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**PMI21** is an investigational targeted alpha therapy developed by Precision Molecular Inc., consisting of an astatine-211 (211At)-labeled small molecule inhibitor of prostate-specific membrane antigen (PSMA). PSMA is minimally expressed in normal prostate tissue but highly overexpressed on prostate cancer cells, enabling selective tumor targeting. The PSMA-binding and 211At-labeling moieties are optimized for high tumor uptake, rapid clearance from normal tissues, and potent alpha-particle emission that delivers high-energy, short-range radiation to kill cancer cells while minimizing off-target toxicity compared to beta-emitters or multi-alpha emitters like actinium-225. PMI21 is licensed from Johns Hopkins University and supplied with 211At via Ionetix, with plans for clinical trials in metastatic prostate cancer.[1][2][3]
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