How can cancer treatments be made safer, more personalized, and ultimately more effective? Radiotheranostics may offer one of the clearest answers. These emerging cancer therapies have the potential to find cancer cells with remarkable precision—and treat them at the same time.
As more radiotheranostic therapies enter clinical practice, demand for the medical isotopes that make them work is rapidly rising. But today’s supply chain is still limited. SHINE is helping to strengthen that supply by producing high-purity isotopes and expanding the infrastructure needed to support future growth.
In this post, we’ll explain what radiotheranostics are, how they work, and the potential advantages they offer. We’ll also cover why more dependable isotope production will be essential to making these promising treatments available to more patients around the world.
The word radiotheranostics (ray-dee-oh-ther-uh-NOS-tiks) combines radio, signifying the use of radioactive isotopes, with theranostics, a blend of therapeutics and diagnostics.
Think of a radiotheranostic drug, or radiopharmaceutical, as a heat-seeking missile for cancer cells or a GPS-guided medicine that can find and attack those cells. Why are those comparisons apt? Because radiotheranostics can both locate cancer cells through medical imaging and treat them with targeted radiation.
At the heart of that dual capability are two key components:
Here’s how the radiotheranostic process unfolds in clinicaluse:
Radiotheranostics build on decades of nuclear-medicine research and FDA-approved therapies already used in clinics and hospitals around the world. They are grounded in proven science, careful dosing, and well-established safety practices.
One of the best-known radiotheranostic isotopes in use today is lutetium-177 (Lu-177), the isotope behind the FDA-approved medicines Lutathera® and Pluvicto®. These treatments are now widely used for certain neuroendocrine and prostate cancers, providing physicians a targeted option for cancers that can be challenging to treat with surgery, chemotherapy, or external radiation alone.
SHINE supports this growing field by supplying Ilumira, high-purity, non-carrier-added Lu-177, used by radiopharmaceutical developers in both clinical and commercial programs.
A key reason Lu-177 is so practical for cancer care is its half-life, which is about 6.6 days. Half-life describes how long it takes for half of the radioactive material to naturally decay.
For patients and clinicians, this matters because:
Some clinicians compare half-life to ice melting—steady, controlled, and easy to predict.
Because of its favorable half-life and well-understood behavior in the body, Lu-177 is now used in radiotheranostic treatments around the world. However, global production capacity supports fewer than 250,000 patient treatments per year, underscoring why a more dependable, high-quality isotope supply is needed.
Lu-177’s track record helps anchor the entire field of radiotheranostics: physicians know how it behaves, researchers continue to build on it, and patients can feel reassured knowing it comes from decades of nuclear-medicine practice.
Several clinical practices work together to make radiotheranostics a precise and highly regulated form of cancer therapy:
Personalized dosing through dosimetry. Clinicians calculate how much radiation a tumor—and nearby healthy tissue—is likely to absorb. This process, known as dosimetry, helps ensure each patient receives a dose strong enough to treat the cancer while keeping exposure elsewhere as low as reasonably achievable.
Established safety profiles. Every radiotheranostic has an FDA-approved prescribing label that outlines expected side effects and any required precautions. As with any cancer therapy, side effects can occur. In many cases, because fewer healthy cells are exposed, the side effects may be more manageable than those seen with systemic chemotherapy.
PET and SPECT imaging for monitoring and reassurance. Because these medicines can be imaged directly, doctors can confirm the radiopharmaceutical reached the intended cancer targets and follow how they move through the body. This clarity can also help patients understand that radiotheranostics tend to be delivered in a more focused way than the broader exposure people may think of when they hear the word “radiation.”
High-purity isotopes play an important role in radiotheranostic medicine. With fewer impurities, radiopharmacies can count on predictable high-yielding radiolabeling, and hospitals can keep patient schedules on track. Products such as non-carrier-added Lu-177 also support consistent handling across clinics. In short, high-purity isotopes help maintain the reliable, predictable supply that radiotheranostic treatments depend on.
Conventional cancer treatments—such as chemotherapy, immunotherapy external-beam radiation, and surgery—can be effective. But they also have significant limitations. Radiotheranostics add something new: radiation that works from within and concentrates in cancer cells with a specific molecular marker, an approach designed to limit exposure elsewhere.
FDA-approved radiotheranostic therapies are already treating patients worldwide, and clinical trials are rapidly expanding their use. For many patients, potential advantages may include:
To explore active clinical trials, see How to Find Clinical Trials for Radiotheranostic Cancer Treatments.
Demand for therapeutic isotopes is rising as more radiotheranostic drugs enter clinical trials and broader clinical use. But production remains concentrated in a small number of aging nuclear reactors—most of which are located outside the United States. Any reactor outage or international transport delay can disrupt treatment schedules.
Producing medical isotopes at scale also requires specialized facilities and stringent quality controls. And because isotopes like Lu-177 decay within days, they must be produced close to where patients are treated and shipped rapidly. Expanding access will require new capacity that can reliably deliver medical-grade isotopes at consistent quality and scale.
SHINE is developing next-generation production capabilities to make isotope supply more resilient and more accessible. This includes fusion-based neutron production, which provides a scalable, dependable source of irradiation for isotope manufacturing. To support this effort, SHINE is advancing key facilities like these
Radiotheranostics are rapidly expanding across oncology. Dozens of new therapies are now in clinical trials for cancers such as breast, glioblastoma, ovarian, and melanoma, as well as several rare forms. Current research includes work on:
As the science progresses, dependable access will require strong coordination across research, clinical care, and industry. SHINE is investing in capabilities needed to support that progress—from high-purity Lu-177 production to foundational work for additional medical isotopes.
