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Actinium-225 DOTA-substance P is an investigational radiopharmaceutical designed for targeted alpha therapy (TAT) of brain tumors, specifically glioblastoma and recurrent high-grade gliomas. It consists of the alpha-emitting radionuclide actinium-225 (half-life of 9.92 days) chelated via a DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) linker to substance P, a neuropeptide. Substance P acts as a high-affinity ligand for the neurokinin-1 receptor (NK-1R), which is significantly overexpressed in glioblastoma cells compared to healthy brain tissue. The drug is typically administered locally via intratumoral or intracavitary injection using stereotactically inserted port-a-cath systems. Once bound to the receptor, the actinium-225 delivers high-energy alpha particles with a short range (a few cell diameters), causing lethal double-strand DNA breaks in tumor cells while sparing adjacent healthy brain parenchyma.
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