Quantifying DNA strand breaks from targeted alpha emitters 225Ac and 227Th via Geant4-DNA: implications for RBE and cell survival

These findings underscore the potential of ²²⁵Ac and ²²⁷Th in targeted radionuclide therapy, particularly for tumors resistant to conventional treatments. The high RBE and complex DNA damage induced by these radionuclides suggest they could enhance therapeutic efficacy when combined with other treatment modalities, such as chemotherapy or immunotherapy, and may benefit patients with tumors exhibiting high DNA repair capacity. This study provides valuable insights for optimizing TAT protocols and advancing the clinical translation of ²²⁵Ac and ²²⁷Th therapies.