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Tb-161-DOTAGA-Glu-(FAPI)2 is an investigational, next-generation dimeric radioligand therapy designed to target fibroblast activation protein (FAP). The drug consists of a dimeric FAP inhibitor (DOTAGA-Glu-(FAPI)2) labeled with the therapeutic radionuclide terbium-161 (Tb-161). The dimeric structure of the targeting ligand provides enhanced tumor uptake and prolonged tumor retention compared to monomeric FAP inhibitors. Terbium-161 is an emerging radionuclide that offers a therapeutic advantage over lutetium-177 by emitting both low-energy beta particles and short-range Auger electrons, delivering a highly localized radiation dose to micro-metastases while sparing surrounding healthy tissue. The agent is being developed by Telix Pharmaceuticals (as part of its TLX400 program) in collaboration with the Thera4Care consortium for the treatment of FAP-expressing advanced solid tumors, including sarcomas, ovarian cancer, and pancreatic cancer.
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