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As a result, attention has shifted toward alpha-emitters heading into 2026. This shift is largely pragmatic. Alpha radiation delivers substantially higher energy over a very short range and does not depend on many of the biological factors that limit drugs whose mechanism is primarily biological in nature. For tumors that have proven difficult to treat with chemotherapy, immunotherapy, or external beam radiation, this has become a relevant distinction. The growing number of alpha-emitter programs in clinical development suggests that this is no longer a peripheral strategy but a central one ."
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Nevertheless, there continue to remain well-established limitations to beta-emitters as an effective tumor treatment, particularly in tumors characterized by hypoxia, dense stroma, limited vascular access, or prior treatment resistance. These constraints became more apparent as developers attempted to move beyond the initial set of responsive indications