It’s true. We had the approval of lutetium PSMA 617 now for almost four years. I think it was in 2018 and 2022, that’s 2018 for the first approval in certain countries and 2022 for the US, but that’s great. It really paved the way for PSMA targeted ligand therapy approaches. And that’s the first generation. I think in 10 to 20 years from now, we’ll have plenty of others in the prostate cancer space, but also beyond prostate cancer...
It’s true. We had the approval of lutetium PSMA 617 now for almost four years. I think it was in 2018 and 2022, that’s 2018 for the first approval in certain countries and 2022 for the US, but that’s great. It really paved the way for PSMA targeted ligand therapy approaches. And that’s the first generation. I think in 10 to 20 years from now, we’ll have plenty of others in the prostate cancer space, but also beyond prostate cancer. And using PSMA and also other targets, potentially. Using PSMA, we can move from lutetium, using actinium, using lead-212, another alpha emitter, using astatine-211, another alpha emitter with a very short half-life. Terbium-161, that’s also Auger electrons, so it has a different effect on the cells and on the matter. And in terms of the carrier, the ligand, the molecule moiety that brings the isotope onto the target, we use 617 for now, but there are many second generation ligands that are being developed by multiple academic research teams and sponsors, trying to increase the uptake into the PSMA expressing cancer cells, decrease the uptake into the normal organs. So there are some with dual attachment points on PSMA. So it creates a higher binding affinity. It’s covalent binding. You have some that use an albumin binder. So it creates a longer circulation time into the body because they are not rapidly excreted into the urine by the kidney. So it’s more sufficient time for the ligand to be bound to the cancer cells because they are not going into the urine. We can change the lipophilicity as well. So the intrinsic lipophilicity and hydrophilic properties of the molecule that can play a role in the binding on the salivary gland and the kidney. So people are trying to work really on second generation ligand to really improve this biodistribution profile to have a better therapeutic index. So I think many more will come.
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