Lu-177-PSMA is a beta emitter. Compared to beta-emitters, alpha-emitters are less penetrating but much more damaging to DNA. Actinium-225-PSMA is an alpha emitter paired with an anti-PSMA monoclonal antibody. This phase I dose-escalation study demonstrated the safety of Actinium-225-PSMA for patients with metastatic prostate cancer. At the dose selected for further phase 2 study, there were no dose-limiting toxicities and 46.9% of patients had a 50% or greater decline in PSA. This study paves the way for larger trials of PSMA alpha-emitter therapy for prostate cancer. | Tagawa, J Clin Oncol 2023
