Targeted alpha therapy in prostate cancer: review of available agents in clinical practice

Q J Nucl Med Mol Imaging. 2025 Jun;69(2):118-128. doi: 10.23736/S1824-4785.25.03642-8.

Abstract

Targeted alpha therapy (TAT) has shown promise in prostate cancer patients, both hormone-sensitive and castration-resistant, with or without prior treatment. TAT's radiobiological properties explain why it is more potent than other forms of ionizing radiation, such as the clinically approved [177Lu]Lu-PSMA-617. Although most TAT agents used in compassionate care or clinical trials target the prostate-specific membrane antigen (PSMA), some alternatives are yet to be used clinically, some of which aim to address PSMA-negative prostate cancer. These include [223Ra]RaCl2, which is approved for palliative bone pain, and a variety of other non-PSMA antigen or receptor-targeting medicines. Whereas this study focuses on TAT medicines that are currently available for clinical use, it also explores these preclinical agents.

Publication types

  • Review

MeSH terms

  • Alpha Particles* / therapeutic use
  • Humans
  • Male
  • Molecular Targeted Therapy* / methods
  • Prostatic Neoplasms* / radiotherapy