The latest weapon in the battle against cancer is showing promising results — and it’s a growing opportunity for investors, according to Redburn Atlantic. Radiopharmaceuticals are used to detect and treat the disease. They have also helped provided more accurate diagnoses and a way to attack tumors without damaging healthy cells. Big pharma is betting billions on the treatments, with a number of acquisitions in the space in recent years. To treat cancer, targeted radiopharmaceutical therapy directly goes after tumors with radiation by binding a radioactive particle to a targeting molecule. Right now it is a small market, worth less than $2 billion in 2023, analyst Ed Ridley-Day wrote in a note last week. By 2035, he expects the total addressable market to reach more than $215 billion. “Demand is accelerating rapidly, supported by new drug approvals and substantial industry development,” he said. “Radiopharmaceuticals offer the potential for improved outcomes in most patient populations, with a strong safety profile compared with the SoC [standard of care], and a lower cost of development and treatment than both biologics and radiotherapy.” At Ridley-Day’s count, there are currently 235 therapeutic agents in the pipeline, in various trial phases. Novartis is the leader in the space, with two therapies on the market. Pluvicto treats advanced prostate cancer, and Lutathera targets neuroendocrine tumors. In May, the company announced it was acquiring Mariana Oncology for $1 billion. Mariana Oncology is a preclinical-stage company focused on developing radiopharmaceutical programs that treat breast, prostate and lung cancers. Other pharmaceutical companies have also recently made acquisitions. Eli Lilly , best known for its diabetes and weight-loss drugs, bought Point Biopharma in December for $1.4 billion, while Bristol-Myers Squibb finalized its $4.1 billion acquisition of RayzeBio in February. In June, U.K.-based AstraZeneca entered the space with its purchase of clinical-stage biopharmaceutical company Fusion Pharmaceuticals for $2.4 billion. It’s AstraZeneca that made Ridley-Day’s buy list. AZN 1Y mountain AstraZeneca’s one-year performance “AstraZeneca has undergone one of the most comprehensive and rapid R & D overhauls in recent times, moving from a woeful track record of late-state pipeline failures to building an impressive pipeline and nearly quintupling its overall success rate,” he said. The company saw success with its launches of oncology drugs like Imfinzi, Tagrisso and Lynparza, Ridley-Day pointed out. Its radiopharma business should begin contributing to sales in 2029 with the expected launch of its prostate cancer therapy. “By 2030E, therefore, the radiopharma contribution will still likely be small (less than 1% of group sales), but Astra’s stated intention of combining this approach with its modalities offers considerable potential yet to be announced,” he said. Yet the therapies are only half the story, he noted. Solid manufacturing and supply are also important, which it gained with its Fusion acquisition, he said. U.S.-listed shares of AstraZeneca are up about 17% year to date. Delving into diagnostics There are also opportunities in the radiopharma diagnostics space, according to Redburn Atlantic. Molecular imaging can help provide a more accurate diagnosis because it uses radiation-emitting isotopes and positron emission tomography (PET) or 3D single photon emission computer tomography, Ridley-Day said. It also helps improve the targeting treatment, he added. He expects the global market to reach $10.7 billion by 2027, up from an estimated $6.5 billion in 2024. “These markets have high barriers to entry, the supply chain is highly regulated with safe handling of radioactive material at a premium, and manufacturing complex,” he wrote. GE Healthcare Technologies and Lantheus Holdings are two of the names best positioned to benefit, he said. A strong, sustained fundamental demand for imaging, increasing demand for radiopharmaceuticals and the potential for further share gains in patient monitoring should help GE Healthcare reach its mid-term revenue guidance of mid-single-digit organic growth, said Ridley-Day. He also reiterated his buy rating and bumped up his price target to $105 from $90 last week. The target implies more than 20% upside from Wednesday’s close. GEHC YTD mountain GE Healthcare’s one-year performance “We expect the company to be able to deliver strong improvements in profitability, supported by operational leverage, improving mix — led by accelerating growth in radiopharmaceuticals — and an extensive efficiency programme,” he wrote. Meanwhile, Ridley-Day initiated coverage last week on Lantheus with a buy rating and $175 price target, suggesting nearly 72% upside from Wednesday’s close. LNTH 1Y mountain Lantheus Holding’s one-year performance The company is a leading supplier of radiopharma diagnostic agents and is also moving into radiopharma therapeutics. It has a “strong pipeline of radionuclides for both diagnosis and therapy,” he said. “Lantheus benefits from its focus on this rapidly expanding market, with 78% of revenues from radiopharmaceuticals and related products,” Ridley-Day added. Shares of GE Healthcare have gained about 12% so far this year, while Lantheus is up 68% year to date.
