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177Lu-NM600 is a targeted radionuclide therapy (TRT) consisting of the tumor-selective alkylphosphocholine (APC) analog NM600 chelated with the beta-emitting radioisotope lutetium-177. NM600 acts as a targeting vector that exploits the high density of lipid rafts in the plasma membranes of cancer cells, facilitating selective uptake and prolonged retention across a wide variety of tumor types. Once localized, the lutetium-177 delivers ionizing radiation to the tumor, inducing DNA damage and stimulating a pro-inflammatory response characterized by type I interferon (IFN1) signaling and increased infiltration of CD8+ T cells. This agent is being investigated for its potential to enhance the efficacy of immune checkpoint inhibitors by converting immunologically "cold" tumors into "hot" tumors. It is currently in Phase 1 clinical development for several solid tumors, including head and neck squamous cell carcinoma and prostate cancer.
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