Actinium-225 targeted alpha particle therapy for prostate cancer

Abstract

Targeted alpha particle therapy (TAT) has emerged as a promising strategy for the treatment of prostate cancer (PCa). Actinium-225 ( 225 Ac), a potent alpha-emitting radionuclide, may be incorporated into targeting vectors, causing robust and in some cases sustained antitumor responses. The development of radiolabeling techniques involving EDTA, DOTA, DOTPA, and Macropa chelators has laid the groundwork for advancements in this field. At the forefront of clinical trials with 225 Ac in PCa are PSMA-targeted TAT agents, notably [ 225 Ac]Ac-PSMA-617, [ 225 Ac]Ac-PSMA-I&T and [ 225 Ac]Ac-J591. Ongoing investigations spotlight [ 225 Ac]Ac-hu11B6, [ 225 Ac]Ac-YS5, and [ 225 Ac]Ac-SibuDAB, targeting hK2, CD46, and PSMA, respectively. Despite these efforts, hurdles in 225 Ac production, daughter redistribution, and a lack of suitable imaging techniques hinder the development of TAT. To address these challenges and additional advantages, researchers are exploring alpha-emitting isotopes including 227 Th, 223 Ra, 211 At, 213 Bi, 212 Pb or 149 Tb, providing viable alternatives for TAT.