DDW Editor Reece Armstrong speaks to Dr Ebrahim Delpassand, CEO of RadioMedix, about scaling access to radiopharmaceuticals and the company’s attempt to innovate in hard-to-treat cancers.

RA: Could you discuss RAHA-100 and your goal of democratising access to the 212Pb isotope – why is this important? 

ED: One of the central challenges in radiopharmaceutical targeted alpha therapy has been that the biology has often outpaced the infrastructure. Pb-212 has long been recognised as a highly promising isotope because alpha particles deliver intense, localised energy that induces double-strand DNA breaks, which cancer cells struggle to repair. That mechanism offers the potential to eradicate even resistant tumours with far greater potency than beta-emitting radiation. Yet for many years, that therapeutic promise remained largely theoretical, constrained by limited and centralised isotope supply. 

RAHA-100 was developed to address that gap. By reducing dependence on the US Department of Energy’s limited centralised Pb-212 supply and enabling more consistent, GMP-grade isotope production within qualified manufacturing settings, it makes alpha therapy more clinically attainable rather than purely experimental. Reliable access matters not only for patient treatment, but for drug development itself. When isotope supply is dependable, researchers can radiolabel Pb-212 to new targets, explore combination regimens, and design multi-site trials that were previously impractical or simply unreachable. In that sense, the importance of RAHA-100 lies less in the device itself and more in what it allows the field to do. 

RA: Do radiopharmaceuticals suffer from the kinds of supply issues we’ve seen advanced therapies suffer from? 

ED: Yes, although the nature of the constraints can be different. Like cell and gene therapies, radiopharmaceuticals depend on specialised manufacturing, highly controlled processes, and coordination across multiple systems. In addition, radioactive decay introduces time sensitivity that further limits flexibility in production and distribution. For alpha-emitting therapies, isotope availability has been a particularly persistent constraint. Limited supply, short half-lives, and manual production steps have historically made it difficult to scale programs or run multi-centre trials. These challenges don’t necessarily prevent innovation, but they slow it and introduce risk at every stage of development. Addressing them requires infrastructure that is designed around clinical realities, not just scientific potential. 

RA: What are the advantages and disadvantages of being a family-led business?  

ED: Being family-led company is deeply personal. This company started as a shared commitment to solve problems we were seeing in patient cancer care, and my family has remained supportive and involved because they believe in that mission as strongly as I do. Working with family brings a level of trust, accountability, succession, and long-term commitment that’s difficult to replicate. That said, it isn’t always easy. Like any close working relationship, disagreements happen, and when they involve family, they can be more complicated. But those discussions are also candid and grounded in shared values and mutual trust. At the end of the day, building something as challenging as a radiopharmaceutical company requires resilience, and doing it alongside people you trust completely has been a strength rather than a liability. 

RA: Your pipeline consists of both therapeutics and diagnostics. How essential are diagnostics in the areas of oncology you’re targeting with radiopharmaceuticals? 

ED: Diagnostics are essential because radiopharmaceuticals only work if the underlying biology is understood and monitored over time. In the cancers we’re targeting, target expression can vary between patients and can also change due to disease progression or regression. Without diagnostic insight, it becomes difficult to know whether a therapy is still appropriate or likely to be effective. Diagnostic pairs of therapeutic drugs act as a “test drive” before exposing the patients to stronger therapeutic pair. This is a unique aspect of the “Nuclear Theranostics” that does not exist in other disciplines. 

Diagnostics help identify the right patients upfront, but they also play a role in assessing recurrence and disease evolution. They allow clinicians to see whether the target remains present and whether re-treatment or a different approach is warranted. From a development standpoint, this leads to more informed trial design and clearer interpretation of outcomes. For radiopharmaceuticals, diagnostics do not need to be separate from therapeutics but can rather be integrated to deliver precision over the full course of disease. 

RA: You previously served as Deputy Chair and Chief of Clinical Nuclear Medicine at MD Anderson Cancer Center. What were some of your biggest learnings from that time and has that influenced RadioMedix in any way? 

ED: My time at MD Anderson taught me that patients with difficult-to-treat cancers need more than incremental improvements. Many of the patients we treated had advanced cancers and limited alternatives, and while access was important, what mattered just as much was whether the therapies themselves could offer something meaningfully better. 

I saw firsthand that radiopharmaceuticals had real potential for these patients, but also that progress could stall if these treatments were not developed to be both precise enough and durable enough to remain viable as disease evolved. That experience shaped RadioMedix’s philosophy on advancing radiopharmaceuticals, so that therapies can improve over time and remain available to patients who may need them not just once, but throughout the course of their disease. 

RA: Oncology is an incredibly active space for biotech but progress can be slow. What are still some of the biggest challenges for developing effective oncology therapies?
 

ED: One of the biggest challenges in oncology is that many cancers are biologically complex and adaptive. Tumours evolve, develop resistance, and often respond differently across patients, which makes durable benefit difficult to achieve. Even when a target is well understood, translating that biology into a therapy that is both effective and tolerable can take years. 

Another challenge is execution. Clinical development is often slowed by manufacturing limitations, trial design constraints, and difficulties identifying the right patients early. In newer modalities like radiopharmaceuticals, these challenges are compounded by the need for specialised infrastructure and expertise. Progress depends not only on scientific insight, but on building the systems that allow therapies to be tested and delivered effectively. 

RA: Moreso, you’re targeting hard-to-treat cancers such as neuroendocrine and pancreatic cancers. What are the challenges of these specific cancers and what potential do radiopharmaceuticals offer? 

ED: These cancers are difficult for different reasons, but they share a lack of durable treatment options. Pancreatic cancer is often diagnosed late and is biologically aggressive, with limited tolerance for systemic therapies. Neuroendocrine tumours can be slower growing, but they frequently recur and require treatments that can be used effectively over time. 

Radiopharmaceuticals offer a differentiated approach by delivering radiation directly to cancer cells. In these settings, the potency of alpha-emitting therapies creates an opportunity to achieve meaningful tumour control, even in resistant disease. That level of precision and potency creates an opportunity to limit damage to surrounding tissue, which is critical in these hard-to-treat settings. 

RA: Could you discuss the approach of using alpha therapies to target cancers and the mechanism of action behind your AlphaMedix candidate? 

ED: Alpha therapies are designed to deliver intense, localised radiation over a very short distance. If we are successful in delivering lethal dose of radiation in a targeted fashion, you can kill any cancer cells. Alpha particles deposit a high amount of energy in targeted cells, causing double-strand DNA breaks that are difficult for cancer cells to repair. This makes them particularly relevant in tumours that have become resistant to other forms of treatment. 

AlphaMedix applies this approach in somatostatin receptor–expressing tumours, where the biology is well understood but current therapies can have limitations in durability. By coupling a proven targeting mechanism with a Pb-212 alpha emitter, AlphaMedix delivers radiation directly to cancer cells while limiting exposure to surrounding tissue. The intent is to increase tumour cell death without relying on higher systemic doses, which is especially important in patients who may require repeated or sustained treatment. 

RA: How encouraging were the Phase II data for AlphaMedix presented last year?

ED: The Phase II data were encouraging because AlphaMedix showed antitumour activity in a patient population with very limited treatment options, alongside a safety profile that was manageable and consistent with expectations for this type of therapy. Importantly, the results supported advancing the programme responsibly into later-stage development. 

The data also helped clarify practical questions around dosing, tolerability, and how patients respond over time, which was critical in informing the Phase III decision. More broadly, the results were encouraging for targeted alpha therapy as a modality, helping demonstrate that its biological promise can translate into clinically workable treatments. 

RA: What are your plans for 2026?
 

In 2026, the focus is on scaling RAHA-100 to support programmes that depend on more consistent access to Pb-212, while continuing to advance our own internal research efforts in addressing unmet needs in oncology such as brain tumours and pancreatic cancer. As alpha-emitter development accelerates, ensuring isotope availability keeps pace is critical so programs are not constrained by logistics rather than science. 

At the same time, we are continuing to build and refine our internal pipeline, applying what we’ve learned clinically and operationally to identify where targeted radiopharmaceuticals may offer meaningful benefit. More broadly, the goal is to align infrastructure and discovery so promising ideas, whether developed internally or with partners, can be pursued in a practical and sustainable way for patients. 

Biography

Dr Ebrahim Delpassand is a board-certified nuclear medicine physician with extensive experience in oncology. He previously served as Deputy Chair and Chief of Clinical Nuclear Medicine at MD Anderson Cancer Center, founded Excel Diagnostics & Nuclear Oncology Center, is a principal investigator and sponsor of multiple INDs, and is an adjunct professor at the University of Texas and Baylor College of Medicine. 

From DDW Volume 27 – Issue 2, Spring 2026 – Read the digital issue here