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Ac-PSMA-XT (XT381) is a novel targeted alpha-particle emitting radioligand therapy (TAT) developed for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The therapeutic agent consists of a ligand that specifically targets the prostate-specific membrane antigen (PSMA), which is highly expressed on the surface of prostate cancer cells, labeled with the alpha-emitting radioisotope Actinium-225. Upon binding to PSMA-positive tumor cells, the Actinium-225 delivers high linear energy transfer (LET) radiation, which induces lethal double-strand DNA breaks within the cancer cells. This mechanism allows for precise tumor cell eradication with limited exposure to surrounding healthy tissues. Early clinical data from Phase I studies indicate deep PSA declines and a manageable safety profile in heavily pretreated patients.
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