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225Ac-hNd2 (also known as NMT25) is an investigational, targeted alpha-particle therapeutic radiopharmaceutical developed by Nihon Medi-Physics. It consists of a recombinant humanized monoclonal antibody, hNd2, which specifically targets Mucin 5AC (MUC5AC), conjugated to the alpha-emitting radionuclide actinium-225 (225Ac). MUC5AC is a secreted mucin that is highly overexpressed in several malignancies, particularly pancreatic ductal adenocarcinoma (PDAC), as well as gastric, esophageal, colorectal, and liver cancers. In normal tissues, MUC5AC is restricted to the mucosal epithelium of specific organs, whereas in tumors, it is found in the stromal compartment adjacent to cancer cells, making it an attractive target for radioligand therapy. Upon binding to MUC5AC, the alpha particles emitted throughout the 225Ac decay chain induce DNA double-strand breaks, leading to potent cytotoxicity in tumor cells. 225Ac-hNd2 is developed as a theranostic pair alongside 89Zr-hNd2 (NMK89), which is used for PET imaging to select patients with MUC5AC-positive tumors.
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