Agents & tracers

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.

A second taxane that works after docetaxel and beat a second hormone pill head-to-head (CARD).

A pill that blocks both blood-vessel growth and the MET escape pathway, used in kidney, liver, thyroid and, since 2025, neuroendocrine cancers.

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.

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.

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.

The first chemotherapy to extend life in prostate cancer (2004), now part of triplet therapy at first metastatic diagnosis.

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.

A PD-L1 blocker that became standard after chemoradiation for stage III lung cancer, and now in bladder, biliary, and gastric cancers.

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.

An mTOR-blocking pill that doubled progression-free time with exemestane in 2012 and is now paired with the oral SERD giredestrant.

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.

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.

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.

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.

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.

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.

Flotufolastat is a third PSMA PET tracer, with a radiohybrid chemistry designed to be reused for therapy.

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.

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.

The radioactive sugar used in almost every cancer PET scan, approved in the 1990s and made fresh each day by regional cyclotrons.

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.

A PET scan that shows which breast cancer deposits still have oestrogen receptors, helping decide whether hormone therapy will work when biopsy is impractical.

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.

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.

The PET scan for neuroendocrine tumours that finds far more disease than older scans and confirms eligibility for lutetium radioligand therapy (the theranostic pair).

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.

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.

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.

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.

Telix's ready-to-label kit that lets any nuclear medicine department make the gallium PSMA scan for prostate cancer.

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.

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.

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.

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.

Novartis' gallium PSMA scan kit, approved the same day as Pluvicto as the test that qualifies men for that radioactive drug.

Lutetium-177 dotatate was the first modern radioligand therapy (2018), for neuroendocrine tumours, and is now used in first line.

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.

A radioactive drug that seeks out PSMA on prostate cancer cells; the best-selling radiopharmaceutical ever.

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.

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.

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.

Piflufolastat F-18 (Pylarify) is the leading PSMA PET tracer for prostate cancer, with a new formulation approved in March 2026.

The original targeted radiotherapy: thyroid cells soak up iodine, so radioactive iodine destroys leftover thyroid tissue and metastases while sparing everything else.

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.

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.

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.

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.

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.

The first drug ever to extend life in advanced liver cancer (2007), now mostly a comparator arm that newer combinations are measured against.

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.

Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.

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.

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.

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.

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.

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.

The purpose-built tracer for sentinel lymph node mapping in breast cancer, melanoma and oral cancer, replacing off-label sulfur colloid.

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.

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.

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.

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.

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.

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.

AAA817 is an experimental radioligand therapy from Novartis Pharmaceuticals in phase 3 trials for prostate cancer, aimed at PSMA.

An alpha-particle version of Lutathera for neuroendocrine tumours that have stopped responding to the beta version.

Alpha-emitting PSMA drugs that produce responses even after Pluvicto fails, held back mainly by isotope supply.

AL2846 is an experimental small-molecule drug from Chia Tai Tianqing Pharmaceutical in phase 3 trials for thyroid cancer, aimed at MET and RET.

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.

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.

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.

JNJ-87189401 is an experimental costimulatory agent from Janssen Research & Development in phase 3 trials for prostate cancer, aimed at PSMA.

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.

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.

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.

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.

High-dose radioactive MIBG delivers radiation from inside neuroblastoma cells that take up noradrenaline; used for relapsed disease and tested in upfront therapy.

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.

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.

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.

A FAP-targeted theranostic pair: one version images almost any solid tumour, the other treats it with radiation.

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.

FPI-2265 is an experimental radioligand therapy from Fusion Pharmaceuticals in phase 2 trials for prostate cancer, aimed at PSMA.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.