Swiss pharma group has become a pioneer in radioligand therapy, a new type of targeted radiotherapy

Novartis has emerged as a pioneer in radioligand therapy (RLT), an innovative form of targeted radiotherapy. Doctors involved in early trials were astonished: for some patients with metastatic cancer, scans showed the disease had been completely eradicated within six months—a result described as "incredible" and "never seen before" by Dr. Michael Morris of Memorial Sloan Kettering Cancer Center.

Unlike traditional radiation, which damages healthy tissues, RLT uses molecules called ligands to deliver radioactive isotopes directly to cancer cells. Novartis entered the field through two key acquisitions: Advanced Accelerator Applications (AAA) in 2017 and Endocyte in 2018. These brought in Lutathera (for gastrointestinal neuroendocrine tumors) and Pluvicto (for prostate cancer), both now approved.

CEO Vas Narasimhan believes the RLT market could reach $25–30 billion if the therapy fulfills its potential. However, significant challenges remain. Radioisotopes must be produced in nuclear reactors, and the resulting drugs have very short shelf lives—requiring production, transport, and administration within three to five days. Each dose is customized for an individual patient.

Additionally, treated patients remain radioactive temporarily, necessitating isolation in shielded rooms in some countries. Their urine must often be collected and stored for up to 70 days. Logistics are complex: Novartis uses GPS-tracked shipments and AI to predict delivery routes, and is expanding global production sites.

Despite the hurdles, competitors like Lilly, AstraZeneca, and Sanofi have recently acquired RLT startups. Novartis, however, claims a “five-year head start,” with seven candidates in 15 clinical trials and control over much of the isotope supply.

According to a Novartis shareholder, building a full RLT ecosystem could take 10–15 years. But with expanded approvals and ongoing research into applications for lung, breast, and other cancers, targeted therapies like RLT are widely seen as the future of oncology.

(Source: Financial Times)