form of iodine are permanently placed inside a tumour, most often the prostate, where they slowly release radiation over several months and then become harmless.","tags":"brachytherapy prostate cancer gamma/X-ray emitter permanent implant","route":"/drugs/i-125-seeds/","status":"approved","indications":"prostate prostate-high-risk"},{"id":"ac-225-fpi-2068","kind":"drug","name":"Actinium-225 FPI-2068","aka":"225Ac-FPI-2068 [225Ac]-FPI-2068","tldr":"An antibody engineered to grab onto two markers found together on some solid tumours, but not on healthy cells, carries a powerful short-range radioactive payload into the tumour to try to destroy it.","tags":"alpha therapy bispecific antibody EGFR cMET actinium-225 phase 1","route":"/drugs/ac-225-fpi-2068/","status":"phase-1"},{"id":"b-ac225-supply","kind":"bottleneck","name":"Actinium-225 supply","aka":"","tldr":"There is barely enough of the radioactive metal actinium-225 in the world to treat a few hundred patients a year, even though several new cancer drugs need it. New ways of making it are being built, but they are not yet running at full scale.","tags":"alpha emitter supply chain actinium-225","route":"/bottlenecks/b-ac225-supply/"},{"id":"b-mo99-supply","kind":"bottleneck","name":"Molybdenum-99 supply","aka":"","tldr":"Most of the world's everyday nuclear medicine scans depend on a radioactive metal, molybdenum-99, made in a handful of ageing research reactors. When one of them breaks down, hospitals thousands of miles away run short of scans within days because the material decays so fast it cannot be stockpiled.","tags":"supply chain molybdenum-99 technetium-99m reactor infrastructure","route":"/bottlenecks/b-mo99-supply/"},{"id":"b-enriched-target-material","kind":"bottleneck","name":"Enriched target material for therapeutic isotopes","aka":"","tldr":"Making the pure form of lutetium-177 used in cancer drugs like Pluvicto requires starting from a rare, heavily purified metal called ytterbium-176. Almost all of the world's supply of that starting material has come from one country, which is a risky place for the whole medicine to depend on.","tags":"supply chain ytterbium-176 lutetium-177 enrichment","route":"/bottlenecks/b-enriched-target-material/"},{"id":"b-hot-lab-capacity","kind":"bottleneck","name":"Hot lab and shielded treatment room capacity","aka":"","tldr":"Even where the radioactive medicine itself is available, giving it to a patient needs a specially shielded room, lead-lined equipment, and a toilet that can hold radioactive waste safely. Most hospitals only have one or two of these set up, which limits how many patients they can treat each week.","tags":"infrastructure hot lab capacity","route":"/bottlenecks/b-hot-lab-capacity/"},{"id":"b-authorized-user-shortage","kind":"bottleneck","name":"Authorized user shortage for radionuclide therapy","aka":"","tldr":"In the US, only specially trained doctors are legally allowed to give radioactive cancer treatments. Whether there are enough of these doctors to keep up with demand is genuinely disputed: regulators and physician groups have looked at the numbers and reached different conclusions.","tags":"workforce regulation authorized user","route":"/bottlenecks/b-authorized-user-shortage/"},{"id":"b-nuclear-medicine-workforce","kind":"bottleneck","name":"Nuclear medicine technologist and physicist workforce","aka":"","tldr":"Radioactive cancer treatments need specially trained technologists and physicists to prepare and check every dose, and there simply are not enough of them. Hospitals in Europe, the US and Canada are all reporting job vacancies that stay open for months.","tags":"workforce technologists training","route":"/bottlenecks/b-nuclear-medicine-workforce/"},{"id":"b-dosimetry-standardisation","kind":"bottleneck","name":"Dosimetry standardisation for radioligand therapy","aka":"","tldr":"Doctors give almost every patient the same fixed amount of radioactive drug, rather than measuring how much radiation each person's tumour and organs actually absorb and adjusting the dose. Personalising the dose might work better for some patients, but nobody has yet proven it clearly enough for it to become the standard of care.","tags":"dosimetry standardisation guideline","route":"/bottlenecks/b-dosimetry-standardisation/"},{"id":"b-reimbursement-coding","kind":"bottleneck","name":"Reimbursement and coding for radiopharmaceuticals","aka":"","tldr":"In the US, insurance pays extra for a new radioactive scan for a couple of years, then that extra payment can suddenly stop, even though the drug still costs the same to make. That cliff has already made at least one scan much harder for patients to get.","tags":"reimbursement CMS coding access","route":"/bottlenecks/b-reimbursement-coding/"},{"id":"b-cold-chain-logistics","kind":"bottleneck","name":"Cold chain and time-critical logistics","aka":"","tldr":"Radioactive medicines keep losing strength from the moment they are made, so a doctor prescribes a specific amount to arrive at a specific time. If a flight is delayed, an airline refuses the cargo, or customs holds the package for even a few hours, the dose can decay below the amount a patient needs and has to be thrown away.","tags":"logistics Class 7 cold chain half-life","route":"/bottlenecks/b-cold-chain-logistics/"},{"id":"b-site-readiness-referral","kind":"bottleneck","name":"Site readiness and referral pathway delays","aka":"","tldr":"Getting a patient from 'this treatment might help you' to actually receiving it can take weeks or months, because the scan, the specialist review and the treatment often happen at different places, and not every hospital is equipped to give the treatment at all.","tags":"access referral care pathway","route":"/bottlenecks/b-site-readiness-referral/","indications":"prostate-mcrpc neuroendocrine"},{"id":"b-radioactive-waste-regulation","kind":"bottleneck","name":"Radioactive waste handling and disposal regulation","aka":"","tldr":"Every radioactive treatment leaves behind radioactive waste, such as used vials and, for a short time, the patient's own urine, which has to be safely stored until it stops being radioactive. The rules and the physical space needed for this differ from hospital to hospital and country to country, and building enough of that safe storage takes time.","tags":"regulation waste disposal radiation safety","route":"/bottlenecks/b-radioactive-waste-regulation/"},{"id":"b-rlt-trial-capacity","kind":"bottleneck","name":"Clinical trial capacity for radioligand therapy","aka":"","tldr":"There are so many new radioactive cancer drugs now being tested that the trials themselves compete with each other, and with approved treatments, for the same scarce radioactive material, the same specially licensed hospital rooms, and the same trained staff. Sometimes a trial has to pause enrolling new patients simply because the isotope has run out.","tags":"clinical trials capacity isotope supply","route":"/bottlenecks/b-rlt-trial-capacity/"},{"id":"opendose","kind":"collection","name":"OpenDose","aka":"","tldr":"A free online resource that lets nuclear medicine physicists look up how much radiation dose different organs receive from radioactive drugs, instead of everyone recalculating it from scratch.","tags":"dosimetry open data physics","route":"/collections/opendose/"},{"id":"icrp-publications","kind":"collection","name":"ICRP publications and dose coefficient databases","aka":"","tldr":"The international body that sets the reference numbers used to work out how much radiation dose a patient, worker or member of the public gets, published as reports and downloadable spreadsheets.","tags":"dosimetry regulation physics","route":"/collections/icrp-publications/"},{"id":"nrc-regulations-part35","kind":"collection","name":"US NRC 10 CFR Part 35 (Medical Use of Byproduct Material)","aka":"","tldr":"The US federal rulebook that says which doctors and hospitals are allowed to give patients radioactive drugs, and what safety checks they must do.","tags":"regulation United States safety","route":"/collections/nrc-regulations-part35/"},{"id":"iaea-isotope-databases","kind":"collection","name":"IAEA nuclear data and isotope databases","aka":"","tldr":"A set of free online tools from the UN's nuclear agency that show the physical properties of every known radioactive atom, including the ones used in cancer scans and treatments.","tags":"isotopes physics open data","route":"/collections/iaea-isotope-databases/"},{"id":"snmmi-procedure-standards","kind":"collection","name":"SNMMI Procedure Standards","aka":"","tldr":"The US nuclear medicine society's rulebooks for how to correctly perform each type of scan or radioactive treatment, so results are comparable between hospitals.","tags":"guidelines practice standards","route":"/collections/snmmi-procedure-standards/"},{"id":"eanm-guidelines","kind":"collection","name":"EANM Guidelines","aka":"","tldr":"The European nuclear medicine society's free rulebooks for how to correctly perform each type of scan or radioactive treatment.","tags":"guidelines practice standards","route":"/collections/eanm-guidelines/"},{"id":"imaging-data-commons","kind":"collection","name":"NCI Imaging Data Commons (IDC)","aka":"","tldr":"A free, US government-run online library of cancer scan images that any researcher can browse and download without asking permission first.","tags":"open data imaging United States","route":"/collections/imaging-data-commons/"},{"id":"ejnmmi","kind":"journal","name":"European Journal of Nuclear Medicine and Molecular Imaging (EJNMMI)","aka":"EJNMMI European Journal of Nuclear Medicine","tldr":"A long-running European medical journal that publishes new research on radioactive scans and radioactive treatments.","tags":"journal nuclear medicine","route":"/journals/ejnmmi/"},{"id":"theranostics-journal","kind":"journal","name":"Theranostics","aka":"","tldr":"A fully free-to-read journal that publishes research combining diagnosis and treatment, including radioactive drugs.","tags":"journal open access theranostics","route":"/journals/theranostics-journal/"},{"id":"clinical-nuclear-medicine","kind":"journal","name":"Clinical Nuclear Medicine","aka":"CNM","tldr":"A monthly US medical journal for doctors who use radioactive scans and treatments in everyday patient care.","tags":"journal nuclear medicine clinical","route":"/journals/clinical-nuclear-medicine/"},{"id":"nuclear-medicine-and-biology","kind":"journal","name":"Nuclear Medicine and Biology","aka":"Nucl Med Biol NMB","tldr":"A scientific journal for the chemistry side of radioactive drugs: how they are made, tested in cells and animals, and first tried in patients.","tags":"journal radiochemistry radiopharmacy","route":"/journals/nuclear-medicine-and-biology/"},{"id":"ejnmmi-radiopharmacy-and-chemistry","kind":"journal","name":"EJNMMI Radiopharmacy and Chemistry","aka":"EJNMMI Radiopharm Chem","tldr":"A specialist journal, launched in 2015, for the chemistry of making new radioactive imaging and therapy drugs.","tags":"journal radiochemistry open access","route":"/journals/ejnmmi-radiopharmacy-and-chemistry/"},{"id":"journal-of-nuclear-cardiology","kind":"journal","name":"Journal of Nuclear Cardiology","aka":"JNC","tldr":"The official journal of the American nuclear cardiology society, covering heart scans that use radioactive tracers.","tags":"journal cardiology nuclear medicine","route":"/journals/journal-of-nuclear-cardiology/"},{"id":"bracco","kind":"company","name":"Bracco Imaging","aka":"Bracco Imaging S.p.A. Bracco Group","tldr":"An Italian company that makes the dyes and tracers doctors use to see inside the body on X-ray, CT, MRI, ultrasound and PET/SPECT scans, and, through a subsidiary, some of the radioactive scans used to find prostate cancer.","tags":"contrast media diagnostics prostate cancer imaging","route":"/companies/bracco/","status":"active"},{"id":"life-molecular-imaging","kind":"company","name":"Life Molecular Imaging","aka":"LMI","tldr":"A company that makes Neuraceq, an injectable radioactive tracer that lights up Alzheimer's plaques on a PET brain scan, and is now owned by Lantheus.","tags":"PET tracer Alzheimer's imaging amyloid PET","route":"/companies/life-molecular-imaging/","status":"active"},{"id":"advancell","kind":"company","name":"AdvanCell","aka":"AdvanCell Isotopes","tldr":"An Australian biotech building its own supply of the rare radioactive metal lead-212 so it can make alpha-particle cancer therapies, starting with one for prostate cancer.","tags":"lead-212 targeted alpha therapy prostate cancer","route":"/companies/advancell/","status":"active"},{"id":"ionetix","kind":"company","name":"IONETIX","aka":"Ionetix Corporation","tldr":"A Michigan company that builds compact superconducting particle accelerators and uses them to make radioactive materials for both diagnostic scans and cancer therapies, including two rare isotopes, actinium-225 and astatine-211.","tags":"cyclotron actinium-225 astatine-211 isotope supply","route":"/companies/ionetix/","status":"active"},{"id":"niowave","kind":"company","name":"Niowave","aka":"Niowave, Inc.","tldr":"A Michigan company that produces medical radioactive materials, including some used for cancer treatment, using a superconducting particle accelerator instead of a nuclear reactor.","tags":"superconducting linac actinium-225 molybdenum-99 isotope production","route":"/companies/niowave/","status":"active"},{"id":"bwxt-medical","kind":"company","name":"BWXT Medical","aka":"BWXT Medical Ltd.","tldr":"A Canadian company, owned by the US nuclear firm BWXT, that is building a made-in-Canada supply of the technetium generators hospitals use for the vast majority of nuclear medicine scans, plus other isotopes and radiotherapy hardware.","tags":"molybdenum-99 technetium-99m generator radioembolisation","route":"/companies/bwxt-medical/","status":"active"},{"id":"quirem-medical","kind":"company","name":"Quirem Medical","aka":"Quirem Medical B.V.","tldr":"A Dutch company, owned by Terumo, that makes tiny radioactive beads containing holmium-166 which are injected into the liver's blood vessels to irradiate liver tumours from the inside, plus the imaging tools used to plan and check that treatment.","tags":"holmium-166 radioembolisation liver cancer SIRT","route":"/companies/quirem-medical/","status":"active"},{"id":"oncobeta","kind":"company","name":"OncoBeta","aka":"OncoBeta GmbH OncoBeta International","tldr":"A German medical device company that makes a skin-patch radiotherapy for early skin cancer: a paste containing a radioactive isotope, rhenium-188, is applied over the tumour for under three hours instead of surgery.","tags":"rhenium-188 skin cancer epidermal brachytherapy beta emitter","route":"/companies/oncobeta/","status":"active"},{"id":"alpha-tau-medical","kind":"company","name":"Alpha Tau Medical","aka":"Alpha Tau DRTS","tldr":"An Israeli company that places tiny radioactive seeds directly inside a solid tumour; the seeds release a burst of highly damaging particles that mostly stay within a few millimetres of the tumour, sparing surrounding healthy tissue.","tags":"radium-224 intratumoural alpha therapy alpha emitter solid tumours","route":"/companies/alpha-tau-medical/","status":"active"},{"id":"nuclidium","kind":"company","name":"Nuclidium","aka":"Nuclidium AG","tldr":"A Swiss biotech using two forms of radioactive copper, one for scanning and one for treatment, joined to the same targeting molecule so the same drug design can both find and then destroy a tumour.","tags":"copper-61 copper-67 theranostics PSMA","route":"/companies/nuclidium/","status":"active"},{"id":"full-life-technologies","kind":"company","name":"Full-Life Technologies","aka":"Full-Life","tldr":"A radiopharmaceutical drug developer with sites in Europe and China that designs its own targeting molecules and pairs them with radioactive actinium or lutetium; its biggest programme, for a receptor found on several solid tumour types, has been licensed to a Korean partner in a deal worth up to $571.5 million.","tags":"actinium-225 neurotensin receptor 1 radionuclide drug conjugate","route":"/companies/full-life-technologies/","status":"active"},{"id":"molecular-targeting-technologies","kind":"company","name":"Molecular Targeting Technologies","aka":"MTTI Molecular Targeting Technologies, Inc.","tldr":"A Pennsylvania biotech that adds a chemical 'handle' to existing radioactive cancer drugs so the drug binds briefly to albumin, the body's most abundant blood protein, letting it linger in the tumour for days on a fraction of the usual radiation dose.","tags":"albumin binding PRRT EvaThera lutetium-177 actinium-225","route":"/companies/molecular-targeting-technologies/","status":"active"},{"id":"f-molecular-imaging","kind":"section","name":"Molecular imaging","aka":"","tldr":"Molecular imaging uses a small radioactive tracer injected into the body and a PET or SPECT camera to show where a specific protein sits on a tumour, so doctors can pick the right treatment and check it is working.","tags":"","route":"/fronts/f-molecular-imaging/","indications":"prostate prostate-bcr prostate-high-risk neuroendocrine rcc"},{"id":"f-radioligand-therapy","kind":"section","name":"Radioligand therapy","aka":"","tldr":"Radioligand therapy attaches a radioactive particle to a molecule that homes in on a tumour, so the radiation is delivered from the inside of the cancer rather than from an external beam.","tags":"","route":"/fronts/f-radioligand-therapy/","indications":"prostate-mcrpc prostate-mhspc neuroendocrine small-intestinal-net pancreatic-net lung-net"},{"id":"f-alpha-therapy","kind":"section","name":"Targeted alpha therapy","aka":"","tldr":"Alpha therapy uses a heavier type of radioactive particle that travels only a few cell widths but hits much harder, aimed at cancer cells that have stopped responding to the gentler beta-particle treatments.","tags":"","route":"/fronts/f-alpha-therapy/","indications":"prostate-mcrpc neuroendocrine metastatic-ppgl"},{"id":"f-isotope-supply","kind":"section","name":"Isotope supply","aka":"","tldr":"The radioactive ingredients in these medicines are made in a small number of ageing reactors and accelerators worldwide, and demand is now growing faster than that supply.","tags":"","route":"/fronts/f-isotope-supply/"},{"id":"f-radiochemistry","kind":"section","name":"Radiochemistry & manufacturing","aka":"","tldr":"Making one of these medicines means attaching a radioactive atom to a targeting molecule and getting it sterile and out the door within hours, before it decays away — a manufacturing problem unlike almost any other medicine.","tags":"","route":"/fronts/f-radiochemistry/"},{"id":"f-dosimetry","kind":"section","name":"Dosimetry","aka":"","tldr":"Dosimetry works out exactly how much radiation dose a patient's tumour and healthy organs actually receive, so treatment can in principle be tailored to the person rather than given as one fixed dose to everyone.","tags":"","route":"/fronts/f-dosimetry/","indications":"neuroendocrine hcc prostate-mcrpc"},{"id":"f-neuro-imaging","kind":"section","name":"Neuro-imaging","aka":"","tldr":"Brain PET scans can now show the sticky protein clumps of Alzheimer's disease directly, and are also used to see how far a brain tumour has spread and whether radiotherapy scarring looks like tumour regrowth.","tags":"","route":"/fronts/f-neuro-imaging/","indications":"glioblastoma meningioma"},{"id":"f-cardiac-imaging","kind":"section","name":"Cardiac imaging","aka":"","tldr":"A radioactive tracer injected into the bloodstream lights up on a scanner wherever the heart muscle is getting enough blood flow, so doctors can see blocked arteries without surgery.","tags":"","route":"/fronts/f-cardiac-imaging/"},{"id":"f-infection-imaging","kind":"section","name":"Infection & inflammation imaging","aka":"","tldr":"The same FDG tracer used to find cancer also lights up sites of infection and inflammation, which helps doctors find hidden abscesses, infected joint replacements or heart-valve infections that scans and blood tests alone can miss.","tags":"","route":"/fronts/f-infection-imaging/"},{"id":"f-bone-targeted","kind":"section","name":"Bone-targeted radiopharmaceuticals","aka":"","tldr":"Some radioactive drugs are built to home in on damaged bone rather than the tumour itself, easing bone pain from cancer that has spread to the skeleton and, in one case, helping patients live longer.","tags":"","route":"/fronts/f-bone-targeted/","indications":"prostate-mcrpc rcc bone-metastases"},{"id":"f-radioembolisation","kind":"section","name":"Radioembolisation","aka":"","tldr":"Radioembolisation delivers tiny radioactive beads directly into the blood vessels feeding a liver tumour through a catheter, so the radiation stays concentrated in the liver instead of spreading through the whole body.","tags":"","route":"/fronts/f-radioembolisation/","indications":"hcc hcc-intermediate"},{"id":"f-regulation-reimbursement","kind":"section","name":"Regulation & reimbursement","aka":"","tldr":"Getting one of these radioactive medicines approved and then actually paid for is its own specialised process, separate from ordinary drugs, and the rules for who pays what changed again for 2026 in the US.","tags":"","route":"/fronts/f-regulation-reimbursement/"},{"id":"idea-tb161-instead-of-lu177","kind":"idea","name":"Terbium-161 instead of lutetium-177 in the same ligands","aka":"","tldr":"Terbium-161 is a close chemical cousin of lutetium-177 that, as well as giving off the same kind of radiation, also releases a shower of extremely short-range electrons. In theory that extra radiation could finish off single cancer cells and tiny clusters that a lutetium-177 treatment might miss, using the same targeting molecules already in use.","tags":"prostate isotope alternative auger electrons","route":"/ideas/idea-tb161-instead-of-lu177/"},{"id":"idea-pretargeted-alpha-therapy","kind":"idea","name":"Pretargeted alpha radioimmunotherapy","aka":"","tldr":"Instead of injecting a radioactive antibody that circulates in the blood for days, doctors first give a plain antibody that finds the tumour, wait for it to clear, then inject a small, fast-moving radioactive alpha payload that only attaches where the antibody is already waiting. This two-step trick could let radioactive antibodies treat solid tumours without poisoning the bone marrow.","tags":"alpha therapy antibody pretargeting","route":"/ideas/idea-pretargeted-alpha-therapy/"},{"id":"idea-dosimetry-guided-dosing-standard","kind":"idea","name":"Kidney-dosimetry-guided dosing as the default for PSMA radioligand therapy","aka":"","tldr":"Right now, most patients get the same number of treatment cycles at the same radioactive dose regardless of their own biology. Measuring how much radiation actually reaches each patient's kidneys after the first dose could let doctors safely give some patients more cycles and stop earlier in others, rather than using one fixed schedule for everyone.","tags":"dosimetry personalised dosing prostate","route":"/ideas/idea-dosimetry-guided-dosing-standard/"},{"id":"idea-rlt-plus-parp-inhibitor","kind":"idea","name":"Adding a PARP inhibitor to PSMA radioligand therapy","aka":"","tldr":"A drug that blocks a cell's DNA-repair enzyme (PARP) is being added to PSMA-targeted radioactive treatment, on the theory that if a cell can't repair the small cuts radiation makes to its DNA, those cuts become fatal breaks that kill the cancer cell.","tags":"combination therapy PARP prostate","route":"/ideas/idea-rlt-plus-parp-inhibitor/"},{"id":"idea-rlt-plus-checkpoint-inhibitor","kind":"idea","name":"Adding a checkpoint inhibitor to PSMA radioligand therapy","aka":"","tldr":"Radiation from a targeted radioactive treatment can spill tumour debris that alerts the immune system. Giving an immunotherapy drug at the same time, to stop the immune system being switched off, is being tested to see if it makes the radioactive treatment work better.","tags":"combination therapy immunotherapy prostate","route":"/ideas/idea-rlt-plus-checkpoint-inhibitor/"},{"id":"idea-neoadjuvant-psma-therapy","kind":"idea","name":"Neoadjuvant PSMA radioligand therapy before prostatectomy","aka":"","tldr":"For men with high-risk prostate cancer that hasn't spread yet, giving a dose or two of PSMA-targeted radioactive treatment before surgery, rather than only using it after the cancer has spread, might kill hidden cancer cells surgery alone would miss. It is still experimental and hasn't yet been shown to help patients live longer or avoid the cancer coming back.","tags":"neoadjuvant prostate surgery","route":"/ideas/idea-neoadjuvant-psma-therapy/"},{"id":"idea-accelerator-ac225-at-scale","kind":"idea","name":"Scaling actinium-225 supply with proton accelerators instead of the thorium-229 cow","aka":"","tldr":"Most of the world's actinium-225, a rare radioactive metal used in some newer cancer treatments, comes from slowly extracting it from an old stockpile of another radioactive element. A different method — firing high-energy protons at ordinary thorium metal in an accelerator — can make much bigger batches, needed if actinium-225 treatments are ever to reach more than a small number of patients.","tags":"isotope supply actinium-225 manufacturing","route":"/ideas/idea-accelerator-ac225-at-scale/"},{"id":"idea-regional-radiopharmacy-network","kind":"idea","name":"In-house hospital radiopharmacy compounding to cut dose waste","aka":"","tldr":"Radioactive treatments lose strength every day as they travel from a central factory to the hospital, so by the time a dose arrives some of its power has decayed away. Installing compact, automated dose-preparation equipment inside individual hospitals, so they compound the treatment themselves from bulk material, could cut that wasted radioactivity and get treatment to more places.","tags":"radiopharmacy supply chain access","route":"/ideas/idea-regional-radiopharmacy-network/"},{"id":"idea-total-body-pet-lower-dose-tracers","kind":"idea","name":"Using total-body PET's sensitivity to cut diagnostic tracer dose, not just scan time","aka":"","tldr":"New whole-body scanners are so much more sensitive than standard PET machines that they can produce a clear picture using a small fraction of the usual radioactive tracer dose. Most of that extra sensitivity has been used to make scans faster; using it instead to lower the radiation dose given to patients and staff is a separate, less-explored option.","tags":"total-body PET dose reduction imaging","route":"/ideas/idea-total-body-pet-lower-dose-tracers/"},{"id":"idea-bispecific-radioligands","kind":"idea","name":"Bispecific PSMA/GRPR radioligands for discordant prostate cancer lesions","aka":"","tldr":"Not every prostate cancer cell carries the same marker: some show the PSMA protein that most scans target, others show a different marker called GRPR instead. A single tracer molecule built to stick to both markers at once could find and treat tumours that a PSMA-only or GRPR-only scan would miss.","tags":"bispecific prostate molecular imaging","route":"/ideas/idea-bispecific-radioligands/"},{"id":"idea-copper-theranostic-pair-standard","kind":"idea","name":"A single-molecule copper-64/copper-67 pair instead of switching ligands between scan and treatment","aka":"","tldr":"Most PSMA treatments use one molecule to take the pre-treatment scan and a slightly different molecule for the actual treatment, so the scan is only an approximate guide. A copper-based pair uses the identical molecule for both steps, just with a different form of copper, so the scan should be a much truer preview of where the treatment radiation will go.","tags":"copper theranostics prostate same-molecule imaging","route":"/ideas/idea-copper-theranostic-pair-standard/"},{"id":"idea-alpha-for-oligometastatic-disease","kind":"idea","name":"Alpha-emitting PSMA therapy for oligometastatic (few-lesion) prostate cancer","aka":"","tldr":"When prostate cancer comes back in just a handful of spots, doctors already zap those spots with precision radiotherapy. Adding a single dose of an alpha-particle radioactive drug at the same time, instead of the more established beta-particle version, might mop up cancer cells too small to see on a scan, because alpha radiation travels a much shorter distance and hits harder in that short range.","tags":"alpha therapy oligometastatic prostate","route":"/ideas/idea-alpha-for-oligometastatic-disease/"},{"id":"idea-fap-theranostics-sarcoma","kind":"idea","name":"FAP-targeted radioligand therapy for sarcoma","aka":"","tldr":"Sarcomas, a group of rare and hard-to-treat cancers, often carry a marker called FAP not just on the supporting tissue around the tumour but on the cancer cells themselves. A radioactive drug built to find FAP is being tried as a treatment, but the small studies done so far disagree about whether it actually shrinks tumours.","tags":"FAP sarcoma theranostics","route":"/ideas/idea-fap-theranostics-sarcoma/"},{"id":"idea-ai-lesion-segmentation-dosimetry","kind":"idea","name":"AI segmentation to make voxel-level radioligand dosimetry practical at scale","aka":"","tldr":"Working out how much radiation a patient's kidneys and tumours received after a radioactive treatment normally means a specialist spending hours tracing organ outlines by hand on a scan. Software that draws those outlines automatically using artificial intelligence can do the same job in minutes, making personalised dose tracking available everywhere, not just in a few specialist centres.","tags":"artificial intelligence dosimetry segmentation","route":"/ideas/idea-ai-lesion-segmentation-dosimetry/"},{"id":"idea-open-dosimetry-data-commons","kind":"idea","name":"An open data commons linking patient-level radiopharmaceutical dosimetry to outcomes","aka":"","tldr":"Every hospital that treats patients with radioactive drugs measures how much radiation reached the tumour and healthy organs, but this data mostly stays locked in each hospital's own files. A shared, public library pooling that dosimetry data, with patient outcomes, would let researchers everywhere build and test better dosing rules, especially smaller centres that don't see enough patients alone.","tags":"open data dosimetry data sharing","route":"/ideas/idea-open-dosimetry-data-commons/"},{"id":"graves-hyperthyroidism","kind":"indication","name":"Graves' disease and hyperthyroidism","aka":"","tldr":"An overactive thyroid gland makes too much thyroid hormone, speeding up the whole body. A drink or capsule of radioactive iodine can shrink and quieten the gland from the inside, without surgery.","tags":"thyroid benign disease SPECT","route":"/indications/graves-hyperthyroidism/"},{"id":"infection-prosthetic-joint","kind":"indication","name":"Prosthetic joint infection","aka":"","tldr":"When a replacement hip or knee might be infected, doctors can label a small sample of the patient's own white blood cells with a radioactive tracer and watch, over a day, whether they gather around the implant the way they would around a real infection.","tags":"infection orthopaedics SPECT","route":"/indications/infection-prosthetic-joint/"},{"id":"fever-of-unknown-origin","kind":"indication","name":"Fever of unknown origin","aka":"","tldr":"When a persistent fever has no obvious cause after the usual tests, a whole-body PET scan using the same sugar tracer as cancer imaging often lights up the hidden infection, inflammation or tumour behind it.","tags":"infection PET inflammation","route":"/indications/fever-of-unknown-origin/"},{"id":"sentinel-node-mapping","kind":"indication","name":"Sentinel lymph node mapping in breast cancer and melanoma","aka":"","tldr":"Before removing lymph nodes to check whether a breast cancer or melanoma has spread, surgeons inject a small radioactive tracer that flows to the very first node the tumour would reach, so only that node needs to come out to find the answer.","tags":"surgery SPECT breast melanoma","route":"/indications/sentinel-node-mapping/"},{"id":"renal-obstruction","kind":"indication","name":"Suspected upper urinary tract obstruction","aka":"","tldr":"When a kidney's drainage tube might be blocked, injecting a tracer that the kidney filters out and watching, with a water pill on board, how fast it washes through shows whether there is a real blockage needing surgery or just a floppy but unobstructed system.","tags":"renal urology SPECT dynamic imaging","route":"/indications/renal-obstruction/"},{"id":"gastrointestinal-bleeding","kind":"indication","name":"Gastrointestinal bleeding localisation","aka":"","tldr":"When bleeding inside the gut is hard to pin down, labelling a patient's own red blood cells with a radioactive tracer and watching where blood leaks into the bowel over several hours can find the source, even if the bleeding comes and goes.","tags":"gastroenterology dynamic imaging emergency","route":"/indications/gastrointestinal-bleeding/"},{"id":"pulmonary-embolism-vq","kind":"indication","name":"Pulmonary embolism: ventilation/perfusion imaging","aka":"","tldr":"To check whether a blood clot has lodged in the lung's blood vessels, a scan compares which parts of the lung get air (ventilation) with which parts get blood flow (perfusion); a clot shows up as an area that is ventilated but not perfused.","tags":"pulmonary SPECT emergency cardiopulmonary","route":"/indications/pulmonary-embolism-vq/"},{"id":"bone-pain-palliation","kind":"indication","name":"Bone pain palliation from osteoblastic metastases","aka":"","tldr":"For cancer that has spread widely to bone and causes pain everywhere at once, a bone-seeking radioactive injection travels to every affected spot in the skeleton and delivers pain-relieving radiation from the inside, sparing a trip to radiotherapy for each site.","tags":"palliative care bone metastases alpha therapy beta emitter","route":"/indications/bone-pain-palliation/"},{"id":"epilepsy-localisation","kind":"indication","name":"Presurgical localisation of drug-resistant focal epilepsy","aka":"","tldr":"For seizures that medication cannot control, a brain PET scan taken between seizures can spot the small area of brain that is misfiring, by showing it using less sugar than the tissue around it, helping surgeons plan an operation to remove it.","tags":"neurology PET epilepsy presurgical","route":"/indications/epilepsy-localisation/"},{"id":"thyroid-nodule-assessment","kind":"indication","name":"Functional assessment of thyroid nodules","aka":"","tldr":"When a lump is found in the thyroid, a scan showing whether it takes up iodine-like tracer more or less than the rest of the gland tells doctors whether it is a low-risk overactive nodule that rarely needs a biopsy, or a quiet 'cold' nodule that does.","tags":"thyroid SPECT triage","route":"/indications/thyroid-nodule-assessment/"},{"id":"f-18","kind":"isotope","name":"Fluorine-18","aka":"18F","tldr":"A short-lived radioactive form of fluorine, made fresh each morning at a local facility, that is attached to a sugar or other small molecule and used for a PET scan.","tags":"positron emitter cyclotron","route":"/isotopes/f-18/","status":"established"},{"id":"ga-68","kind":"isotope","name":"Gallium-68","aka":"68Ga","tldr":"A radioactive metal with a one-hour lifetime that is eluted from a shielded generator or made on a cyclotron and attached to a molecule that finds tumours, giving a PET scan the same day.","tags":"positron emitter generator theranostic pair","route":"/isotopes/ga-68/","status":"established"},{"id":"tc-99m","kind":"isotope","name":"Technetium-99m","aka":"99mTc Tc-99m","tldr":"The single most widely used medical radioisotope: a metastable metal with a six-hour lifetime, milked on demand from a bedside generator (a 'moly cow') and attached to a cold kit to image bone, heart, kidneys or lymph nodes.","tags":"gamma emitter generator most widely used","route":"/isotopes/tc-99m/","status":"established"},{"id":"i-123","kind":"isotope","name":"Iodine-123","aka":"123I","tldr":"A radioactive form of iodine that decays quickly and gives off gamma rays, used to take a picture of the thyroid or, attached to a nerve-tracing molecule, of tumours of the adrenal gland and nervous system, before deciding whether a therapeutic dose of iodine-131 makes sense.","tags":"gamma emitter cyclotron thyroid","route":"/isotopes/i-123/","status":"established","indications":"neuroblastoma pheochromocytoma-paraganglioma thyroid"},{"id":"i-124","kind":"isotope","name":"Iodine-124","aka":"124I","tldr":"A long-lived, PET-visible form of radioactive iodine used to map how a thyroid cancer takes up iodine over several days, so the dose of the treatment isotope, iodine-131, can be planned before it is given.","tags":"positron emitter long-lived PET pre-therapy dosimetry","route":"/isotopes/i-124/","status":"emerging","indications":"thyroid"},{"id":"in-111","kind":"isotope","name":"Indium-111","aka":"111In","tldr":"A radioactive metal used, attached to octreotide, as the original scan for neuroendocrine tumours (Octreoscan) before gallium-68 PET took over, and still used to label white blood cells for infection imaging.","tags":"gamma emitter legacy somatostatin imaging","route":"/isotopes/in-111/","status":"established","indications":"neuroendocrine"},{"id":"cu-64","kind":"isotope","name":"Copper-64","aka":"64Cu","tldr":"A radioactive metal that lasts about half a day, long enough to image slower-moving molecules such as antibodies, and chemically identical to copper-67, the isotope used to treat with the same tracer.","tags":"positron emitter theranostic pair same-element pair","route":"/isotopes/cu-64/","status":"approved"},{"id":"zr-89","kind":"isotope","name":"Zirconium-89","aka":"89Zr","tldr":"A radioactive metal that lasts about three days, long enough to attach to a whole antibody and follow it around the body for several days on a PET scan, which is why it underpins 'immuno-PET'.","tags":"positron emitter immuno-PET long-lived PET","route":"/isotopes/zr-89/","status":"emerging","indications":"rcc"},{"id":"c-11","kind":"isotope","name":"Carbon-11","aka":"11C","tldr":"A radioactive form of ordinary carbon that lasts only about 20 minutes, so it has to be made and used in the same building; it can label real body molecules like choline without changing their chemistry.","tags":"positron emitter ultra-short-lived on-site only","route":"/isotopes/c-11/","status":"established","indications":"prostate"},{"id":"n-13","kind":"isotope","name":"Nitrogen-13","aka":"13N","tldr":"A radioactive gas-forming isotope with a ten-minute lifetime, turned into ammonia and injected to map blood flow to the heart muscle on a PET scan.","tags":"positron emitter ultra-short-lived cardiac perfusion","route":"/isotopes/n-13/","status":"approved"},{"id":"o-15","kind":"isotope","name":"Oxygen-15","aka":"15O","tldr":"A radioactive form of oxygen with a two-minute lifetime, made into water and injected to measure blood flow to the brain or heart; used almost exclusively in research because it decays too fast for routine hospital use in the US.","tags":"positron emitter shortest-lived PET isotope cerebral blood flow","route":"/isotopes/o-15/","status":"emerging"},{"id":"rb-82","kind":"isotope","name":"Rubidium-82","aka":"82Rb","tldr":"A radioactive potassium look-alike that lasts only about 75 seconds, delivered straight from a bedside generator into a vein, used to check blood flow to the heart without needing a cyclotron on site.","tags":"positron emitter generator cardiac perfusion ultra-short-lived","route":"/isotopes/rb-82/","status":"approved"},{"id":"ga-67","kind":"isotope","name":"Gallium-67","aka":"67Ga","tldr":"An older radioactive gallium tracer, given as a citrate injection, that lights up infections and some tumours over a scan taken a few days later; mostly replaced now by FDG PET but still used where PET is unavailable.","tags":"gamma emitter legacy tumour and infection imaging","route":"/isotopes/ga-67/","status":"historic","indications":"neuroendocrine"},{"id":"tl-201","kind":"isotope","name":"Thallium-201","aka":"201Tl","tldr":"A radioactive potassium look-alike with a three-day lifetime, injected to see how well blood reaches, and heart muscle survives in, different parts of the heart on a SPECT scan.","tags":"gamma emitter cardiac perfusion myocardial viability","route":"/isotopes/tl-201/","status":"established"},{"id":"sc-44","kind":"isotope","name":"Scandium-44","aka":"44Sc","tldr":"An experimental radioactive metal, lasting about four hours, being developed as a PET-imageable stand-in for lutetium-177 or other therapy metals so a treatment dose can be planned in advance.","tags":"positron emitter generator experimental theranostic pair","route":"/isotopes/sc-44/","status":"preclinical"},{"id":"y-86","kind":"isotope","name":"Yttrium-86","aka":"86Y","tldr":"A PET-visible radioactive stand-in for the treatment isotope yttrium-90, used to see in advance, on a scan, exactly where a yttrium-90 therapy dose would go and how much radiation each organ would receive.","tags":"positron emitter dosimetry surrogate theranostic pair","route":"/isotopes/y-86/","status":"preclinical"},{"id":"mo-99","kind":"isotope","name":"Molybdenum-99","aka":"99Mo Mo-99","tldr":"The parent isotope shipped worldwide to make technetium-99m, the gamma-ray tracer used in the majority of nuclear medicine scans. It is made in a handful of ageing research reactors, and when one breaks down, scans get delayed or cancelled.","tags":"beta emitter generator parent reactor supply chain ageing infrastructure","route":"/isotopes/mo-99/","status":"established"},{"id":"ge-68","kind":"isotope","name":"Germanium-68","aka":"68Ge Ge-68","tldr":"The long-lived parent locked inside a gallium-68 generator. One loaded column can supply a year's worth of PET tracer doses for prostate cancer and neuroendocrine tumour scans, but the generators themselves have been expensive and slow to get.","tags":"generator parent long-lived supply bottleneck","route":"/isotopes/ge-68/","status":"established"},{"id":"lu-177","kind":"isotope","name":"Lutetium-177","aka":"177Lu Lu-177","tldr":"A radioactive metal that gives off short-range radiation. Attached to a molecule that sticks to a tumour, it irradiates the tumour from the inside while sparing most healthy tissue.","tags":"therapy beta emitter","route":"/isotopes/lu-177/","status":"approved"},{"id":"ac-225","kind":"isotope","name":"Actinium-225","aka":"225Ac Ac-225","tldr":"A metal that fires off very powerful, very short-range radioactive particles as it decays through a chain of daughter atoms. Because the particles barely travel beyond the cell they hit, it can kill a cancer cell while leaving neighbouring healthy cells mostly untouched. Supply is scarce, so it is still mostly used in research studies.","tags":"therapy alpha emitter supply-constrained","route":"/isotopes/ac-225/","status":"phase-2"},{"id":"ra-223","kind":"isotope","name":"Radium-223","aka":"223Ra Ra-223","tldr":"A radioactive form of the mineral radium that behaves like calcium and settles into bone. It gives off very short-range, high-energy particles that damage cancer growing in bone while barely reaching the healthy marrow next to it.","tags":"therapy alpha emitter bone-seeking","route":"/isotopes/ra-223/","status":"approved"},{"id":"i-131","kind":"isotope","name":"Iodine-131","aka":"131I I-131 radioiodine","tldr":"A radioactive form of iodine. Because the thyroid gland naturally absorbs iodine, swallowing it lets the radiation destroy thyroid cells or thyroid cancer cells almost anywhere they have spread, with very little effect on the rest of the body.","tags":"therapy beta emitter gamma emitter","route":"/isotopes/i-131/","status":"approved"},{"id":"y-90","kind":"isotope","name":"Yttrium-90","aka":"90Y Y-90","tldr":"A radioactive metal that fires high-energy particles a short distance into surrounding tissue. Millions of microscopic beads carrying it are injected into the artery feeding a liver tumour, where they lodge and irradiate the tumour from inside.","tags":"therapy beta emitter radioembolisation","route":"/isotopes/y-90/","status":"approved"},{"id":"pb-212","kind":"isotope","name":"Lead-212","aka":"212Pb Pb-212","tldr":"A radioactive metal that, once inside the body, turns itself into a much more damaging particle-emitter over the following hours. It is being explored as a way to deliver strong, short-range radiation without needing the rarer isotopes used in similar treatments.","tags":"therapy alpha emitter in vivo generator","route":"/isotopes/pb-212/","status":"phase-2"},{"id":"bi-213","kind":"isotope","name":"Bismuth-213","aka":"213Bi Bi-213","tldr":"An extremely short-lived radioactive metal that delivers a powerful, very local burst of radiation. Because it decays away within a few hours, it has to be made freshly at the hospital, right before it is given to the patient.","tags":"therapy alpha emitter generator-produced short-lived","route":"/isotopes/bi-213/","status":"phase-1"},{"id":"at-211","kind":"isotope","name":"Astatine-211","aka":"211At At-211","tldr":"A radioactive halogen, chemically similar to iodine, that gives off a single powerful short-range particle as it decays. It has to be made in a particular kind of accelerator and used within hours, which is why only a handful of centres worldwide can supply it.","tags":"therapy alpha emitter halogen supply-constrained","route":"/isotopes/at-211/","status":"phase-1"},{"id":"tb-161","kind":"isotope","name":"Terbium-161","aka":"161Tb Tb-161","tldr":"A radioactive metal, chemically almost identical to the widely-used lutetium-177, that gives off the same kind of medium-range particles plus a burst of extra very-short-range electrons. Those extra electrons may let it do more damage to a cancer cell than lutetium-177 while using the same delivery molecules.","tags":"therapy beta emitter auger electron emitter research-only","route":"/isotopes/tb-161/","status":"phase-1"},{"id":"cu-67","kind":"isotope","name":"Copper-67","aka":"67Cu Cu-67","tldr":"A radioactive form of copper that pairs with a diagnostic twin made of the same element, copper-64. Using the same metal for the scan and the treatment means the tracer behaves identically both times, which should make dosing more predictable.","tags":"therapy beta emitter theranostic pair","route":"/isotopes/cu-67/","status":"phase-2"},{"id":"sm-153","kind":"isotope","name":"Samarium-153","aka":"153Sm Sm-153","tldr":"A radioactive metal, given as an injection, that homes in on the actively growing edges of bone and gives off radiation there. It is used to ease pain from cancer that has spread to bone.","tags":"therapy beta emitter gamma emitter bone-seeking","route":"/isotopes/sm-153/","status":"approved"},{"id":"sr-89","kind":"isotope","name":"Strontium-89","aka":"89Sr Sr-89","tldr":"A radioactive metal that behaves like calcium and is taken up by bone, particularly where cancer has spread there. A single injection can ease bone pain for weeks by irradiating those spots from within.","tags":"therapy pure beta emitter bone-seeking","route":"/isotopes/sr-89/","status":"approved"},{"id":"ho-166","kind":"isotope","name":"Holmium-166","aka":"166Ho Ho-166","tldr":"A radioactive metal built into tiny beads that are injected into the artery feeding a liver tumour, where they lodge and irradiate it from close range. Unlike similar beads made with yttrium-90, these can also be seen clearly on a scan.","tags":"therapy beta emitter gamma emitter radioembolisation MRI-visible","route":"/isotopes/ho-166/","status":"approved"},{"id":"re-188","kind":"isotope","name":"Rhenium-188","aka":"188Re Re-188","tldr":"A high-energy radioactive metal that a hospital can produce on demand from a small on-site generator, similar to how a common medical imaging isotope is made, rather than needing to import it. It is used for hard-to-reach tumours, including liver cancer.","tags":"therapy beta emitter gamma emitter generator-produced","route":"/isotopes/re-188/","status":"phase-2"},{"id":"p-32","kind":"isotope","name":"Phosphorus-32","aka":"32P P-32","tldr":"A radioactive form of phosphorus, one of the oldest radioactive treatments in medicine. Because the body's cells constantly use phosphorus, it can be used to treat certain blood disorders or, injected directly into a body cavity, to control fluid build-up caused by cancer.","tags":"therapy pure beta emitter historic","route":"/isotopes/p-32/","status":"approved"},{"id":"th-227","kind":"isotope","name":"Thorium-227","aka":"227Th Th-227","tldr":"A radioactive metal that, once it decays, keeps generating more damaging radioactive particles inside the tumour for weeks. Because it lasts longer than most similar treatments, it can be attached to slow-moving carriers such as full-sized antibodies.","tags":"therapy alpha emitter antibody-compatible in vivo generator","route":"/isotopes/th-227/","status":"phase-1"},{"id":"ra-224","kind":"isotope","name":"Radium-224","aka":"224Ra Ra-224","tldr":"A radioactive form of radium used mainly as a feedstock: it is loaded into a small on-site generator so that hospitals and manufacturers can draw off a different, more widely used radioactive metal (lead-212) whenever they need it.","tags":"therapy alpha emitter generator parent research-only","route":"/isotopes/ra-224/","status":"phase-1"},{"id":"sc-47","kind":"isotope","name":"Scandium-47","aka":"47Sc Sc-47","tldr":"A radioactive metal being developed to pair with imaging twins made of the same element, scandium-43 or scandium-44. Because it is the same chemical element used for both the scan and the treatment, the tracer should behave identically in both roles.","tags":"therapy beta emitter gamma emitter research-only theranostic pair","route":"/isotopes/sc-47/","status":"preclinical"},{"id":"pluvicto-plus-olaparib","kind":"pairing","name":"177Lu-PSMA-617 (Pluvicto) with olaparib","aka":"","tldr":"An early trial gave the prostate cancer radiotherapy Pluvicto together with the tablet olaparib, on the idea that the pill makes the radiation harder for the cancer cell to repair. Most men's PSA fell, but this is still a small early-stage study, not proof it helps people live longer.","tags":"prostate cancer PARP inhibitor early phase","route":"/pairings/pluvicto-plus-olaparib/"},{"id":"prrt-plus-captem","kind":"pairing","name":"PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)","aka":"","tldr":"For some pancreatic neuroendocrine tumours, doctors add two chemotherapy tablets (capecitabine and temozolomide) to the radioactive PRRT treatment. Trial data suggest the combination may control the pancreatic tumours for longer than either treatment alone, though it caused more blood-count side effects in one gut-tumour subgroup.","tags":"neuroendocrine tumours chemoradionuclide therapy","route":"/pairings/prrt-plus-captem/"},{"id":"radium223-abiraterone-caution","kind":"pairing","name":"Radium-223 with abiraterone: a caution, not a combination","aka":"","tldr":"Giving the bone-targeting radiotherapy radium-223 together with the hormone drug abiraterone does not help patients live longer and roughly doubles or triples the risk of a broken bone compared with abiraterone alone. This combination is no longer recommended.","tags":"prostate cancer safety signal fractures","route":"/pairings/radium223-abiraterone-caution/"},{"id":"fdg-pet-response-adapted-therapy","kind":"pairing","name":"FDG PET then response-adapted chemotherapy","aka":"","tldr":"In Hodgkin lymphoma, a PET scan taken partway through chemotherapy is used to decide whether to keep the same treatment, drop a harsh drug, or step up to something stronger. Trials show this scan-guided approach keeps most patients well without adding one particular lung-damaging drug.","tags":"Hodgkin lymphoma response-adapted therapy FDG PET","route":"/pairings/fdg-pet-response-adapted-therapy/"},{"id":"tare-plus-durvalumab-hcc","kind":"pairing","name":"Radioembolisation (TARE) with durvalumab in hepatocellular carcinoma","aka":"","tldr":"Small early trials are giving liver-directed radiation beads (TARE) together with the immunotherapy drug durvalumab for liver cancer that cannot be operated on. Early results show high tumour shrinkage rates, but these are small studies and it is not yet proven that the combination helps people live longer than either treatment alone.","tags":"hepatocellular carcinoma radioembolisation immunotherapy","route":"/pairings/tare-plus-durvalumab-hcc/"},{"id":"tare-vs-sorafenib-caution","kind":"pairing","name":"Radioembolisation (TARE) compared with sorafenib in hepatocellular carcinoma","aka":"","tldr":"Two large trials tested whether liver-directed radiation beads work better than the pill sorafenib for advanced liver cancer. Neither trial found the radiation beads extended life more than the pill, though patients had fewer side effects and better quality of life with the beads.","tags":"hepatocellular carcinoma radioembolisation negative trial","route":"/pairings/tare-vs-sorafenib-caution/"},{"id":"rituximab-then-ibritumomab-tiuxetan","kind":"pairing","name":"Rituximab pretreatment before ibritumomab tiuxetan (Zevalin)","aka":"","tldr":"Before giving the radioactive lymphoma treatment Zevalin, doctors first give a dose of the antibody drug rituximab. This clears out normal B-cells in the blood so the radioactivity goes to the lymphoma more precisely, and it is a mandatory step on the drug's official label, not an optional extra.","tags":"lymphoma radioimmunotherapy mandatory sequence","route":"/pairings/rituximab-then-ibritumomab-tiuxetan/"},{"id":"beta-psma-then-alpha-psma-rescue","kind":"pairing","name":"177Lu-PSMA-617 then 225Ac-PSMA rescue therapy","aka":"","tldr":"When the standard radioactive prostate cancer treatment (177Lu-PSMA) stops working, some clinics switch to a more powerful alpha-particle version (225Ac-PSMA) as a rescue option. It can bring PSA down in about half of patients, but people who have already failed the beta treatment tend to respond less well and for a shorter time than those who have never had it.","tags":"prostate cancer alpha therapy salvage therapy","route":"/pairings/beta-psma-then-alpha-psma-rescue/"},{"id":"docetaxel-then-lu177-psma","kind":"pairing","name":"Docetaxel (taxane chemotherapy) then 177Lu-PSMA-617","aka":"","tldr":"In the trial that got 177Lu-PSMA-617 (Pluvicto) approved, everyone had already been treated with a taxane chemotherapy drug like docetaxel and with a hormone pill first. That is the treatment order the approval is based on, though a newer trial is now testing whether Pluvicto can be used earlier, before chemotherapy.","tags":"prostate cancer treatment sequencing radioligand therapy","route":"/pairings/docetaxel-then-lu177-psma/"},{"id":"ga68-dotatate-then-lutathera","kind":"pairing","name":"68Ga-DOTATATE PET before Lutathera (177Lu-DOTATATE)","aka":"","tldr":"Before starting the neuroendocrine tumour treatment Lutathera, patients get a somatostatin-receptor PET scan to confirm the tumour actually has the right target for the drug to lock onto. Lutathera's approval and use are built around this scan-first rule.","tags":"neuroendocrine tumours theranostics patient selection","route":"/pairings/ga68-dotatate-then-lutathera/"},{"id":"paper-therap-lancet-2021","kind":"paper","name":"TheraP: [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer","aka":"","tldr":"In men whose prostate cancer had grown after chemotherapy, a radioactive drug that homes in on prostate cancer cells (lutetium-177 PSMA-617) shrank the PSA marker in more men, and caused fewer serious side effects, than the standard chemotherapy drug it was compared with.","tags":"prostate cancer radioligand therapy randomised trial","route":"/key-papers/paper-therap-lancet-2021/"},{"id":"paper-psmafore-lancet-2024","kind":"paper","name":"PSMAfore: 177Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor in taxane-naive mCRPC","aka":"","tldr":"In men with advanced prostate cancer who had not yet had chemotherapy but whose disease had grown on one hormone-blocking drug, switching to the radioactive PSMA treatment kept the cancer under control for longer than switching to a different hormone drug.","tags":"prostate cancer radioligand therapy randomised trial","route":"/key-papers/paper-psmafore-lancet-2024/"},{"id":"paper-zircon-lancet-oncol-2024","kind":"paper","name":"ZIRCON: [89Zr]Zr-girentuximab PET-CT for detecting clear-cell renal cell carcinoma","aka":"","tldr":"A PET scan using a radioactively-labelled antibody could tell, without surgery, whether a suspicious kidney lump was the most common type of kidney cancer - correctly in about 9 out of 10 people.","tags":"renal cell carcinoma PET imaging CAIX","route":"/key-papers/paper-zircon-lancet-oncol-2024/"},{"id":"paper-kratochwil-ac225-psma-jnm-2016","kind":"paper","name":"225Ac-PSMA-617 for PSMA-targeted alpha-radiation therapy of metastatic castration-resistant prostate cancer","aka":"","tldr":"The first published report of two men with very advanced prostate cancer, who had run out of other options, having their cancer disappear on scans after treatment with an alpha-emitting radioactive drug aimed at PSMA.","tags":"alpha therapy prostate cancer first-in-human","route":"/key-papers/paper-kratochwil-ac225-psma-jnm-2016/"},{"id":"paper-strosberg-netter1-qol-jco-2018","kind":"paper","name":"Health-related quality of life in the NETTER-1 trial of 177Lu-Dotatate","aka":"","tldr":"In people with a slow-growing gut cancer, the radioactive treatment lutetium-177 dotatate did not just shrink tumours for longer - it also kept their day-to-day quality of life, including energy, pain and diarrhoea, better for much longer than the older drug it was compared with.","tags":"neuroendocrine tumours PRRT quality of life","route":"/key-papers/paper-strosberg-netter1-qol-jco-2018/"},{"id":"paper-hofman-lupsma-lancet-oncol-2018","kind":"paper","name":"LuPSMA trial: single-arm phase 2 study of 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer","aka":"","tldr":"In an early single-hospital study, most men with advanced prostate cancer who had run out of standard treatments saw their PSA fall by at least half after being treated with the radioactive drug lutetium-177 PSMA-617, with mild side effects.","tags":"prostate cancer radioligand therapy phase 2","route":"/key-papers/paper-hofman-lupsma-lancet-oncol-2018/"},{"id":"paper-sgouros-tat-review-nat-rev-2020","kind":"paper","name":"Radiopharmaceutical therapy in cancer: clinical advances and challenges","aka":"","tldr":"A review, written for drug developers, of how radioactive cancer drugs work, which ones had reached patients by 2020, and what stands in the way of making more of them.","tags":"review radiopharmaceutical therapy","route":"/key-papers/paper-sgouros-tat-review-nat-rev-2020/"},{"id":"paper-herrmann-radiotheranostics-lancet-oncol-2020","kind":"paper","name":"Radiotheranostics: a roadmap for future development","aka":"","tldr":"A group of leading nuclear medicine specialists set out, in one article, what needs to happen - in science, manufacturing, regulation and training - for more radioactive scan-and-treat drugs to reach patients over the following five years.","tags":"review roadmap theranostics","route":"/key-papers/paper-herrmann-radiotheranostics-lancet-oncol-2020/"},{"id":"paper-baum-prrt-1048-patients-oncotarget-2018","kind":"paper","name":"Results and adverse events of personalised peptide receptor radionuclide therapy in 1048 patients with neuroendocrine neoplasms","aka":"","tldr":"The largest single-centre report of a radioactive treatment for neuroendocrine tumours, from over a thousand patients treated across a decade at one German hospital, showing typical survival times and how often serious side effects such as blood cancers occurred.","tags":"neuroendocrine tumours PRRT real-world evidence","route":"/key-papers/paper-baum-prrt-1048-patients-oncotarget-2018/"},{"id":"paper-jadvar-snmmi-psma-auc-jnm-2022","kind":"paper","name":"Appropriate use criteria for prostate-specific membrane antigen (PSMA) PET imaging","aka":"","tldr":"A panel of cancer and imaging specialists agreed, scenario by scenario, when a PSMA PET scan for prostate cancer is a good idea and when it usually is not - a reference clinicians and insurers use to decide who should get the scan.","tags":"guideline PSMA PET appropriate use criteria","route":"/key-papers/paper-jadvar-snmmi-psma-auc-jnm-2022/"},{"id":"paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022","kind":"paper","name":"EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands","aka":"","tldr":"European nuclear medicine physicists set out a detailed, agreed method for measuring exactly how much radiation dose a patient's kidneys and tumours actually receive during lutetium-177 treatments, so that dosing can eventually be tailored to the individual rather than fixed for everyone.","tags":"guideline dosimetry lutetium-177","route":"/key-papers/paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022/"},{"id":"paper-tagawa-ac225-j591-jco-2024","kind":"paper","name":"Phase I dose-escalation study of 225Ac-J591, a PSMA-targeting alpha-emitting antibody, in mCRPC","aka":"","tldr":"The first human test of an alpha-emitting radioactive drug attached to an antibody (rather than a small molecule) against PSMA found a safe dose in men with advanced prostate cancer who had exhausted other treatments, and shrank the PSA marker in nearly half of them - including those whose cancer had already stopped responding to the more common lutetium-177 PSMA treatment.","tags":"alpha therapy prostate cancer phase 1","route":"/key-papers/paper-tagawa-ac225-j591-jco-2024/"},{"id":"scott-tagawa","kind":"person","name":"Scott T. Tagawa","aka":"Scott Tagawa","tldr":"A cancer doctor at Weill Cornell in New York who has spent two decades testing PSMA-targeted radioactive treatments for prostate cancer, from the first antibody versions through to lutetium-177 PSMA-617.","tags":"prostate PSMA clinician","route":"/people/scott-tagawa/"},{"id":"neeta-pandit-taskar","kind":"person","name":"Neeta Pandit-Taskar","aka":"","tldr":"A nuclear medicine doctor who spent 25 years at Memorial Sloan Kettering developing radioactive antibody treatments, including therapies for children with neuroblastoma, before moving to lead nuclear medicine at UPMC Hillman Cancer Center in 2025.","tags":"theranostics radioimmunotherapy clinician","route":"/people/neeta-pandit-taskar/"},{"id":"lisa-bodei","kind":"person","name":"Lisa Bodei","aka":"","tldr":"An Italian-trained nuclear medicine doctor who helped develop the lutetium-177 dotatate treatment for neuroendocrine tumours and now leads targeted radionuclide therapy at Memorial Sloan Kettering in New York.","tags":"neuroendocrine PRRT clinician","route":"/people/lisa-bodei/"},{"id":"matthias-eiber","kind":"person","name":"Matthias Eiber","aka":"","tldr":"A German nuclear medicine physician whose 2015 study of gallium-68 PSMA PET scanning for prostate cancer became one of the most-cited papers in the field, and who now leads theranostics research in Munich.","tags":"PSMA PET clinician","route":"/people/matthias-eiber/"},{"id":"stefano-fanti","kind":"person","name":"Stefano Fanti","aka":"","tldr":"An Italian nuclear medicine professor who built one of Europe's busiest PET centres in Bologna and co-writes the international guidelines that tell doctors when and how to use PSMA PET scans in prostate cancer.","tags":"PSMA guidelines clinician","route":"/people/stefano-fanti/"},{"id":"wolfgang-fendler","kind":"person","name":"Wolfgang P. Fendler","aka":"","tldr":"A German nuclear medicine doctor at Essen who helped design a scoring system, RECIP, for reading follow-up PSMA scans in prostate cancer patients on lutetium therapy, and who co-writes the field's international imaging guidelines.","tags":"PSMA response criteria clinician","route":"/people/wolfgang-fendler/"},{"id":"phillip-kuo","kind":"person","name":"Phillip H. Kuo","aka":"","tldr":"A nuclear medicine physician who helped write the eligibility scans used to select prostate cancer patients for the VISION trial of lutetium-177 PSMA-617, and who also sets national standards for brain PET scans used in Alzheimer's disease.","tags":"PSMA theranostics brain PET clinician","route":"/people/phillip-kuo/"},{"id":"heiko-schoder","kind":"person","name":"Heiko Schöder","aka":"Heiko Schoder","tldr":"A nuclear medicine doctor who runs the molecular imaging service at Memorial Sloan Kettering and has spent years studying how PET scans taken partway through chemotherapy for lymphoma can predict which patients need more or less treatment.","tags":"lymphoma FDG PET clinician","route":"/people/heiko-schoder/"},{"id":"andrei-iagaru","kind":"person","name":"Andrei Iagaru","aka":"","tldr":"A Stanford nuclear medicine professor who led the division for a decade and has published widely on new PET tracers, from FAPI scans of fibrosis-related proteins to whole-body PET scanners that image the entire body at once.","tags":"PSMA FAPI total-body PET clinician","route":"/people/andrei-iagaru/"},{"id":"delphine-chen","kind":"person","name":"Delphine L. Chen","aka":"","tldr":"A Seattle-based nuclear medicine physician-scientist who ran the first human trial of a PET tracer that shows whether a tumour will respond to PARP-inhibitor drugs, and who now directs nuclear medicine and molecular imaging therapy at the Fred Hutchinson Cancer Center.","tags":"PARP PET clinician-scientist","route":"/people/delphine-chen/"},{"id":"erik-mittra","kind":"person","name":"Erik S. Mittra","aka":"","tldr":"A Stanford-trained nuclear medicine doctor who leads the theranostics programme at Oregon Health & Science University and treats neuroendocrine tumour patients with radioactive peptide therapy.","tags":"neuroendocrine PRRT clinician","route":"/people/erik-mittra/"},{"id":"amir-iravani","kind":"person","name":"Amir Iravani","aka":"","tldr":"A nuclear medicine physician-scientist who worked on the practice-changing TheraP and LuPSMA trials in Australia and has moved through Fred Hutchinson to UCLA in 2026 to build a new hospital theranostics programme.","tags":"PSMA theranostics clinician","route":"/people/amir-iravani/"},{"id":"rodney-hicks","kind":"person","name":"Rodney J. Hicks","aka":"","tldr":"An Australian nuclear medicine pioneer who built Peter MacCallum Cancer Centre's molecular imaging and therapy service into a world-renowned unit over three decades, and now runs an independent theranostics centre in Melbourne.","tags":"PSMA theranostics clinician","route":"/people/rodney-hicks/"},{"id":"dale-bailey","kind":"person","name":"Dale L. Bailey","aka":"","tldr":"An Australian medical physicist who helped prove that SPECT scans, not just PET scans, can measure exact amounts of radioactivity in the body, which underpins accurate dosing of radioactive cancer treatments.","tags":"physics dosimetry SPECT","route":"/people/dale-bailey/"},{"id":"michael-lassmann","kind":"person","name":"Michael Lassmann","aka":"","tldr":"A German medical physicist who has led the physics section of Würzburg's nuclear medicine department for three decades and helped set the international standards used to calculate radiation doses from radioactive cancer treatments.","tags":"physics dosimetry","route":"/people/michael-lassmann/"},{"id":"alpha-therapy-roadmap","kind":"roadmap","name":"Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline","aka":"","tldr":"Alpha particles carry much more energy over a much shorter distance than the beta particles used in Lutathera and Pluvicto, so they can be more powerful against small clusters of cancer cells. The first alpha drug was approved in 2013; a wave of alpha versions of existing beta drugs is now in late-stage testing, and the isotopes are still scarce.","tags":"","route":"/roadmaps/alpha-therapy-roadmap/"},{"id":"isotope-supply-roadmap","kind":"roadmap","name":"Isotope supply roadmap: reactor dependence → non-uranium production → accelerator-made actinium","aka":"","tldr":"The radioactive ingredients that make theranostics work come from a small number of ageing nuclear reactors, generators and accelerators around the world. A shortage anywhere in that chain delays cancer scans and treatments; new non-uranium and accelerator-based production lines are being built to fix that, but they take years and hundreds of millions of dollars.","tags":"","route":"/roadmaps/isotope-supply-roadmap/"},{"id":"dosimetry-roadmap","kind":"roadmap","name":"Dosimetry roadmap: MIRD schema → fixed dosing → personalised, image-based dose","aka":"","tldr":"Working out how much radiation a treatment actually delivers to a tumour and to healthy organs, rather than just giving everyone the same fixed amount, could let doctors treat some patients more and some less. The tools to do this patient by patient exist and are used in some specialist centres, but most approved radioligand therapies are still given at one fixed dose to everyone.","tags":"","route":"/roadmaps/dosimetry-roadmap/"},{"id":"sstr-theranostics-roadmap","kind":"roadmap","name":"SSTR theranostics roadmap: octreotide scintigraphy → 68Ga-DOTATATE → 177Lu-DOTATATE → alpha","aka":"","tldr":"Neuroendocrine tumours were the proving ground for the whole idea of theranostics: find a receptor on the tumour, image it with a low-dose radioactive scan, then treat with a matched higher-dose version of the same molecule. That sequence took thirty years to build and is now being extended with more powerful alpha-particle versions.","tags":"","route":"/roadmaps/sstr-theranostics-roadmap/","indications":"neuroendocrine pancreatic-net small-intestinal-net meningioma"},{"id":"psma-theranostics-roadmap","kind":"roadmap","name":"PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha","aka":"","tldr":"Prostate-specific membrane antigen was found on prostate cancer cells in 1987. It took until 2020-2022 for scans and treatments that target it to reach approval, but once they did, PSMA PET and Pluvicto changed how metastatic prostate cancer is staged and treated, and the same target is now being tried earlier in the disease and with more powerful alpha particles.","tags":"","route":"/roadmaps/psma-theranostics-roadmap/","indications":"prostate prostate-mcrpc"},{"id":"neuro-imaging-roadmap","kind":"roadmap","name":"Neuro-oncology imaging roadmap: FDG PET → amino acid PET → SSTR2 theranostics in meningioma","aka":"","tldr":"Ordinary sugar-based PET scans do not work well in the brain because healthy brain tissue itself uses a lot of sugar. Nuclear medicine had to develop tracers that light up brain tumours specifically, first amino acid tracers for gliomas and then a receptor tracer that also opens the door to a matched radioactive treatment for meningioma.","tags":"","route":"/roadmaps/neuro-imaging-roadmap/","indications":"glioblastoma meningioma"},{"id":"caix","kind":"target","name":"CAIX (carbonic anhydrase IX)","aka":"CA9 G250 antigen MN antigen","tldr":"A protein that clear cell kidney cancer makes almost all the time because of a gene fault. It helps the tumour survive in low-oxygen conditions, and antibodies that stick to it can be used to find or treat the cancer.","tags":"renal cell carcinoma hypoxia antibody target","route":"/targets/caix/"},{"id":"nis-symporter","kind":"target","name":"NIS (sodium-iodide symporter)","aka":"Sodium/iodide cotransporter SLC5A5","tldr":"A protein in the thyroid that pulls iodine out of the blood to make thyroid hormone. It is the reason radioactive iodine can find and treat thyroid cancer almost anywhere in the body.","tags":"thyroid ion transporter theranostics","route":"/targets/nis-symporter/"},{"id":"norepinephrine-transporter","kind":"target","name":"Norepinephrine transporter (NET)","aka":"NET Noradrenaline transporter","tldr":"A protein on nerve cells and adrenal-type tumour cells that pulls noradrenaline back inside after it has been released. A radioactive drug called MIBG looks and acts enough like noradrenaline that this same protein carries it into neuroblastoma and phaeochromocytoma cells, so doctors can see or treat the tumour.","tags":"neuroendocrine paediatric transporter","route":"/targets/norepinephrine-transporter/"},{"id":"amyloid-beta","kind":"target","name":"Amyloid beta plaques","aka":"Aβ beta-amyloid neuritic plaques","tldr":"Sticky clumps of protein that build up in the brain in Alzheimer's disease. PET scans using tracers that bind these clumps can show a doctor how much amyloid is present, well before it would show up on a brain biopsy.","tags":"neurology Alzheimer's disease protein aggregate","route":"/targets/amyloid-beta/"},{"id":"tau-protein","kind":"target","name":"Tau protein (neurofibrillary tangles)","aka":"PHF-tau aggregated tau NFTs","tldr":"A protein that normally helps hold nerve cells together but, in Alzheimer's disease, twists into tangles inside the cells. A PET tracer called flortaucipir binds these tangles so doctors can see how far the disease has spread in the brain.","tags":"neurology Alzheimer's disease protein aggregate","route":"/targets/tau-protein/"},{"id":"dopamine-transporter","kind":"target","name":"Dopamine transporter (DAT)","aka":"DAT","tldr":"A protein on the ends of brain cells that make dopamine, which recycles the dopamine after it has done its job. A scan using a tracer that sticks to this protein can show whether those brain cells are dying, which happens in Parkinson's disease.","tags":"neurology Parkinson's disease transporter","route":"/targets/dopamine-transporter/"},{"id":"bone-hydroxyapatite","kind":"target","name":"Bone mineral (hydroxyapatite)","aka":"Hydroxyapatite bone mineral matrix","tldr":"The hard mineral that makes up bone. Certain radioactive drugs stick to this mineral wherever bone is being actively rebuilt, which is how bone scans find fractures, infection and cancer that has spread to bone, and how some treatments deliver radiation straight to bone metastases.","tags":"bone mineral palliation","route":"/targets/bone-hydroxyapatite/"},{"id":"glut-hexokinase","kind":"target","name":"GLUT1 / hexokinase (glucose metabolism)","aka":"GLUT1 SLC2A1 hexokinase II HK2","tldr":"The two-step system cells use to pull in and lock up glucose for energy. Many cancers rely on this system much more heavily than normal tissue, and a radioactive sugar look-alike called FDG exploits it to light up tumours on a PET scan.","tags":"metabolism glycolysis pan-cancer","route":"/targets/glut-hexokinase/"},{"id":"integrin-avb3","kind":"target","name":"Integrin αvβ3","aka":"Integrin alpha-v beta-3 vitronectin receptor","tldr":"A docking protein on the surface of cells that are building new blood vessels, including the blood vessels a growing tumour needs. Peptides that mimic the docking sequence (RGD) can be radiolabelled to see where this new blood-vessel growth, or the tumour cells themselves, are most active.","tags":"angiogenesis integrin RGD peptide","route":"/targets/integrin-avb3/"},{"id":"cck2-receptor","kind":"target","name":"CCK2 receptor (gastrin receptor)","aka":"CCK2R CCK-B receptor gastrin receptor","tldr":"A docking site for the hormone gastrin, found at very high numbers on medullary thyroid cancer cells. Minigastrin-like radioactive drugs can bind it to find or treat that cancer, though they also light up the stomach because the same receptor lines it normally.","tags":"neuroendocrine thyroid GPCR","route":"/targets/cck2-receptor/"},{"id":"upar","kind":"target","name":"uPAR (urokinase plasminogen activator receptor)","aka":"uPAR PLAUR","tldr":"A protein that helps cancer cells break through surrounding tissue and spread. Higher amounts on a tumour are linked to more aggressive disease, and a PET tracer built on a small peptide can measure how much of it a tumour has.","tags":"invasion prostate cancer prognostic biomarker","route":"/targets/upar/"},{"id":"mesothelin","kind":"target","name":"Mesothelin (MSLN)","aka":"MSLN","tldr":"A protein normally found only on the thin lining of the chest and abdomen, but made in large amounts by mesothelioma and by most pancreatic and many ovarian cancers. Because healthy organs barely make it, it is an attractive handle for antibody-based imaging and treatment.","tags":"mesothelioma pancreatic cancer ovarian cancer antibody target","route":"/targets/mesothelin/"},{"id":"her3","kind":"target","name":"HER3 (ERBB3)","aka":"ERBB3 erb-b2 receptor tyrosine kinase 3","tldr":"A receptor on the surface of most lung cancer cells that helps tumours resist treatment. Drugs aimed at it exist, but measuring how much of it a tumour carries has so far failed to predict who benefits.","tags":"adc-target resistance lung","route":"/targets/her3/","indications":"nsclc"},{"id":"cldn18-2","kind":"target","name":"Claudin-18.2","aka":"CLDN18.2 claudin 18 isoform 2 CLDN18","tldr":"A protein that seals the gaps between stomach lining cells. It stays on many stomach cancers as they spread, and two approved treatments are given only to patients whose biopsy shows it.","tags":"adc-target car-t-target companion diagnostic gastric","route":"/targets/cldn18-2/","indications":"gastric-oesophageal-cancer"},{"id":"alpha-synuclein","kind":"target","name":"Alpha-synuclein","aka":"a-synuclein SNCA alpha synuclein aggregates","tldr":"The protein that clumps inside brain cells in Parkinson's disease and related conditions. Nobody can yet see those clumps in a living person, which is why these diseases are still diagnosed by watching the patient.","tags":"neurology protein aggregate unmet need","route":"/targets/alpha-synuclein/","indications":"parkinsonian-syndromes"},{"id":"tpbg-5t4","kind":"target","name":"5T4 (trophoblast glycoprotein)","aka":"5T4 TPBG 5T4 oncofetal antigen WAIF1","tldr":"A protein the placenta makes during pregnancy that many cancers switch back on while most healthy adult tissue does not. Antibody-drug conjugates against it have been tested in patients, and since 2024 the first radiolabelled versions have reached people in China.","tags":"oncofetal antigen antibody target ADC-validated China","route":"/targets/tpbg-5t4/","indications":"colorectal-cancer pancreatic-cancer prostate-mcrpc prostate-nepc"},{"id":"sortilin","kind":"target","name":"Sortilin (SORT1)","aka":"SORT1 Neurotensin receptor 3 NTSR3 Gp95","tldr":"A receptor that pulls molecules into cells and is found at high levels in several cancers, including ovarian, endometrial and triple-negative breast cancer. A peptide-drug conjugate against it is in a phase 1 trial, and the first radioactive pair (one version for scans, one for treatment) was published in 2026.","tags":"internalising receptor peptide-drug conjugate theranostic pair","route":"/targets/sortilin/","indications":"breast-triple-negative"},{"id":"bradykinin-b1-receptor","kind":"target","name":"Bradykinin B1 receptor (B1R)","aka":"B1R BDKRB1 BKR1 B1BKR","tldr":"A receptor that healthy tissue barely makes but inflammation and many cancers switch on. Gallium-68 and fluorine-18 peptides built from B1R-blocking drugs give sharp PET images in mice, but no B1R tracer has been given to a patient.","tags":"GPCR peptide receptor preclinical only unmet need","route":"/targets/bradykinin-b1-receptor/","indications":"glioblastoma"},{"id":"dlg4-psd95","kind":"target","name":"DLG4 (PSD-95)","aka":"PSD-95 PSD95 SAP90 postsynaptic density protein 95 DLG4","tldr":"The main scaffold protein on the receiving side of brain synapses. Losing synapses tracks memory decline in Alzheimer's disease, but today's synapse PET scans only see the sending side (SV2A). No tracer for PSD-95 has been published, so the receiving side cannot yet be imaged.","tags":"neurology synaptic density no tracer yet unmet need","route":"/targets/dlg4-psd95/","indications":"alzheimers-disease"},{"id":"dota-chelation","kind":"technology","name":"DOTA chelation","aka":"DOTA 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid","tldr":"DOTA is a small ring-shaped molecule that grips a radioactive metal atom tightly inside its cage, so the metal stays attached to the drug instead of drifting off into the body.","tags":"chemistry chelator","route":"/technologies/dota-chelation/"},{"id":"macropa-chelation","kind":"technology","name":"Macropa chelation","aka":"H2macropa bp18c6","tldr":"Macropa is a newer ring-shaped molecule built specifically to grip large radioactive metal atoms, such as the alpha-emitter actinium-225, quickly and at room temperature, which older molecules like DOTA cannot do well.","tags":"chemistry chelator alpha therapy","route":"/technologies/macropa-chelation/"},{"id":"sarcophagine-chelation","kind":"technology","name":"Sarcophagine chelation","aka":"Sar cage amine chelator MeCOSar","tldr":"Sarcophagine is a cage-shaped molecule that locks copper atoms inside so tightly that the copper cannot escape once the imaging or treatment dose is made, even inside the body.","tags":"chemistry chelator copper-64","route":"/technologies/sarcophagine-chelation/"},{"id":"pretargeted-radioimmunotherapy","kind":"technology","name":"Pretargeted radioimmunotherapy","aka":"PRIT pretargeting","tldr":"Instead of attaching radioactivity directly to a slow-moving antibody, doctors first inject the antibody alone, let it find the tumour and clear from the blood over some days, then inject a small fast-clearing radioactive tag that clicks onto the antibody only where it has stuck to the tumour.","tags":"chemistry radioimmunotherapy click chemistry","route":"/technologies/pretargeted-radioimmunotherapy/"},{"id":"albumin-binder-ligands","kind":"technology","name":"Albumin-binder ligands","aka":"albumin-binding moiety Evans blue conjugate IPBA conjugate","tldr":"Attaching a small chemical 'hook' that grips the body's own albumin protein makes a radioactive drug stay in the bloodstream for longer, so more of it reaches the tumour before it is cleared out through the kidneys.","tags":"chemistry pharmacokinetics PSMA","route":"/technologies/albumin-binder-ligands/"},{"id":"radiohybrid-chemistry","kind":"technology","name":"Radiohybrid (rh) chemistry","aka":"rhPSMA SiFA chemistry silicon fluoride acceptor","tldr":"A radiohybrid molecule carries two possible attachment points, one for a fast PET-friendly radioactive fluorine tag and one for a radioactive metal used for treatment, so the imaging and treatment versions of the drug are chemically identical twins.","tags":"chemistry PET PSMA","route":"/technologies/radiohybrid-chemistry/"},{"id":"mo99-tc99m-generators","kind":"technology","name":"Molybdenum-99/technetium-99m generators","aka":"Mo-99/Tc-99m generator technetium cow","tldr":"A shielded column device lets hospitals 'milk' the world's most-used medical radioisotope, technetium-99m, fresh every day from a longer-lived parent isotope that is shipped to them from a reactor.","tags":"generator technetium supply chain","route":"/technologies/mo99-tc99m-generators/"},{"id":"ge68-ga68-generators","kind":"technology","name":"Germanium-68/gallium-68 generators","aka":"68Ge/68Ga generator GalliaPharm","tldr":"A compact column loaded with a long-lasting parent isotope lets a PET radiopharmacy produce fresh gallium-68, used in scans such as PSMA and DOTATATE PET, on demand without needing a cyclotron.","tags":"generator gallium-68 PET","route":"/technologies/ge68-ga68-generators/"},{"id":"sr82-rb82-generators","kind":"technology","name":"Strontium-82/rubidium-82 generators","aka":"82Sr/82Rb generator CardioGen-82 RUBY-FILL","tldr":"A generator produces a very short-lived radioactive potassium-like tracer on demand at the bedside, allowing a heart PET scan to be finished in minutes without needing an on-site cyclotron.","tags":"generator cardiac PET rubidium-82","route":"/technologies/sr82-rb82-generators/"},{"id":"automated-synthesis-modules","kind":"technology","name":"Automated synthesis modules","aka":"TRACERlab FASTlab cassette-based radiosynthesizer","tldr":"A shielded robotic 'chemistry-in-a-box' machine mixes and purifies radioactive drugs behind thick walls, so staff never have to handle dangerous, highly radioactive liquids by hand.","tags":"manufacturing PET GMP","route":"/technologies/automated-synthesis-modules/"},{"id":"hot-cells-and-shielding","kind":"technology","name":"Hot cells and radiation shielding","aka":"hot cell L-block radiopharmacy shielding","tldr":"Radioactive drugs are made and handled behind thick walls of lead, tungsten or concrete inside sealed, negative-pressure boxes with built-in robot arms, so the radiation stays contained and staff outside stay safe.","tags":"radiation safety manufacturing GMP","route":"/technologies/hot-cells-and-shielding/"},{"id":"quantitative-spect","kind":"technology","name":"Quantitative SPECT","aka":"qSPECT SPECT/CT quantification","tldr":"Modern gamma-camera scans can now be turned into maps of exactly how much radioactivity (in becquerels) sits in each part of the body, not just a picture, which is what lets doctors calculate a real radiation dose to a tumour or organ.","tags":"dosimetry imaging physics SPECT","route":"/technologies/quantitative-spect/"},{"id":"monte-carlo-dosimetry","kind":"technology","name":"Monte Carlo dosimetry","aka":"GATE MCNP voxel S-values","tldr":"Powerful computer simulations trace millions of individual particles of radiation as they fly through a virtual copy of a patient's body, giving the most detailed and realistic estimate of exactly how much radiation dose each organ and tumour actually receives.","tags":"dosimetry simulation physics","route":"/technologies/monte-carlo-dosimetry/"},{"id":"spect-dosimetry-workflow","kind":"technology","name":"SPECT dosimetry workflow for radionuclide therapy","aka":"post-therapy dosimetry EANM dosimetry SOP","tldr":"After a radioactive treatment injection, patients are scanned two or three times over about a week so doctors can calculate exactly how much radiation dose the tumour and organs like the kidneys actually received, and adjust future doses if needed.","tags":"dosimetry clinical protocol PRRT","route":"/technologies/spect-dosimetry-workflow/"},{"id":"ai-in-nuclear-medicine","kind":"technology","name":"AI in nuclear medicine","aka":"deep learning PET/SPECT aPROMISE","tldr":"Computer software trained on thousands of scans can now automatically outline tumours on PET and SPECT images in seconds instead of the 30-45 minutes it takes a doctor, though a specialist still checks the result.","tags":"AI imaging PSMA","route":"/technologies/ai-in-nuclear-medicine/"},{"id":"cold-kit-formulation","kind":"technology","name":"Cold kit formulation","aka":"technetium cold kit lyophilised radiopharmaceutical kit","tldr":"Many everyday radioactive scan drugs come as a freeze-dried powder in a sealed vial; the hospital pharmacy just adds the freshly produced radioactive solution and the finished injectable drug forms in minutes, no chemistry lab required.","tags":"manufacturing cold kit technetium","route":"/technologies/cold-kit-formulation/"},{"id":"radiolabelling-quality-control","kind":"technology","name":"Radiolabelling quality control","aka":"radiochemical purity testing radio-TLC radio-HPLC","tldr":"Before any radioactive drug is given to a patient, a quick chemistry test checks that the radioactive atom is properly and completely attached to the drug molecule, rather than floating free, because free radioactivity goes to the wrong place in the body.","tags":"quality control GMP chemistry","route":"/technologies/radiolabelling-quality-control/"},{"id":"alpha-daughter-redistribution","kind":"technology","name":"Alpha-emitter daughter redistribution ('free daughter' problem)","aka":"nuclear recoil effect free daughter problem","tldr":"When an alpha-emitting radioactive drug decays inside the body, the recoil kick is so strong that the leftover radioactive fragment breaks loose from the drug and can drift to organs like the kidneys, causing side effects the original drug was never meant to cause.","tags":"alpha therapy chemistry toxicity","route":"/technologies/alpha-daughter-redistribution/"},{"id":"krenning-score","kind":"term","name":"Krenning score","aka":"","tldr":"A 0-to-4 scale doctors use to describe how strongly a tumour lights up on a somatostatin receptor scan, by comparing it with the normal liver and spleen. A higher score generally means the tumour is a good candidate for peptide receptor radionuclide therapy.","tags":"scoring system SSTR imaging PRRT eligibility","route":"/terms/krenning-score/"},{"id":"psma-rads","kind":"term","name":"PSMA-RADS (PSMA reporting and data system)","aka":"","tldr":"A standard 1-to-5 scale that nuclear medicine doctors use to describe how likely a spot seen on a PSMA PET scan is to be prostate cancer, so different hospitals describe the same finding the same way.","tags":"reporting system PSMA PET structured reporting","route":"/terms/psma-rads/"},{"id":"deauville-for-pet","kind":"term","name":"Deauville five-point scale for PET","aka":"","tldr":"A simple 1-to-5 score doctors use on a PET scan of lymphoma to say whether treatment is working, by comparing how bright the tumour looks against two normal reference areas: the blood in the chest and the liver.","tags":"response criteria lymphoma FDG PET","route":"/terms/deauville-for-pet/"},{"id":"tumour-to-background-ratio","kind":"term","name":"Tumour-to-background ratio (TBR)","aka":"","tldr":"A simple number that says how much brighter a tumour looks on a scan compared with the normal tissue around it or nearby. A higher ratio makes a tumour easier to see and count.","tags":"quantitative imaging SUV response assessment","route":"/terms/tumour-to-background-ratio/"},{"id":"fixed-versus-personalised-dosing","kind":"term","name":"Fixed versus personalised (dosimetry-guided) dosing","aka":"","tldr":"Most radioactive cancer treatments today give every patient the same amount, on the same schedule, regardless of body size. Researchers are testing whether measuring how much radiation reaches a patient's kidneys and tumours, and adjusting the dose accordingly, works better and is safer.","tags":"dosimetry PRRT individualised therapy","route":"/terms/fixed-versus-personalised-dosing/"},{"id":"salivary-gland-toxicity","kind":"term","name":"Salivary gland toxicity (xerostomia) from PSMA radioligand therapy","aka":"","tldr":"PSMA radioligand therapy can dry out the mouth because normal salivary glands pick up a small amount of the drug along with the tumour. It's very common but usually mild, and is one of the main reasons patients ask about the treatment beforehand.","tags":"adverse effect PSMA therapy quality of life","route":"/terms/salivary-gland-toxicity/"},{"id":"renal-protection-amino-acids","kind":"term","name":"Renal protection with amino acid co-infusion","aka":"","tldr":"Before a peptide receptor radionuclide therapy infusion, patients are given an IV drip of two amino acids, lysine and arginine, which reduces how much radioactivity the kidneys reabsorb and hold onto, protecting kidney function.","tags":"nephroprotection PRRT supportive care","route":"/terms/renal-protection-amino-acids/"},{"id":"myelosuppression-after-rlt","kind":"term","name":"Myelosuppression after radioligand therapy","aka":"","tldr":"Radioactive cancer treatments that circulate through the blood also irradiate bone marrow, so blood counts (red cells, white cells, platelets) can drop. Doctors check blood counts regularly and pause or reduce treatment if counts fall too far.","tags":"adverse effect haematology radioligand therapy","route":"/terms/myelosuppression-after-rlt/"},{"id":"extravasation-radiopharmaceutical","kind":"term","name":"Radiopharmaceutical extravasation","aka":"","tldr":"Sometimes an injected radioactive tracer or treatment leaks into the tissue around the vein instead of going into the bloodstream. For scanning tracers this usually just affects image quality; for treatment doses it can occasionally injure the skin and needs prompt attention.","tags":"injection safety adverse event NRC","route":"/terms/extravasation-radiopharmaceutical/"},{"id":"radiation-safety-officer","kind":"term","name":"Radiation Safety Officer (RSO)","aka":"","tldr":"Every US clinic or hospital that uses radioactive drugs must have one named, specially qualified person responsible for making sure radiation is used and stored safely.","tags":"NRC 10 CFR Part 35 radiation protection programme","route":"/terms/radiation-safety-officer/"},{"id":"authorized-user","kind":"term","name":"Authorized User (AU)","aka":"","tldr":"In the US, only a physician who has completed specific radiation training and case experience, and who is named on the clinic's license, is legally allowed to order and give radioactive drugs to patients.","tags":"NRC 10 CFR Part 35 physician credentialing","route":"/terms/authorized-user/"},{"id":"alara","kind":"term","name":"ALARA (as low as is reasonably achievable)","aka":"","tldr":"A rule that radiation should always be kept as low as practically possible, not just below the legal limit, taking into account cost, technology and benefit.","tags":"NRC radiation protection 10 CFR Part 20","route":"/terms/alara/"},{"id":"hot-lab","kind":"term","name":"Hot lab (radiopharmacy dispensing area)","aka":"","tldr":"The specially shielded room in a hospital or radiopharmacy where radioactive drugs are received, checked, prepared and measured before they are given to patients.","tags":"radiopharmacy shielding facility design","route":"/terms/hot-lab/"},{"id":"dose-calibrator","kind":"term","name":"Dose calibrator","aka":"","tldr":"A shielded instrument that measures exactly how much radioactivity is in a syringe or vial before it's given to a patient, so the dose matches the prescription.","tags":"NRC quality control instrumentation","route":"/terms/dose-calibrator/"},{"id":"radiopharmacy-term","kind":"term","name":"Radiopharmacy (practice and discipline)","aka":"","tldr":"Radiopharmacy is the specialised branch of pharmacy that prepares radioactive drugs safely, correctly and on time, since these medicines decay and can't simply be reordered from a shelf.","tags":"USP <825> compounding quality control","route":"/terms/radiopharmacy-term/"},{"id":"release-criteria","kind":"term","name":"Product release criteria (radiopharmaceutical quality control)","aka":"","tldr":"Before any batch of radioactive drug can be given to a patient, it has to pass a checklist of quality tests, such as being the right radioactive strength, sterile, and chemically pure.","tags":"USP <825> quality control GMP","route":"/terms/release-criteria/"},{"id":"nrc-licensing","kind":"term","name":"NRC medical-use licensing (10 CFR Part 35)","aka":"","tldr":"Any US clinic that wants to use radioactive drugs for patients must first get a specific license, either from the federal Nuclear Regulatory Commission or from the state government where it's located, proving it can handle the material safely.","tags":"NRC 10 CFR Part 35 Agreement States","route":"/terms/nrc-licensing/"},{"id":"patient-release-criteria","kind":"term","name":"Patient release criteria after radioactive treatment","aka":"","tldr":"After certain radioactive treatments, US rules set a specific radiation limit that must be checked before a patient can safely go home, and if the dose to a household member could exceed a lower limit, the patient gets written safety instructions (including, if relevant, guidance on breastfeeding).","tags":"NRC 10 CFR 35.75 patient discharge","route":"/terms/patient-release-criteria/"},{"id":"theranostic-pair-term","kind":"term","name":"Theranostic pair","aka":"","tldr":"A matched set of two radioactive drugs built on the exact same molecule: one labelled with a radioactive tag good for taking pictures (a PET scan), the other labelled with a different radioactive tag good for treatment, so the scan predicts where the treatment will go.","tags":"theranostics radiochemistry drug pairing","route":"/terms/theranostic-pair-term/"},{"id":"flare-phenomenon","kind":"term","name":"Flare phenomenon","aka":"","tldr":"Right after some cancer treatments start working, a scan can briefly look worse before it looks better, because healing bone or an early immune response makes lesions light up more, not because the cancer has actually grown. Doctors wait and repeat the scan before deciding treatment has failed.","tags":"response assessment bone imaging prostate cancer","route":"/terms/flare-phenomenon/"},{"id":"specific-activity","kind":"term","name":"Specific activity and molar activity","aka":"","tldr":"A measure of how much of a radioactive drug is genuinely radioactive versus how much is ordinary, non-radioactive filler of the same molecule. Higher specific activity means more radioactive atoms are packed onto the targeting molecules, so fewer 'cold' (non-radioactive) copies compete for the same receptors.","tags":"","route":"/terms/specific-activity/"},{"id":"no-carrier-added","kind":"term","name":"No-carrier-added (n.c.a.) and carrier-added production","aka":"","tldr":"A way of describing how 'pure' a batch of radioactive material is: whether ordinary, non-radioactive atoms of the same element were deliberately or accidentally mixed in during manufacture.","tags":"","route":"/terms/no-carrier-added/"},{"id":"chelator-term","kind":"term","name":"Chelator (bifunctional chelating agent)","aka":"","tldr":"A molecular 'cage' that grips a radioactive metal atom tightly so it stays attached to the drug all the way to the tumour, instead of leaking out and going to the wrong part of the body.","tags":"","route":"/terms/chelator-term/"},{"id":"radiochemical-purity","kind":"term","name":"Radiochemical purity (RCP)","aka":"","tldr":"A quality check on a radioactive drug that asks: of all the radioactivity in the vial, what fraction is actually in the correct, working chemical form, rather than stuck to the wrong molecule or floating free?","tags":"","route":"/terms/radiochemical-purity/"},{"id":"radionuclidic-purity","kind":"term","name":"Radionuclidic purity","aka":"","tldr":"A check that the radioactivity in a vial really comes from the intended radioactive element, and not from some other radioactive contaminant left over from how it was made.","tags":"","route":"/terms/radionuclidic-purity/"},{"id":"becquerel-curie","kind":"term","name":"Becquerel and curie (units of radioactivity)","aka":"","tldr":"The two units used to state how radioactive something is. The becquerel (the modern, official unit) counts one radioactive decay per second; the curie (the older unit, still common in the United States) equals 37 billion decays per second.","tags":"","route":"/terms/becquerel-curie/"},{"id":"absorbed-dose-term","kind":"term","name":"Absorbed dose and the gray (Gy)","aka":"","tldr":"A measure of how much radiation energy actually landed in a piece of tissue, not how radioactive the source was. It is what determines whether a tumour or an organ is actually being treated or harmed.","tags":"","route":"/terms/absorbed-dose-term/"},{"id":"equivalent-dose","kind":"term","name":"Equivalent dose and effective dose (sievert)","aka":"","tldr":"A way of converting a physical radiation dose into a single number for comparing radiation risk across different types of radiation and different organs. It is used for radiation-protection purposes, not for prescribing cancer treatment doses.","tags":"","route":"/terms/equivalent-dose/"},{"id":"linear-energy-transfer","kind":"term","name":"Linear energy transfer (LET)","aka":"","tldr":"A measure of how densely a particle of radiation deposits its energy as it travels through tissue. Alpha particles dump their energy in a short, dense burst; beta particles and gamma rays spread it thinly over a much longer track.","tags":"","route":"/terms/linear-energy-transfer/"},{"id":"relative-biological-effectiveness","kind":"term","name":"Relative biological effectiveness (RBE)","aka":"","tldr":"A number that says how much more (or less) biological damage a given amount of one type of radiation causes compared with the same physical amount of a reference radiation. Alpha particles are typically several times more damaging, gray for gray, than the beta particles used in more established radioligand therapies.","tags":"","route":"/terms/relative-biological-effectiveness/"},{"id":"mird-formalism","kind":"term","name":"MIRD formalism","aka":"","tldr":"The standard recipe physicists use to work out how much radiation dose a patient's organs and tumours actually received from an injected radioactive drug, based on how long it stayed in the body and where it went.","tags":"","route":"/terms/mird-formalism/"},{"id":"time-activity-curve","kind":"term","name":"Time-activity curve (TAC)","aka":"","tldr":"A graph of how much of an injected radioactive drug is present in an organ or tumour at different times after the injection. It shows the drug arriving, peaking and then clearing out, and it is the raw data that personalised radiation-dose calculations are built from.","tags":"","route":"/terms/time-activity-curve/"},{"id":"biological-half-life","kind":"term","name":"Biological half-life","aka":"","tldr":"The time it takes the body to clear out half of a substance through ordinary biological processes (metabolism and excretion), separate from any radioactive decay. A drug that the kidneys clear quickly has a short biological half-life regardless of which radioactive atom is attached to it.","tags":"","route":"/terms/biological-half-life/"},{"id":"effective-half-life","kind":"term","name":"Effective half-life","aka":"","tldr":"The real-world time it takes for the radioactivity in a patient's organ to fall by half, combining both the radioactive atom's own decay and the body's own clearance of the drug. It is always shorter than either process acting alone, and it is the number that actually drives how much radiation dose an organ receives.","tags":"","route":"/terms/effective-half-life/"},{"id":"radiolysis","kind":"term","name":"Radiolysis (self-radiolysis of radiopharmaceuticals)","aka":"","tldr":"A radioactive drug can damage itself: the radiation it gives off breaks apart water and other molecules in the vial, creating reactive fragments that attack the drug molecule and reduce how much of it is still working correctly by the time it reaches the patient.","tags":"","route":"/terms/radiolysis/"},{"id":"decay-correction","kind":"term","name":"Decay correction","aka":"","tldr":"Adjusting a radioactivity measurement to account for the fact that the sample kept decaying between the moment it was measured and the moment you actually care about, such as when the dose was drawn up versus when it was injected, or between two scans taken hours apart.","tags":"","route":"/terms/decay-correction/"},{"id":"partial-volume-effect","kind":"term","name":"Partial volume effect (PVE)","aka":"","tldr":"A PET or SPECT scan can make small tumours or lesions look fainter than they really are, simply because the scanner cannot see fine detail perfectly; the true 'brightness' gets smeared out over a wider area, especially in objects smaller than about 1-2 cm.","tags":"","route":"/terms/partial-volume-effect/"},{"id":"attenuation-correction","kind":"term","name":"Attenuation correction","aka":"","tldr":"Radiation coming from deep inside the body has to pass through more tissue to reach the scanner's detectors than radiation from near the skin, so without correction, deep organs look falsely dim. Attenuation correction uses a separate scan (usually a CT) to fix this and make the image quantitatively accurate.","tags":"","route":"/terms/attenuation-correction/"},{"id":"time-of-flight-pet","kind":"term","name":"Time-of-flight (TOF) PET","aka":"","tldr":"A more precise kind of PET scanner that measures the tiny difference in arrival time between the two flashes of light produced by each radioactive decay, which helps pinpoint where in the body the decay happened and produces clearer, less noisy images, especially in larger patients.","tags":"","route":"/terms/time-of-flight-pet/"},{"id":"activity-prescription","kind":"term","name":"Activity prescription: fixed versus dosimetry-guided dosing","aka":"","tldr":"Deciding how much radioactive drug to give a patient. Most approved radioligand therapies today use the same fixed amount for everyone, but some clinics instead measure each patient's own radiation exposure and adjust the amount up or down to try to give more benefit with less harm.","tags":"","route":"/terms/activity-prescription/"},{"id":"zircon","kind":"trial","name":"ZIRCON","aka":"89Zr-girentuximab phase 3 trial","tldr":"A single PET scan with a radioactive antibody (89Zr-girentuximab, brand TLX250-CDx) can tell whether an unexplained kidney lump is a clear cell kidney cancer before surgery, so some patients might be spared an unnecessary biopsy or operation.","tags":"diagnostic trial renal cell carcinoma immuno-PET","route":"/trials/zircon/","status":"completed"},{"id":"lighthouse","kind":"trial","name":"LIGHTHOUSE","aka":"18F-rhPSMA-7.3 newly diagnosed prostate cancer trial","tldr":"A PET scan using a PSMA-targeting tracer (later approved as Posluma) was tested in men newly diagnosed with high-risk prostate cancer to see how well it spots cancer that has already spread to lymph nodes or elsewhere in the body before surgery.","tags":"diagnostic trial prostate cancer staging","route":"/trials/lighthouse/","status":"completed"},{"id":"spotlight","kind":"trial","name":"SPOTLIGHT","aka":"18F-rhPSMA-7.3 biochemical recurrence trial","tldr":"A PET scan (the tracer later approved as Posluma) was tested in men whose PSA rose again after treatment for prostate cancer, to see how often it can find exactly where the cancer has come back.","tags":"diagnostic trial prostate cancer biochemical recurrence","route":"/trials/spotlight/","status":"completed"},{"id":"condor","kind":"trial","name":"CONDOR","aka":"18F-DCFPyL biochemical recurrence trial","tldr":"A PET scan using a PSMA tracer (piflufolastat F-18, brand Pylarify) was tested in men whose prostate cancer PSA had risen again but standard scans could not find where, to see how reliably it could locate the recurrence.","tags":"diagnostic trial prostate cancer biochemical recurrence","route":"/trials/condor/","status":"completed"},{"id":"osprey","kind":"trial","name":"OSPREY","aka":"18F-DCFPyL staging and recurrence trial","tldr":"An earlier study of the same PSMA PET scan later branded Pylarify, testing how well it detects lymph node spread before surgery in high-risk prostate cancer, and how well it confirms recurrent or spreading disease when a biopsy is possible.","tags":"diagnostic trial prostate cancer staging","route":"/trials/osprey/","status":"completed"},{"id":"falcon","kind":"trial","name":"FALCON","aka":"18F-fluciclovine biochemical recurrence management trial","tldr":"A PET scan using the tracer fluciclovine (brand Axumin) was tested in UK men whose prostate cancer PSA had risen again, to see how often the scan changed the treatment doctors planned to give.","tags":"diagnostic trial prostate cancer biochemical recurrence management impact","route":"/trials/falcon/","status":"completed"},{"id":"upfront-psma","kind":"trial","name":"UpFrontPSMA","aka":"ANZUP sequential LuPSMA and docetaxel trial","tldr":"In men newly diagnosed with prostate cancer that has already spread widely, giving two doses of the radioactive drug lutetium-PSMA before starting chemotherapy cleared PSA to undetectable levels in more men than chemotherapy alone, without adding side effects.","tags":"radioligand therapy prostate cancer hormone-sensitive first line","route":"/trials/upfront-psma/","status":"active"},{"id":"enza-p","kind":"trial","name":"ENZA-p","aka":"ANZUP 1901","tldr":"Adding the radioactive drug lutetium-PSMA to the hormone drug enzalutamide, with the dose adjusted according to a mid-treatment PET scan, kept prostate cancer under control for longer and helped men with high-risk metastatic disease live longer than enzalutamide on its own.","tags":"radioligand therapy prostate cancer combination therapy adaptive dosing","route":"/trials/enza-p/","status":"active"},{"id":"lutectomy","kind":"trial","name":"LuTectomy","aka":"Neoadjuvant 177Lu-PSMA-617 before radical prostatectomy","tldr":"In men about to have their prostate removed for high-risk cancer, giving one or two doses of the radioactive drug lutetium-PSMA beforehand delivered a meaningful radiation dose straight to the tumour, was well tolerated, and did not make the surgery harder or riskier.","tags":"radioligand therapy prostate cancer neoadjuvant dosimetry","route":"/trials/lutectomy/","status":"active"},{"id":"prince-trial","kind":"trial","name":"PRINCE","aka":"PSMA-lutetium Radionuclide Therapy and ImmuNotherapy in Prostate CancEr","tldr":"Combining the radioactive drug lutetium-PSMA with the immunotherapy drug pembrolizumab produced strong PSA responses in men with advanced, heavily pretreated prostate cancer, with side effects in line with what each drug causes on its own.","tags":"radioligand therapy prostate cancer immunotherapy combination","route":"/trials/prince-trial/","status":"completed"},{"id":"aurora-flurpiridaz","kind":"trial","name":"AURORA","aka":"International Study to Evaluate Diagnostic Efficacy of Flurpiridaz (18F) Injection PET MPI","tldr":"A new PET heart-imaging tracer called flurpiridaz was tested against the standard SPECT heart scan in people with suspected coronary artery disease, and found blocked arteries more reliably, especially in women and people with obesity, while using about half the radiation dose.","tags":"diagnostic trial cardiology PET tracer myocardial perfusion","route":"/trials/aurora-flurpiridaz/","status":"completed"},{"id":"ideas-amyloid","kind":"trial","name":"IDEAS (Imaging Dementia-Evidence for Amyloid Scanning)","aka":"IDEAS study","tldr":"A large US Medicare study asked whether a brain scan that detects amyloid protein (a hallmark of Alzheimer's disease) actually changes what doctors do for patients with memory problems; it found that doctors changed the treatment or diagnosis plan for roughly six in ten patients after seeing the scan.","tags":"diagnostic trial neurology amyloid PET coverage with evidence development","route":"/trials/ideas-amyloid/","status":"completed"}]