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Terbium Tb 161 PSMA is an experimental radiopharmaceutical developed for the treatment of metastatic castration-resistant prostate cancer (mCRPC). It consists of the radionuclide terbium-161 ($^{161}$Tb) conjugated to a targeting ligand such as PSMA-617 or PSMA-I&T, which binds with high affinity to the Prostate-Specific Membrane Antigen (PSMA) overexpressed on prostate cancer cells. Terbium-161 is considered a promising successor or complement to lutetium-177 ($^{177}$Lu) because it emits not only beta-minus particles but also a high yield of short-range Auger and conversion electrons. This combination results in a higher linear energy transfer (LET) and increased localized radiation dose, which is potentially more effective at eradicating micro-metastases and individual cancer cells that might survive standard beta-emitter therapies. The drug is currently being evaluated in early-phase clinical trials to determine its safety, dosimetry, and efficacy compared to existing radioligand therapies.
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