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203Pb-DOTAM is a radiopharmaceutical imaging agent developed by Hoffmann-La Roche in collaboration with Orano Med as part of the CEA-PRIT 2.0 pretargeted radioimmunotherapy (PRIT) platform. It functions as a diagnostic and dosimetry surrogate for the therapeutic alpha-emitter 212Pb-DOTAM. The system employs 'SPLIT' (SeParated v-domains LInkage Technology) bispecific antibodies that target Carcinoembryonic Antigen (CEA), which is highly expressed in metastatic colorectal cancer. These antibodies localize to the tumor and subsequently capture the chelated lead-203 (203Pb) via a high-affinity DOTAM-binding site. This approach allows for precise SPECT imaging to visualize tumor uptake and calculate radiation dosimetry prior to the administration of the therapeutic lead-212 (212Pb) counterpart, minimizing off-target toxicity and enhancing the precision of targeted alpha therapy.
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