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Actinium Ac 225 alpitatug satetraxetan (JNJ-69086420) is a first-in-class, targeted alpha-particle radiopharmaceutical (radioimmunotherapy) developed by Johnson & Johnson in collaboration with Diaprost. It consists of alpitatug, a humanized IgG1 monoclonal antibody targeting human kallikrein-2 (hK2, encoded by the KLK2 gene), conjugated via a satetraxetan (DOTA-derivative) chelator to the alpha-emitting radioisotope actinium-225 (225Ac). hK2 is a prostate-specific serine protease highly expressed on the cell surface of prostate cancer cells with minimal expression in normal non-prostate tissues. Upon binding to hK2, the conjugate is internalized, delivering a highly cytotoxic dose of short-range alpha radiation directly to the tumor cells, causing double-strand DNA breaks and cell death. It is currently in Phase 1 clinical development for the treatment of advanced prostate cancer, including metastatic castration-resistant prostate cancer (mCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC).
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