Astatine-211 as an emerging radioisotope for Targeted Alpha Therapy (TAT)

Cancer treatment presents complex challenges, necessitating the exploration of innovative approaches for diagnosis and therapy. Among emerging prospects, Radiopharmaceutical Therapy (RPT) using α- emitting radionuclides has gained notable attention. This article provides an overview of the literature on Targeted Alpha Therapy (TAT), explicitly focusing on astatine-211 (211At). It discusses methodologies for labeling 211At, along with the associated challenges, to contribute to a deeper understanding of its potential role in TAT. The physical properties of 211At make it a promising candidate for treating micrometastases and disseminated tumours. Its high linear energy transfer and limited tissue range minimize the damage to healthy cells. The review explores the implications of the ongoing research project NOAR-COST focused on Network for Optimized Astatine labeled Radiopharmaceuticals. Overall, the article underscores the growing significance of the α-emitting radionuclides in cancer therapy and provides an overview of the clinical studies, highlighting the potential for 211At to become a pivotal component of TAT.