Actinium-225 PSMA agents
Alpha-emitting PSMA drugs that produce responses even after Pluvicto fails, held back mainly by isotope supply.
Overview
Novartis (225Ac-PSMA-617, phase 3 AcTION), Bayer (225Ac-PSMA-Trillium with albumin binder, PAnTHA phase 1 at ASCO GU 2026), Fusion/AstraZeneca (FPI-2265, 225Ac-PSMA-I&T, phase 3 AlphaBreak), and academic 225Ac-PSMA data from South Africa and Germany. Xerostomia from salivary uptake is dose-limiting.
Ball-and-stick model from PubChem 2D record (no 3D conformer available). PubChem record
PubChem holds the unlabelled ligand, so the radionuclide itself is not in this drawing.
PSMA ligand with 225Ac; four alpha emissions per decay chain. Connects to PSMA.
- PSMA / SSTR-positive cell
1.Radioligand circulates and binds PSMA on tumour cells
- Route
- IV infusion
- Schedule
- Trial regimens ~100 kBq/kg every 6-8 weeks
- Monitoring
- Salivary gland toxicity (xerostomia), renal function, blood counts
Source: clinicaltrials.gov. Doses are for orientation; the current label governs.
Deals
Deal map| Date | Deal | Type | Upfront | Total | Source |
|---|---|---|---|---|---|
| 2024-03-19 | Fusion Pharmaceuticals (AstraZeneca) to AstraZeneca FPI-2265 (actinium-225 PSMA) and the Fusion targeted alpha therapy platform | Acquisition | $21.00 per share in cash, about $2.0bn | up to about $2.4bn including a $3.00 per share contingent value right | source |
Compare all products across the US, EU, UK, Japan, China and Australia →
- Jun 2024Filing / dealUS
AstraZeneca completes Fusion Pharmaceuticals acquisition; FPI-2265 phase 3 planned source
| Adverse event |
|---|
| Xerostomia |
| Anaemia |
| Thrombocytopenia |
| Renal toxicity |
Dose-limiting in academic series. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
| Country | Reimbursement | List price | Assistance |
|---|---|---|---|
| United States | Investigational (phase 3) | not disclosed | - |
| Germany | Compassionate use at selected centres (Heidelberg and others) | not disclosed | - |
List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.
Trials
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Landmark trials
An alpha-emitting radioactive drug built on a PSMA-targeting antibody, rather than the small-molecule ligands used in existing PSMA therapies, was safe enough to move into further testing and shrank PSA in roughly a third to a half of heavily pre-treated men, including some whose cancer had already stopped responding to lutetium-177 PSMA therapy.
This was the first evidence, in two patients, that attaching a more powerful (alpha-emitting) form of radiation to the same PSMA-seeking molecule used in lutetium-177 PSMA therapy could produce a complete response even in prostate cancer that had already stopped responding to the beta-emitter version.
Latest papers
topQuery for this drug: (TITLE:"Actinium-225 PSMA agents" OR ABSTRACT:"Actinium-225 PSMA agents" OR TITLE:"225Ac-PSMA-617" OR ABSTRACT:"225Ac-PSMA-617" OR TITLE:"225Ac-PSMA-I&T" OR ABSTRACT:"225Ac-PSMA-I&T" OR TITLE:"BAY 3563254 Trillium" OR ABSTRACT:"BAY 3563254 Trillium") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Actinium-225 PSMA agents, not a curated reading list.
Similar pages
not linked directly; found by shared links- CompanyTerraPower Isotopes
Shares Recover legacy radium-226 sources worldwide as the feedstock for actinium-225, Actinium-225 supply, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, Radiopharmaceutical roadmap: iodine → lutetium → actinium.
- AgentFPI-2265
Shares Phase Ib/II Platform Study of Multiple Anti-Cancer Agents in Participants With Metastatic Prostate Cancer, AstraZeneca, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, Actinium-225 supply: thorium stocks, accelerators and radium targets.
- CompanyOrano Med
Shares Recover legacy radium-226 sources worldwide as the feedstock for actinium-225, Actinium-225 supply, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, Radiopharmaceutical roadmap: iodine → lutetium → actinium.
- AgentActinium-225 DOTATATE
Shares Recover legacy radium-226 sources worldwide as the feedstock for actinium-225, Beta radioligand → alpha radioligand, Actinium-225 supply, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline.
- CompanyRayzeBio (BMS)
Shares Actinium-225 supply, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, Radiopharmaceutical roadmap: iodine → lutetium → actinium, Actinium-225 supply: thorium stocks, accelerators and radium targets.
- PersonUwe Haberkorn
Shares 177Lu-PSMA-617 then 225Ac-PSMA rescue therapy, 225Ac-PSMA-617 for PSMA-targeted alpha-radiation therapy of metastatic castration-resistant prostate cancer, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha.
- AgentActinium-225 FPI-2068
Shares Fusion Pharmaceuticals (AstraZeneca), AstraZeneca, Targeted alpha therapy, Actinium-225.
- CompanyAdvanCell
Shares Actinium-225 supply: thorium stocks, accelerators and radium targets, Metastatic castration-resistant prostate cancer, PSMA, Targeted alpha therapy.