Situation in Widening Countries and Ambitions

Alpha therapy, particularly Targeted Alpha Therapy (TAT), represents a rapidly advancing field in nuclear medicine with significant potential for highly selective and effective cancer treatment. Among alpha-emitting radionuclides, astatine-211 (²¹¹At) has attracted increasing attention due to its favorable physical properties, suitable half-life, and promising preclinical and early clinical results.
In the context of widening countries, the development and implementation of ²¹¹At-based alpha therapy presents both opportunities and challenges. Countries that already possess cyclotron facilities are in a comparatively advantageous position, as the production of ²¹¹At relies on medium-energy cyclotrons capable of alpha particle irradiation of bismuth targets. This existing infrastructure provides a foundation for local radionuclide production, research, and potential clinical translation. However, the situation remains complex due to technical, regulatory, and logistical constraints.
Key challenges include the optimization of production routes, radiochemical separation, quality control, and the establishment of robust supply chains within the short half-life of ²¹¹At. In addition, limited experience with alpha-emitting radiopharmaceuticals, regulatory preparedness, and the need for specialized training and multidisciplinary collaboration further complicate implementation in widening countries.
Despite these obstacles, growing ambitions in nuclear medicine, increasing participation in international research networks, and targeted investments in infrastructure and human capacity create a favorable environment for progress. Strengthening regional cooperation, harmonizing regulatory frameworks, and supporting translational research are essential steps toward enabling widening countries to contribute meaningfully to the advancement of ²¹¹At-based targeted alpha therapy.