Mohammad Shadid, PhD, MBA

🚨 The Isotope Wars in Radiopharma - who wins? → The field has 300+ therapeutic RLT trials active right now. → But the constraint is no longer molecules. → It’s atoms. ⚛️ Lu-177 → Scaled but Fragile Capacity looks abundant: Novartis, ITM Isotope Technologies Munich SE, SHINE Technologies, Curium Pharma have all scaled reactor output. On paper, supply is “unconstrained.” But resilience still depends on: • A handful of aging European reactors • Enriched Yb-176 - historically Russian, only now diversifying One outage or geopolitical hiccup, and the chain cracks. 🔥 Ac-225 → The Existential Choke Point Global supply remains in low single-digit curies per year. Even if U.S. Department of Energy (DOE), TerraPower, NorthStar Medical Radioisotopes, LLC, BWXT, ITM Isotope Technologies Munich SE, and Eckert & Ziegler SE all scale… 👉 One successful PSMA launch could swallow most of it overnight. That’s why investors are actively funding hedges: Pb-212, At-211, Tb-161, Cu-67. ☢️ Pb-212 → Industrial Scale in Sight Orano Med is leading the way. → With parent Orano’s thorium supply, they control the feedstock others lack. → Their Alpha Therapy Labs in the US and France target >10,000 doses/year by mid-decade, scaling 10× by 2030. → The generator model makes Pb-212 a true hedge against Ac-225 scarcity - and Orano Med is the company best placed to deliver it at scale. 🌀 At-211, Cu-67, Tb-161 → Next Plays • At-211: 7.2h half-life → hyper-local cyclotron networks now being built in US/EU. • Cu-67: Moving into clinical supply (Clarity Pharmaceuticals ↔ Nucleus RadioPharma deal), with Nusano targeting production in its new facility build-out (2025–26). • Tb-161: “Lu-177-plus” physics, but depends on scarce Gd-160 enrichment - only now diversifying outside Russia/China. 🏭 Vertical Integration = The Moat This is the pattern: • Novartis building its own isotope lines • Eli Lilly and Company acquiring POINT Biopharma, a wholly owned subsidiary of Eli Lilly and Company • Lantheus buying Evergreen Theragnostics • ASP Isotopes scaling Yb-176 & Gd-160 enrichment • Orano Med - uniquely de-risked, with parent Orano’s thorium supply enabling secured Pb-212 production at industrial scale • Eckert & Ziegler SE expanding Ac-225 and Pb-212 supply chains in Europe The game is shifting from “who has the ligand” → who owns isotope + GMP + logistics. 🔮 The Thesis This isn’t one bottleneck. It’s three simultaneous wars: 1️⃣ Physics - half-lives dictate your business model 2️⃣ Geopolitics - precursor supply concentrated in Russia/China 3️⃣ Capital - only those locking supply with prepaid deals today will still be running by 2027 📈 My Prediction ➡️ By 2027, valuations in radiopharma won’t hinge on clinical data alone. ➡️ They’ll hinge on who survived the isotope wars with supply secured. What's your prediction? #radiopharma #isotopes #RLT #theranostics

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