Novartis Invests $745M to Compete with BMS and Lilly in the Radiopharma Race

Novartis has partnered with Ratio Therapeutics in a deal potentially worth up to $745 million to develop a radiopharmaceutical targeting somatostatin receptor 2 (SSTR2) for cancer. Ratio will lead preclinical development, and once a candidate is selected, Novartis will handle the rest of the development, manufacturing, and commercialization. This collaboration strengthens Novartis’ position in the competitive radiopharmaceutical market, where it faces rivals like Bristol Myers Squibb (BMS) and Eli Lilly. The partnership builds on Novartis’ existing portfolio, including its two approved radioligand therapies, and positions the company to expand its manufacturing capabilities in this growing field.

Novartis’ Lutathera Shines in Rare Cancer Treatment, but Growing Need Fuels Search for Better Alternatives

Novartis’ Lutathera, approved in 2018, targets SSTR2, a receptor found on gastroenteropancreatic neuroendocrine tumors, and has proven effective in delivering radioactive isotopes directly to cancer cells while minimizing damage to healthy tissues. In 2024, Lutathera generated $534 million, a 17% increase from the previous year. However, despite Lutathera’s success, many patients eventually experience disease progression, highlighting the need for more effective alternatives and options for those who relapse. This has driven interest in expanding SSTR2-targeting therapies into new indications and improving outcomes for patients with limited options.

Additionally, there is a push to expand SSTR2-targeting therapies into new indications.  Lutathera targets SSTR2, a receptor found in high levels on the surface of gastroenteropancreatic neuroendocrine tumors. These tumors, although rare, can be difficult to treat, as they often grow slowly but spread to other parts of the body over time. Lutathera’s ability to specifically target and deliver radioactive isotopes to these tumors has made it a critical treatment option. However, as the disease progresses, patients often face limited options, driving the need for new therapies that can offer better outcomes and broader application.

The Race for Optimal Isotopes in SSTR2-Targeting Therapies

As Novartis continues to lead in this space, competitors such as BMS and Eli Lilly are ramping up their investments. BMS acquired RayzeBio, and Lilly purchased Point BioPharma, both companies focusing on SSTR2-targeting therapies. Additionally, Perspective Therapeutics is developing its own candidate. These efforts showcase the growing interest in radiopharmaceuticals, particularly for cancers that overexpress SSTR2.

The treatments in development utilize different types of radioactive isotopes, or “payloads,” each with distinct properties. Novartis’ Lutathera and Lilly’s PNT2003 both use Lutetium-177, a beta-emitting isotope that targets tumor cells. In contrast, BMS and Perspective Therapeutics are exploring Actinium-225 and Lead-212, which are alpha-emitting isotopes. These alpha-emitters release more energy, potentially making them more effective in destroying tumor cells.

The choice of radiation payload plays a crucial role in differentiating these treatments. Beyond the payload, the targeting molecule and linker technology are also critical. These factors determine how well the drug is absorbed by the tumor and how it avoids healthy tissue. In the competitive radiopharmaceutical market, developers must carefully balance efficacy, safety, and tolerability to ensure their treatments succeed.

Follow the Money: Big Pharma Makes Bold Moves with Billions in M&A

Big Pharma is scrambling to invest in radiopharmaceutical biotechs, inspired by Novartis’ market dominance. With two approved therapies, Novartis leads the way, but competitors like Lilly, Sanofi, and BMS are hot on its heels. These companies are pursuing big-ticket acquisitions and partnerships in the complex radiopharma space, seeking to secure a foothold in the growing market.

Novartis has been aggressive in expanding its pipeline, acquiring Endocyte  for $2 billion in 2018. Earlier this year, the company acquired Mariana Oncology for $1 billion and also expanded its radiopharmaceutical portfolio through a licensing deal with PeptiDream, valued up to $2.71 billion.

In response, Eli Lilly made headlines in October 2023 with a $1.4 billion acquisition of Point BioPharma. The company then followed up with a partnership with Aktis Oncology, potentially worth over $1 billion, in May of this year. Meanwhile, Bristol Myers Squibb spent over $4 billion in December 2023 to acquire RayzeBio, while Sanofi entered the space with a licensing deal with RadioMedix and Orano Med for a next-generation radioligand medicine targeting rare cancers.

Radiopharmaceutical Race Heats Up as BMS, Lilly, and Novartis Develop Competing SSTR2-Targeting Therapies

Following the cash flow, it is apparent that BMS and Lilly are strengthening their radiopharmaceutical portfolios through key acquisitions. Looking at the type, BMS acquired RayzeBio, which develops SSTR2-targeting therapies using Actinium-225, an alpha-emitting isotope. Lilly, on the other hand, acquired Point BioPharma, which is advancing PNT2003, a radiopharmaceutical that also targets SSTR2 and uses Lutetium-177, a beta-emitting isotope. Additionally, Perspective Therapeutics is developing its own SSTR2-targeting drug, further intensifying the competition in this space.

The choice of radioactive payloads is a critical factor in these companies’ strategies. Both Novartis’ Lutathera and Lilly’s PNT2003 utilize Lutetium-177, a beta-emitter that delivers targeted radiation to tumors. Meanwhile, BMS and Perspective are focusing on Actinium-225 and Lead-212, which are alpha-emitters known for releasing more energy. This increased energy potentially allows these therapies to more effectively destroy cancer cells.

In addition to the payload, the targeting molecule and linker technology play vital roles in determining a drug’s success. These elements influence how efficiently the drug targets tumors and minimizes harm to healthy tissues. As companies like Novartis, BMS, and Lilly race to develop and commercialize SSTR2-targeting therapies, these factors will dictate which treatments lead the market.

As these companies battle for dominance, radiopharmaceuticals are quickly becoming a key focus for Big Pharma. The specialized nature of these treatments makes these deals far more complex than typical acquisitions. Consequently, the competition is fierce, and all eyes are on the next big move in this rapidly expanding sector.

Author

Bernice Lottering