Nuclear medicine next decade: shift from β (177Lu) to α (225Ac, 212Pb). α has 100× cytotoxicity, short range protects normal tissue. Pipelines: 225Ac-PSMA, 225Ac-FAP, 225Ac-DOTATATE (RYZ101), 212Pb-DOTAMTATE. New targets (FAP, GD2, HER2, αvβ6). Manufacturing wall (Oak Ridge, Karlsruhe, PSI, JAEA). Final volume.
Novartis Pluvicto (mCRPC, $1B+ annual revenue) and Lutathera (NET) clinical and commercial success moved nuclear medicine from niche to mainstream. Short isotope half-life and specialized facility requirements make Vertical Integration (production-synthesis-distribution-delivery chain) decisive competitive advantage. Endocyte acquisition $2.1B, Point Biopharma $1.4B, 14-site global manufacturing network. Vol. 1.
The April 2026 issue of Nature Medicine published a landmark paper validating the real-world clinical utility of tumor whole-genome sequencing (WGS) in solid cancers. WGS identifies additional actionable findings in 10-20% of patients beyond standard panels — driving treatment changes, response, and survival. “WGS for the right patient, not every patient” — a tiered model is the realistic answer.
Structural comparison of CAR-T’s three commercialization paths (autologous, allogeneic, in vivo) across 7 axes. Market projection: $16.5B in 2030, $35B in 2035, with in vivo’s late-decade growth. Final volume.
April 21, 2026 Eli Lilly to acquire Kelonia Therapeutics for up to $7B—the largest in vivo CAR-T M&A signaling pharma majors’ serious entry. Kelonia’s PreciseTarget LNP delivers CAR mRNA to T cells in vivo, softening ex vivo CAR-T’s three walls (manufacturing time, cost, toxicity) simultaneously. Vol. 1.
Cell April 2026 paper used human iPSC-derived cerebellar organoids + CRISPR to reproduce all four medulloblastoma subtypes (WNT, SHH, Group 3, Group 4) in real time. Cell of origin for each subtype directly confirmed. Vismodegib and BET inhibitor responses validated in subtype-specific manner. Personalized-therapy organoid proof of concept. Vol. 2.