{"id":222,"date":"2026-06-26T18:42:20","date_gmt":"2026-06-26T18:42:20","guid":{"rendered":"https:\/\/reprints.ygsgroup.com\/bloomberg\/?page_id=222"},"modified":"2026-07-01T12:46:54","modified_gmt":"2026-07-01T12:46:54","slug":"c153508","status":"publish","type":"page","link":"https:\/\/reprints.ygsgroup.com\/bloomberg\/c153508\/","title":{"rendered":"C153508"},"content":{"rendered":"\n
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Industries | The Big Take<\/p>\n\n\n\n

A $30 Billion Cancer Breakthrough Is Under Threat From Global Conflicts<\/h1>\n\n\n\n

The Russia-Ukraine war, China\u2019s rare earth controls and the Iran turmoil risk hurting a promising corner of the $280 billion cancer-treatment market.<\/p>\n\n\n\n

By Sonja Wind, Lisa Pham, and Fabienne Kinzelmann<\/p>\n\n\n\n

June 24, 2026<\/p>\n\n\n\n

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The production of radioactive lutetium-177, used in radioligand therapy for cancer treatment, at an ITM site in Neufahrn, Germany. Photographer: Jana Islinger\/Bloomberg<\/em><\/p>\n\n\n\n

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At the Hirslanden clinic overlooking Switzerland\u2019s picturesque Lake Lucerne, prostate cancer patient J\u00f6rg Pegelow lies on a reclining chair as a doctor wearing two sets of gloves \u2014 one made with lead \u2014 injects a saline solution laced with a radioactive drug into a vein in his arm.<\/p>\n\n\n\n

For the 82-year-old retired former head of purchasing at German supermarket chain Rewe, the treatment is the latest in his almost two-decade-long battle with the disease: He tried radiation, which \u201cdestroyed\u201d his intestines, and hormone blockers that gave him osteoporosis. On his second cycle of the radioactive-drug treatment, the octogenarian has high hopes for the therapy.<\/p>\n\n\n\n

\u201cI can go home tomorrow, and then there\u2019s nothing, except that my wife needs to keep some distance for a few days,\u201d Pegelow says, talking excitedly about a trip to Greece he\u2019s planning. \u201cUnlike chemo, which really wipes you out, traveling is no problem at all with this treatment.\u201d<\/p>\n\n\n\n

Radioligand therapy, the targeted delivery of a radioactive drug to kill diseased cells, is quickly turning into a breakthrough strategy for cancer. Unlike external radiation, which irradiates broad areas, or chemotherapy, which indiscriminately hits rapidly dividing cells, the treatment directly targets cancer cells, sparing most surrounding healthy tissues.<\/p>\n\n\n\n

With thousands of patients trying it globally, the therapy is emerging as one of the fastest-growing corners in the world of oncology \u2014 one currently spearheaded by European companies like Novartis AG, with US and Chinese players nipping at their heels. The global radioligand therapies market was valued at about $3.2 billion in 2025 and is set to grow to about $30 billion by 2034. It\u2019s among the most promising of a handful of emerging new technologies in the more than $280 billion cancer-treatment market.<\/p>\n\n\n\n

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Patient J\u00f6rg Pegelow receives radioligand therapy at the Hirslanden clinic in Lucerne. Photographer: Stefan Wermuth\/Bloomberg<\/em><\/p>\n\n\n\n

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But as wars and geopolitical turmoil threaten the supply chains for radioactive material, the industry is scouring the world for alternative sources to avert a slowdown in momentum for the treatment. Russia\u2019s invasion of Ukraine and China\u2019s export restrictions on several rare earth elements have hastened the search for other suppliers of isotopes. And the Iran war forced some drug developers to stockpile raw materials.<\/p>\n\n\n\n

The global tensions come on top of other hurdles for the therapy. Producing the medicine requires access to a nuclear reactor, while the short lifespan of radioactive material means the drugs need to be prepared relatively close to where they\u2019re going to be administered. Additionally, hospitals need isolated wards, waste-management infrastructure and qualified staff to handle radioactive material. With about six cycles of treatment needed and the list price for a prostate cancer drug of about \u00a320,000 ($27,000) a pop in the UK and roughly $50,000 in the US, the therapy is also not cheap.<\/p>\n\n\n\n

But none of that is deterring companies.<\/p>\n\n\n\n

Swiss pharma giant Novartis dominates the market currently because of its two US Food and Drug Administration-approved radioligand therapies \u2014 Pluvicto for prostate cancer and Lutathera for neuroendocrine tumors \u2014 which together generated $2.8 billion in net sales last year. The company is now dedicating 40% of its cancer research and development budget to radioligand therapies, and expects Pluvicto alone to generate $5 billion in sales in 2030.<\/p>\n\n\n\n

Germany\u2019s closely held ITM Isotope Technologies Munich SE is awaiting US regulatory approval for its experimental drug to rival Lutathera, with a decision expected over the summer. Also trying to enter this market are companies like Bristol-Myers Squibb Co., AstraZeneca Plc and Eli Lilly & Co., while many European hospitals have access to in-house formulations or brews similar to the yet-to-be approved drug from Boston-based Curium.<\/p>\n\n\n\n

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The production system for the hot-cell facility at the ITM site in Neufahrn, Germany. Photographer: Jana Islinger\/Bloomberg<\/em><\/p>\n\n\n\n

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\u201cRadiopharmaceuticals are a game changer and we believe have the potential to become a mainstream treatment,\u201d Victor Bulto, president of Novartis\u2019 US operations, said in an interview.<\/p>\n\n\n\n

In February, the American Society for Radiation Oncology\u2019s symposium in California cited an analysis of Medicare claims data showing a more than 2,000% growth in intravenous radiopharmaceutical therapy in the decade to 2023. The industry is in its very early stages, with the potential to broaden its use in diagnosis and treatment across a wide range of cancers.<\/p>\n\n\n\n

\u201cRadioactivity has cell-destroying capability; we essentially destroy the genetic material of the tumor,\u201d says Janusch Blautzik, head of the therapy unit at the Hirslanden clinic\u2019s Institute of Radiology and Nuclear Medicine. \u201cMore emitters will come to the market. That will be the future.\u201d<\/p>\n\n\n\n

Here\u2019s how the therapy works: A small amount of radioactive material, called a radioisotope, is paired with a ligand, or a molecule that binds to a receptor present in cancer cells. The radioactive isotopes emit radiation that penetrates the cancer cells, damages their DNA and results in their death. The therapy has the ability to target cancer cells even in metastatic areas \u2014 where the disease has spread.<\/p>\n\n\n\n

\u201cThere are two parts to the process: the first is making the hot radioactive isotope \u2014 that\u2019s the bit which will kill the cancer cell. Step two is taking that hot radioactive isotope and attaching it to a chemical that can take it to the target. That\u2019s the warhead that you\u2019re attaching to a missile that will find the cancer,\u201d Andrew Cavey, ITM\u2019s chief executive officer, explains in an interview.<\/p>\n\n\n\n

Making radioisotopes like lutetium-177, deployed in Pluvicto and Lutathera, is a complex process and uses an isotope of a rare earth element known as ytterbium mined in countries like China, Australia, Russia and the US. Until a few years ago, almost all of the ytterbium-176 \u2014 nuclear medicine\u2019s preferred isotope \u2014 came from Russia, something companies are trying to move away from.<\/p>\n\n\n\n

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Chemicals used in the purification and production of lutetium-177 at ITM. Photographer: Jana Islinger\/Bloomberg<\/em><\/p>\n\n\n\n

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\u201cITM made a very deliberate effort seven years ago on diversifying our supply away from Russia towards a North American supplier,\u201d Cavey said, adding that the pivot accelerated after the invasion of Ukraine in February 2022, even though medical isotopes are exempt from sanctions. \u201cWe find that it helps de-risk our business to have a North American supply source and not be subject to the evolutions of geopolitics.\u201d The Iran war prompted the company to protectively reorder materials like helium needed in its production process.<\/p>\n\n\n\n

It also hasn\u2019t helped that China added ytterbium in October to its list of rare earths subject to controls. Although implementation has been suspended until November this year, it has added to the sector\u2019s uncertainty.<\/p>\n\n\n\n

\u201cAssuming that China would continue to allow exports of controlled materials for medical applications, there are other risks there \u2014 they are now requiring detailed info from buyers in export license applications, including what some companies have described as trade secrets,\u201d said Chris Kennedy, an analyst at Bloomberg Economics.<\/p>\n\n\n\n

Access to nuclear reactors remains another challenge. Enriched ytterbium-176 needs to be bombarded with neutrons at a nuclear reactor to make it radioactive and transform it into lutetium-177.<\/p>\n\n\n\n

With Russian atomic centers an increasingly unattractive option, European drug producers now rely on aging research reactors susceptible to maintenance shutdowns. One such reactor in the Dutch village of Petten temporarily went offline in 2024 \u2014 with thousands of patient appointments at hospitals, mostly for medical imaging, canceled as a result.<\/p>\n\n\n\n

The European Commission\u2019s recent push may spur the roll out of small modular reactors, but their focus is mostly on chemical industries and data centers rather than the production of medical radioisotopes. That\u2019s driving companies further afield. ITM, for instance, has a partnership with Canada\u2019s Bruce Power.<\/p>\n\n\n\n

On the outskirts of Munich, under tight security, ITM operates what it says is the world\u2019s largest lutetium-177 production site. A Bloomberg reporter \u2014 like the plant\u2019s employees \u2014 had to wear protective clothing, shoe covers and a radioactivity-measuring dosimeter. ITM gets enriched ytterbium-176 \u2014 which looks like white powder \u2014 from a North American partner.<\/p>\n\n\n\n

The material, which the company says is \u201cway more expensive than gold,\u201d is sealed into ampules and sent to reactors \u2014 like its Canadian partner\u2019s nuclear plant \u2014 where it\u2019s irradiated to create lutetium-177. It is then returned to ITM for a patented purification process before being shipped to customers including Novartis.<\/p>\n\n\n\n

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Leak testing of a transport container.Photographer: Jana Islinger\/Bloomberg<\/em><\/p>\n\n\n\n

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Once prepared, the medicine faces yet another challenge: half-life, or the time it takes for the radioisotope to decay by half, affecting its potency to kill cancer cells. Lutetium-177 has a half-life of 6.6 days; actinium-225, a radioisotope that\u2019s garnering a lot of interest from drugmakers, has a half-life of 9.9 days, according to Andy Hsieh, an analyst at William Blair. Technetium-99m, the world\u2019s most widely used diagnostic isotope, decays within hours. That means medicines using these unstable elements can\u2019t sit on shelves for months \u2014 or even weeks.<\/p>\n\n\n\n

The medicine\u2019s ephemeral nature means it has to be produced close to where it\u2019s needed or near a transport center that can get it there. ITM supplies to more than 400 destinations a week, using a network of airlines, specialist road haulage firms and logistics partners. Novartis, meanwhile, has three radioligand manufacturing sites in the US and four in Europe, with plans to build two more in each of those regions. It is also building two in Asia, one each in Japan and China.<\/p>\n\n\n\n

The reliance on planes came into focus amid the conflict in the Middle East, with airspaces closed or airports damaged. Transporting radioactive drugs by sea isn\u2019t always an option because of the limited shelf life. ITM said it could \u201crapidly reroute\u201d medical radioisotope shipments away from Middle East transit routes thanks to its experience with pandemic-era supply chains. For its part, Novartis, which has contended with air freight disruptions during snow storms, is beefing up its US ground network and has even hired its own truck drivers.<\/p>\n\n\n\n

\u201cInfrastructure both for manufacturing as well as the delivery of the therapy are challenges,\u201d said Jeff Jones, an analyst at Oppenheimer & Co. \u201cYou\u2019re handling a radioactive product, so you need trained personnel, you need facilities, you need waste handling.\u201d<\/p>\n\n\n\n

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A trained professional prepares a radioactive drug at the Hirslanden clinic. Photographer: Stefan Wermuth\/Bloomberg<\/em><\/p>\n\n\n\n

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At the University Hospital in Essen, Germany, patients are housed in the building\u2019s lower levels, with windows and doors lined with lead to prevent radiation from escaping. Toilet contents from patient rooms are stored in containers in the basement until radiation levels fall before being released into the sewage system.<\/p>\n\n\n\n

The rooms have a thick concrete wall to shield nurses from patients. A small robot delivers snacks and water to patients while they are still radioactive. The isolation can be difficult, said Enrico, 46, who was diagnosed with a pancreatic tumor in 2020 and later developed a metastasis in his liver. While he had considered chemotherapy, he saw radioligand therapy as a better option.<\/p>\n\n\n\n

\u201cI didn\u2019t have any side effects\u201d aside from a slight feeling of dizziness for a few minutes at the beginning of the treatment, he said.<\/p>\n\n\n\n

Demand for the therapy is high. The Essen hospital has limited capacity, and bed availability is a key bottleneck, said Ken Herrmann, chair of the nuclear medicine department. Unlike in the US, where it\u2019s often an outpatient treatment, in Germany patients stay for about 48 hours. With only eight beds, the hospital can handle just over 1,000 cases a year, he said. A new building set to open this summer will make it one of the biggest nuclear medicine hubs in Europe.<\/p>\n\n\n\n

\u201cRadioligands are no longer seen as a niche curiosity, and are increasingly regarded as an important therapeutic platform with clear relevance in prostate cancer and neuroendocrine tumors, and potentially broader applications over time,\u201d said Ailsa Craig, a portfolio manager at the International Biotechnology Trust. \u201cThe field is still defined by three unresolved questions: which patients should receive them, how toxicity can be reduced, and where they should sit in the treatment sequence relative to chemotherapy, hormonal therapy, and emerging targeted agents.\u201d<\/p>\n\n\n\n

The therapy might also not work for all cancers since some tumors are known to be more sensitive to radiation than others. It\u2019s most effective when there is clear target expression on imaging, such as prostate-specific membrane antigen, or PSMA, Craig said.<\/p>\n\n\n\n

In spite of those limitations, the medical industry is convinced radiopharmaceuticals are finally having their day in the sun \u2014 roughly a century after their potential was first seen. Although nuclear medicine, or the application of radioactive substances in the diagnosis and treatment of disease, traces its roots to the 1920s, its march has been slow.<\/p>\n\n\n\n

\u201cThe industry didn\u2019t invent it, but it did conduct the studies that led to the breakthrough,\u201d said Michael Nader, head of radiopharmacy at the University Hospital in Essen. \u201cThere\u2019s now something of a gold rush. Big Pharma used to have no interest in nuclear medicine. Now all the major players are moving in.\u201d<\/p>\n\n\n\n

Novartis\u2019 interest in it goes back to at least 1997. But it was researchers in the Netherlands who began studying the use of an experimental drug with lutetium-177 to treat gastroenteropancreatic neuroendocrine tumors, a rare type of cancer that grows in areas such as the stomach, small intestine and pancreas. Doctors at the Erasmus Medical Center in Rotterdam soon started treating patients from all over the world, including Apple Inc. co-founder Steve Jobs.<\/p>\n\n\n\n

Several doctors from the Rotterdam hospital banded to form a startup in 2001 called BioSynthema Inc., which was then sold for \u20ac10.7 million ($12.2 million) in 2010 to Advanced Accelerator Applications SA, a spin-off radiopharmaceutical firm established by Stefano Buono, a former physicist at the European Organization for Nuclear Research, known as CERN.<\/p>\n\n\n\n

\u201cNo pharma company had ever had experience in radioactive material and drugs,\u201d Buono said in an interview. \u201cThe meeting of engineers, chemistry and pharmaceuticals, this merging of competencies, made our solution so effective.\u201d<\/p>\n\n\n\n

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Left: An ITM employee measuring the radiation dose rate of a ytterbium transport container. Right: An open container for the radioactive drug at the Hirslanden clinic. Photographers: Jana Islinger\/Bloomberg; Stefan Wermuth\/Bloomberg<\/em><\/p>\n\n\n\n

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AAA reformulated the medicine to create a ready-to-use injectable drug and carried out clinical trials, paving the way for its commercial use. By the time Novartis completed its $3.9 billion acquisition of AAA in early 2018, the drug now known as Lutathera had won European regulatory approval and was on the cusp of getting US cl<\/a>earance<\/a>.<\/p>\n\n\n\n

Interest accelerated with the emergence of Pluvicto for prostate cancer \u2014 the most common cancer in men in much of the world, according to the Lancet Commission.<\/p>\n\n\n\n

Pluvicto also had its roots in Europe. In 2014, the German Cancer Research Center gave a company called ABX an exclusive worldwide license on a lutetium-based drug for the treatment of prostate cancer. ABX took it to mid-stage clinical trials and also licensed it to Endocyte, which Novartis bought, with the drug going on to become Pluvicto.<\/p>\n\n\n\n

The late-stage study results for Pluvicto, which had impressive data in terms of the reduction in the risk of disease recurrence or death, \u201creally put radiopharmaceuticals on the map,\u201d said William Blair\u2019s Hsieh. \u201cIt was no longer just a niche modality.\u201d<\/p>\n\n\n\n

Bayer AG, which years ago had shown some interest in the technology, is hoping its early-stage actinium-225-based alpha therapy can be a potential successor to Pluvicto.<\/p>\n\n\n\n

\u201cThe promise of radioligand therapy today is pretty much in prostate cancer,\u201d said Christine Roth, Bayer\u2019s head of global product strategy and commercialization. \u201cI think the big question is can you move this treatment modality into other tumor types? We have even more work going on early in our pipeline to look at opportunities there.\u201d<\/p>\n\n\n\n

Companies like Switzerland\u2019s Nuclidium AG are trying copper-67 as an alternative to lutetium-177 because it avoids nuclear reactors, reduces hospital waste issues and is not dependent on Russian-origin raw materials. But the radioisotope\u2019s half life of just 2.6 days could complicate its use.<\/p>\n\n\n\n

In the US, Bristol-Myers Squibb is conducting late-stage trials for a drug using actinium-225 to treat neuroendocrine tumors. It\u2019s also in early testing for breast cancer. Eli Lilly bought Point Biopharma Global Inc. in 2023, gaining access to its facility in Indianapolis and a research and development center in Toronto. Lilly also entered into a pact with Radionetics Oncology Inc. in 2024.<\/p>\n\n\n\n

China has identified radiopharmaceuticals as an area of drug research it wants to accelerate. Chinese companies are starting to generate early clinical data for new cancer targets, Oppenheimer\u2019s Jones wrote in a note in January.<\/p>\n\n\n\n

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Janusch Blautzik, head of the therapy unit at the Hirslanden’s Institute of Radiology and Nuclear Medicine, speaks to a patient at the clinic. Photographer: Stefan Wermuth\/Bloomberg<\/em><\/p>\n\n\n\n

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As the treatment starts to take root across the globe, at the Swiss clinic, Pegelow is optimistic.<\/p>\n\n\n\n

\u201cIf I survive another five to six years with this, maybe there will be new therapies,\u201d he said.<\/p>\n\n\n\n

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Posted from Bloomberg.com<\/em>, June 24, 2026, copyright by Bloomberg L.P. with all rights reserved.
This reprint implies no endorsement, either tacit or expressed, of any company, product, service or investment opportunity. 
#C153508 Managed by The YGS Group, 800.290.5460. For more information visit www.YGSContentLicensing.com.<\/p>\n\n\n\n

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For more information about ITM, visit: www.itm-radiopharma.com<\/a>
Follow ITM on LinkedIn: https:\/\/www.linkedin.com\/company\/itm-radiopharma\/<\/a><\/p>\n\n\n\n

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By Sonja Wind, Lisa Pham, and Fabienne Kinzelmann June 24, 2026 The production of radioactive lutetium-177, used in radioligand […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-222","page","type-page","status-publish","hentry"],"yoast_head":"\nC153508 - Bloomberg<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/reprints.ygsgroup.com\/bloomberg\/c153508\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"C153508 - Bloomberg\" \/>\n<meta property=\"og:description\" content=\"Industries | The Big Take A $30 Billion Cancer Breakthrough Is Under Threat From Global Conflicts The Russia-Ukraine war, China\u2019s rare earth controls and the Iran turmoil risk hurting a promising corner of the $280 billion cancer-treatment market. 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