Perspective Therapeutics, Inc. Morgan Stanley 24th Annual Global Healthcare Conference

Well, Kelly, thank you for you, the team, and Morgan Stanley for hosting us. We're pretty excited to tell the story.

Thanks, Kelly. It's a great question. When we think about cancer and how we treat it, and because cancer cells are so similar to the human cells they come from, it's really hard to target just them and not healthy tissue. We think about the growth of chemotherapy using chemicals that try to take advantage of cancer cells growing a little faster. We think about things we try to do with the immune system to recognize only a certain kind of cell and not others. We think about external beam therapy and external radiation and all the other healthy tissue that hits as well. We have a really interesting opportunity here, especially with alpha particles, to use one of the most powerful mechanisms in the universe, atomic particles smashing into cancer cells to destroy them.

I think that opens up a lot of opportunities to have a different way to treat cancer cells that we don't want. Where it gets really interesting for the pharmaceutical business as an industry is that this is the first time you've taken a modality like radiation and made this a therapeutic drug, right? We can actually turn what used to be a device-based business of external beam that damaged a lot of healthy tissue and take it as a drug and a pharmaceutical inside the patient's body. The mechanism of action, the side effects, they're all orthogonal to each other, so you don't expect things to compound on the safety side, but you also expect then multiple approaches do everything they can to actually hit the cancer cell. We talk about chemo, chemoradiation. Chemo got more targeted with ADCs. Now radiation's becoming targeted with radiopharmaceuticals.

Targeted chemoradiation, we think, is a big plus.

It's a great question, and we think about when the company started as a spin-out from the University of Iowa. Back in 2015, the company founders, Dr. Schultz and Dr. Johnson, were focusing on a safer way to treat kids with pediatric neuroblastoma. Everyone's familiar with the periodic table, but there's something called the Segrè chart, and the Segrè chart shows all possible isotopes and what could exist. They looked at that and said, "You know what? Lead looks really interesting." Lead has a short enough half-life that you can give a hard, fast punch to the tumor. It's got a long enough half-life that it can exist for a period of time. If your isotope exists for seconds only, you can't make it. If it exists for thousands of years, it's going to be really tricky on the safety level.

Lead also has an elemental twin, lead-203, so you could actually image with the same chemical entity as you are treating with. That opened up a lot of possibility to help pre-screen kids for potential therapy and pre-screen adults for potential therapy. The challenge with lead, 212 especially, was that it was not available, and you could only get lead-212 at that point from the U.S. Department of Energy, and it would be the third Tuesday of every month, and it was really difficult to do any kind of research. The other issue as well was that lead did not have a specific chelator, a safe way to take just that lead, hold its daughter bismuth as well, and have both of those release their energy onto the tumor. Like all good scientists, our team invented both of those.

We have a proprietary generator that we have shipped around the world. We have actually made over 400 generators to date with our company. We have treated over 120 patients in the U.S. We have treated over 30 patients outside the U.S. The ability to bring a really hard-punching isotope is great, and what is extraordinary is in the past year, we have now seen the first-in-human images of lead-212. This is the first time we actually literally see the therapy as it happens in the patient's body and calculate dosimetry.

I want to give a great shout-out to Novartis and the teams at Advanced Accelerator Applications for helping develop LUTATHERA into a medicine that is now, I think, approaching about $1 billion or so in revenues. It is a beta emitter. It has been a lot better than nothing, right? Patients, their only choice was failing a somatostatin analog and treating symptoms was really limited from chemo options. LUTATHERA is a very interesting medicine with a beta emitter. We think that an alpha emitter will actually have a lot more potency, and most importantly, if we can do that safely, that is when we can actually bring, we think, a really compelling choice for patients. We have had a lot of physician engagement. I think the LUTATHERA overall response rates are interesting. The disease control rates are interesting. The question is, can we do better with a more potent payload?

And we really think we can.