What’s Hot in 2025: Radiopharmaceuticals

Paul Ehrlich's idea goes nuclear: shooting radioactive "bullets" with precise aim at tumor sites within the body gets explored as treatment option. This kicks off our month-long series of forecasts for 2025. Please stay tuned to hear more from our scientific experts.

Nuclear imaging has long utilized these specialized agents for everyday diagnostics, but now radiopharmaceuticals are being investigated for further applications in clinical practice as either a response biomarker to adjust immune checkpoint inhibitor therapy¹ in real time or for improving cancer patient outcomes as a stand-alone intervention or companion with other treatments.

Accordingly, the rejuvenated exploration of radiopharmaceuticals over the coming years could generate $27 billion in investment by 2031², provided that reliable procurement of radioactive materials can be secured, and that in vivo pharmacokinetics of these novel conjugates can be controlled. Essentially, drug developers experiment with payloads that emit ionizing radiation and direct it to different organs with hopefully minimal exposure to healthy tissues. As with other antibody drug conjugates radioimmunotherapies rely on monoclonal antibodies chemically modified with a linker, which chelate lanthanide and actinide isotopes.

Indeed, the antibody-mediated targeting of tumor specific antigens allows narrower delivery of a cytotoxic payload to malignant tissue³ than regular radiation treatment alone. This means physicians could be handed a more effective combination of already applied therapeutic interventions. Look to more large drug companies pursuing this strategy (through acquisitions and strategic partnerships), particularly for their oncology programs.

References:

1. Ridge N. A. et al. Radiopharmaceuticals as novel immune system tracers, Advances in Radiation Oncology, 2022, 7(5):100936. https://doi.org/10.1016/j.adro.2022.100936

2. https://www.pharmexec.com/view/report-radiopharmaceutical-market-expected-reach-26-51-billion-2031

3. Martiniova L et al. The role of radiolabeled monoclonal antibodies in cancer imaging and ADC treatment, The Cancer Journal 2022, 28(6):446-453. DOI: 10.1097/PPO.0000000000000625

--Christoph Eberle, PhD, Principal Scientist III, In Vitro Pharmacology/Oncology, Charles River