Auger Electron Emitters – Why Consider this Therapeutic Option?

Auger electron emitters represent a paradigm shift in targeted radionuclide therapy, offering unprecedented cytotoxic precision by delivering high-energy electrons within a nanometer-scale range. This ESMIT webinar, led by Prof. Jean-Pierre Pouget and Dr. Samantha Thierry, and moderated by Dr. Dana Niculae, explores the unique opportunities and radiopharmaceutical challenges of targeted Auger electron (AE) therapies in cancer treatment. AE emitters, such as iodine-125, indium-111, gallium-67, and terbium-161, offering a highly precise “middle ground” of linear energy transfer that destroys cancer cell DNA while completely sparing surrounding healthy tissue. Crucially, the field is expanding with emerging radioisotopes in the preclinical development phase (i.e. cobalt-58m, bromine-77, copper-64 and Erbium-165) which are widening the horizon for novel theranostic pairings and target-specific applications. Because these radionuclides demand exact intracellular—and ideally sub-nuclear—localization to induce lethal, double-strand DNA breaks, the success of the therapy depends entirely on the development of highly specific targeting vectors. This session will address the complex radiobiology of these varied Auger emitters, outlining the critical role of subcellular targets in localized irradiation alongside emerging research into cell-to-cell communication, including cytotoxic or immunostimulatory paracrine effects.

From a practical radiopharmacy perspective, the presentation will bridge the gap between benchtop chemistry and clinical translation by reviewing systematic in vitro and in vivo research evaluating the efficacy of these short-range therapeutic tools. The speakers will share clinical and preclinical examples, contrasting the performance of AE therapies with conventional external beam radiotherapy and traditional beta-emitting radionuclides. Finally, the discussion will narrow its focus to the development of highly potent thallium-201 radionuclide therapies. Attendees will gain detailed insights into innovative methods for ²⁰¹Tl oxidation, chelator binding, and nanoparticle formulation, providing radiopharmacists with the essential chemical and formulation strategies required to successfully target and destroy tumour cells.

By the end of this webinar, participants will be able to:

• Evaluate the distinct radiobiological mechanisms of established and emerging preclinical Auger electron emitters compared to conventional beta-emitters and external beam radiotherapy.
• Analyze the critical role of subcellular and sub-nuclear targeting vectors required to effectively maximize the nanometer-range cytotoxicity of Auger therapies.
• Describe the impact of localized cellular irradiation on tumor biology, including cytotoxic mechanisms and immunostimulatory paracrine effects.
• Formulate radiochemical strategies for challenging isotopes.

• Researchers in radiopharmaceutical sciences: biologists, chemists, biochemists, pharmacists, medical physicists; clinical radiopharmacists, nuclear medicine physicians in radiotherapy, oncologists and related nuclear medicine professionals.