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Background <p>Astatine-211, <sup>211</sup>At, has long been a candidate for Targeted Alpha Therapy, TAT. However, over time, hurdles in the development of chemistry, the establishment of radiopharmacies, and the demonstration of its potential in clinical trials have been hampered by its limited availability. It is one of the rarest elements on earth and must be produced artificially. The main production route is by irradiating natural bismuth with helium ions in a cyclotron, utilizing the nuclear reaction <sup>209</sup>Bi(α,2n)<sup>211</sup>At. It requires a medium-energy cyclotron capable of producing a 29&#xa0;MeV α-beam. Early on, there were several such cyclotrons in Europe and worldwide, but to this day, only a few have been producing <sup>211</sup>At. Now, many of the old cyclotrons have been decommissioned, leaving even fewer options. However, the situation is about to change with the installation of several new cyclotrons with the capacity to produce a relevant α-beam. In addition, there are also prospects evaluating the production of <sup>211</sup>At in linear particle accelerators, LINACs, with which <sup>211</sup>At potentially can be produced in very high amounts and high activity levels. Taking advantage of LINAC machines and new and old cyclotrons still in operation can solve the limited access to <sup>211</sup>At today. With the production capacity in place, the astatine produced must be delivered in a relevant form to the end user. For this purpose, it also needs to meet all regulations for transporting radioactive material. </p> Main body <p>This work is the result of European Cooperation in Science and Technology, COST Action CA 19114, Network for Optimized Astatine labeled Radiopharmaceuticals, NOAR, Work Group 1 assignments, focusing on all aspects on <sup>211</sup>At production and availability. The review addresses the progress of <sup>211</sup>At in terms of the requirement for its targetry, production, transport and the chemical and physical form for its delivery.</p> Conclusion <p>With all efforts in production and making <sup>211</sup>At available it has the potential to be the next generation Targeted Alpha Therapy radionuclide in Europe and worldwide.</p>

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Solving the limited availability of Astatine-211 from a European perspective: from production to the end user

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月17日

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  • Sture Lindegren,
  • Holger Jensen,
  • Hans Van de Maele,
  • Renata Mikolajczak,
  • Haingo Rabarijaona,
  • Emma Aneheim

摘要

Background

Astatine-211, 211At, has long been a candidate for Targeted Alpha Therapy, TAT. However, over time, hurdles in the development of chemistry, the establishment of radiopharmacies, and the demonstration of its potential in clinical trials have been hampered by its limited availability. It is one of the rarest elements on earth and must be produced artificially. The main production route is by irradiating natural bismuth with helium ions in a cyclotron, utilizing the nuclear reaction 209Bi(α,2n)211At. It requires a medium-energy cyclotron capable of producing a 29 MeV α-beam. Early on, there were several such cyclotrons in Europe and worldwide, but to this day, only a few have been producing 211At. Now, many of the old cyclotrons have been decommissioned, leaving even fewer options. However, the situation is about to change with the installation of several new cyclotrons with the capacity to produce a relevant α-beam. In addition, there are also prospects evaluating the production of 211At in linear particle accelerators, LINACs, with which 211At potentially can be produced in very high amounts and high activity levels. Taking advantage of LINAC machines and new and old cyclotrons still in operation can solve the limited access to 211At today. With the production capacity in place, the astatine produced must be delivered in a relevant form to the end user. For this purpose, it also needs to meet all regulations for transporting radioactive material.

Main body

This work is the result of European Cooperation in Science and Technology, COST Action CA 19114, Network for Optimized Astatine labeled Radiopharmaceuticals, NOAR, Work Group 1 assignments, focusing on all aspects on 211At production and availability. The review addresses the progress of 211At in terms of the requirement for its targetry, production, transport and the chemical and physical form for its delivery.

Conclusion

With all efforts in production and making 211At available it has the potential to be the next generation Targeted Alpha Therapy radionuclide in Europe and worldwide.