Precision Cancer Therapy: The Promise of Astatine-211 Parthanatine in High-Risk Neuroblastomas

Astatine-211 parthanatine (211At-PTT) is an innovative alpha-emitting radiopharmaceutical therapeutic designed to target poly(adenosine-diphosphate-ribose) polymerase 1 (PARP1) within cancer cells. This treatment is part of a theranostic pair, complementing the diagnostic capabilities of fluorine-18 fluorthanatrace (18F-FTT) used in positron-emission tomography (PET) imaging to assess PARP-1 levels in various adult cancers. Specifically developed for the treatment of high-risk neuroblastomas, 211At-Parthanatine leverages a peptide as its carrier/ligand to deliver precise alpha particle radiation to cancerous cells, promoting targeted destruction with minimal impact on surrounding healthy tissue.

Introduction to Astatine-211 Parthanatine

Astatine-211 parthanatine is at the forefront of targeted cancer therapy, representing a significant advancement in the use of radiopharmaceuticals for therapeutic purposes. Its development marks a pivotal step towards more personalised and efficient cancer treatments, focusing on the mechanism of PARP1 inhibition to combat high-risk neuroblastomas. This radiopharmaceutical’s alpha-emitting properties ensure high-impact delivery to cancer cells while minimising collateral damage, a common concern with traditional radiotherapy.

Mechanism of Action

The mechanism of Astatine-211 parthanatine involves a targeted approach towards cancer cells expressing poly(adenosine-diphosphate-ribose) polymerase 1 (PARP1). PARP1 plays a crucial role in the repair of single-strand DNA breaks. By binding to PARP1 and inhibiting its activity, 211At-Parthanatine impedes the cancer cell’s ability to repair DNA damage, leading to cell death. The delivery of alpha particle radiation directly to these cells further ensures the destruction of cancerous tissue with a high degree of precision.

Carrier/Ligand and Radiation Type

The choice of a peptide as the carrier/ligand for 211At-Parthanatine is instrumental in its ability to specifically target cancer cells overexpressing PARP1. Peptides offer several advantages, including small size, ease of modification, and the ability to cross cellular membranes efficiently. The alpha particles emitted by 211At-Parthanatine are known for their high linear energy transfer (LET), which translates to a potent therapeutic effect within a short range. This characteristic minimises the risk of damage to surrounding healthy tissues, a notable advantage over other forms of radiation.

Theranostic Pairing with 18F-Fluorthanatrace

The theranostic concept embodied by 211At-Parthanatine and its companion diagnostic, 18F-Fluorthanatrace, exemplifies the personalised approach to cancer treatment. 18F-FTT PET imaging allows for the precise identification of tumours with high PARP1 expression, guiding the targeted application of 211At-Parthanatine. This pairing not only enhances the efficacy of the treatment but also allows for real-time monitoring of therapeutic response, enabling adjustments as necessary to optimise outcomes.

Clinical Application and Evaluation

Currently, 211At-Parthanatine is under evaluation in multiple adult cancers, with a specific focus on high-risk neuroblastomas. Neuroblastoma, a cancer arising from nerve tissue, presents a significant challenge due to its aggressive nature and the high risk of relapse. The precision of 211At-Parthanatine offers a promising therapeutic avenue for patients with this diagnosis, potentially improving survival rates and quality of life.


Astatine-211 parthanatine represents a significant breakthrough in the field of oncology, offering a novel, targeted approach to cancer treatment. By focusing on PARP1 inhibition and delivering precise alpha radiation, this radiopharmaceutical promises to advance the treatment of high-risk neuroblastomas and other cancers with high PARP1 expression. In conjunction with the diagnostic capabilities of 18F-FTT, the therapeutic development highlights the potential of theranostic strategies in achieving personalised and effective cancer care. As clinical evaluations continue, the future of 211At-Parthanatine and its impact on oncology remains promising, with the potential to redefine cancer treatment paradigms.

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Tags: Brain Tumors, Cancer, Targeted Radionuclide Therapy
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