I’d say the data so far is indicating that 67Cu is inching ahead of 177Lu when applied correctly.
225Ac I feel is still a few years off and there may yet prove to be complex issues with toxicity and some bad side-effects, as seems to be the case currently.
There will also be some significant commercial and logistics aspects that remain to affect the direction of the marker and these are yet to entirely play out. 177Lu is well-established now and has some growth to eventuate ahead of it, but scaleability is a real problem (1000 fold on setup costs). 225Ac and 67Cu won’t have these problems. It’s possible 67Cu becomes a preferred isotope (in some cases) due to commercial benefits (manufacturing setup costs and logistics) and low toxicity/side-effects, when applied to a good product (such as with 67Cu-SAR-bisPSMA), when compared with certain applications for 177Lu and 225Ac.
I’d say the data so far is indicating that 67Cu is inching ahead...
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