ESMO 2025 | Developing next-generation radioligand therapeutics for solid tumors

So this morning we had a session on radioligand therapy, a whole session on that at ESMO. So it’s great for nuclear medicine physicians to be here at ESMO and have a dedicated session. It highlights the boom, the surge of all this radioligand therapy new application, the diagnostic application that is ongoing. Lutetium PSMA is a great first legacy model for radioligand therapeutics. But yes, we can go beyond that. There are many more to come. We can improve, have new indications. We can improve, have a better use of lutetium PSMA. But more importantly, there are new agents. Alpha emitters, actinium, lead 212, actinium-211, beta emitters, terbium-161. So these are coming. New ligands, second generation ligand, maybe with improved properties, more uptake in the tumor lesions, less uptake in the normal organs. So there is J591, an antibody. There are some with albumin binders with longer circulation time, some with dimerization and dual attachment point to the protein. So these are upcoming. And I think more importantly, there are new targets. ACP3 looks very promising for prostate cancer, but there are others, DLL3, GRPR, HK2, KLK3. There are so many others. And similarly, beyond prostate cancer, beyond neuroendocrine tumors, there are multiple other targets opening the way for multiple other cancer types and diseases, breast cancer, lung cancer, colorectal cancer, pancreatic cancer. We can talk about FAP, we can talk about carbonic anhydrase 9 for clear cell renal carcinoma, GPC3 for liver cancer and so many others. So just to highlight that there are so many new radioligand therapeutics coming and it’s just the beginning of the new wave of radiotheranostics.

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