I wouldn't go so far as to say Pylarify has superior sensitivity and specificity. The available data shows it's only marginally different to Illuccix, and not enough to be a real-world differentiator in most cases.As for 'clinicians getting the drug when they need it' - I cant see how that would apply in prostate cancer imaging. These scans are planned in advance (days to weeks), not emergency cases, so such a matter shouldn't drive the choice.
Where the real differences lie are in:
Half-life: Pylarify (18F) has a longer half-life (110 min), giving more flexibility with imaging windows and centralized production.
Scaleability: Pylarify suits large centres with high throughput due to bulk production in cyclotron facilities.
Point-of-care use: Illuccix (68Ga) shines in decentralised settings where you can generate it on site, dose-by-dose, making it perfect for smaller hospitals or rural centres. This is what the Lantheus team seem to have accepted they cant compete in - hence, no further growth from them. They wont visit small sites, and cant deliver care close to where some patients live.
And, yes, Illuccix is cheaper too. Lantheus alluded to that.
How about 64Cu-Sar-bisPSMA?
Sensitivity and specificity - yet to be confirmed, but looks good so far.
Its half-life is much longer giving flexibility with imaging windows (same day, or next day), and supporting high volume centralized production (produce, and ship). So, it suits centres of all sizes - can be delivered to every place that a plane can reach - even across continents. And yes, it can be shipped in single doses.
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