New frontiers in targeted radiopharmaceuticals

We are harnessing the power of targeted radiation to develop new targets, complement existing therapies and explore new clinical applications. Telix’s aim is to build a pipeline of new product candidates and related platform technologies that can dramatically improve patient outcomes.

The team’s expertise in technology evaluation and product development, along with the Company’s standing as one of the world’s largest dedicated radiopharmaceutical companies has opened up access to a range of new opportunities and partnerships.

1. Targeted alpha therapy (TAT)

 Alpha emitters have the potential to deliver very high amounts of energy to cancer tissue, while the short range can reduce the risk of damage to surrounding healthy cells, increasing the selectivity and potency of the radiation treatment.

Our vision is to develop alpha and beta therapies for the indications we are pursuing, to increase the options available to treat cancer within our portfolio and provide patients with additional options along their treatment journey.

For prostate cancer, we are developing TLX591 – a beta therapy, and the subject of the ProstACT series of studies – in parallel with TLX592, a potential alpha therapy currently being evaluated in the Phase I CUPID trial.

The TLX250 platform is also being explored as a potential alpha therapy in the investigator-initiated Phase II OPALESCENCE and Phase I PERTINENCE studies in breast and bladder cancer, respectively, which completed enrolment during 2023.

2. Immuno-oncology

An increasing body of scientific evidence suggests that low doses of targeted radiation can potentially overcome immune resistance. This approach, known as immunological ‘priming’, has the potential to render tumours more susceptible

to cancer immunotherapy. Several pre-clinical studies have shown an enhanced therapeutic outcome of checkpoint inhibitors when they are administered after a systemic radiotherapy, including rendering immunologically inert tumours sensitive to treatment.

The STARLITE-1 and STARLITE-2 Phase II IITs of TLX250 in kidney cancer therapy are evaluating CAIX-targeted radiation in combination with checkpoint inhibitors – a form of immunotherapy.

3. Tumour microenvironment (TME)

Tumours are complex, heterogeneous collections of cells. Their interaction with the surrounding microenvironment further enhances this complexity and can affect how the tumour grows and spreads. By better understanding the tumour microenvironment (TME) and harnessing the ability of targeted radiation to target multiple parts of the tumour, we are developing new approaches to complement existing treatments and make them more effective. An example of this translational research is our collaboration with Merck KGaA where we are exploring Telix’s targeted radiation in combination with Merck’s DNA damage repair inhibitors.

 We are working with leaders in the field to progress this research and have in-licensed a number of novel radiotracers for translation into new theranostics.

4. Artificial intelligence (AI)

Radio-imaging using targeted radiation relies heavily on digital data processing and input from highly trained technicians and radiologists to correctly interpret data. AI technology has the potential to transform image analysis by improving the accuracy and speed of decision-making for clinicians by recognising complex patterns in large datasets and conducting predictive analysis.

5. Surgical solutions

During 2023, with the acquisition of Lightpoint Medical’s SENSEI® radio-guided surgery (RGS) business, we established a new MedTech Division.

To fully explore the capabilities of the SENSEI® probe and role of Telix’s targeting agents in the operating theatre, we are exploring the use of different agents, alternative radioisotope and fluorescent payloads, and new detection technology to enhance surgical outcomes. This includes prototyping early drugs and devices for development as medical devices by the Lightpoint team.