Driven by dual impetuses of supportive policies and cutting-edge technological breakthroughs, the global and Chinese radiopharmaceutical (nuclear medicine) sectors have undergone profound innovative leaps and transformative paradigm shifts in recent years. Moving beyond their traditional foothold in well-established oncology indications, radiopharmaceutical products are now expanding their utility into a diverse spectrum of solid tumors and a broad range of non-oncological therapeutic areas. This paper is dedicated to systematically sorting out and analyzing the pivotal advances and evolutionary trends shaping the global and Chinese radiopharmaceutical landscapes in 2025, against the backdrop of the deepening integration of diagnostic and therapeutic functionalities. These critical developments are manifested in three core dimensions. First, in terms of radionuclide supply, China has achieved a landmark breakthrough in the domestic mass production of lutetium-177 (1 77Lu), a workhorse radionuclide for targeted therapies. In contrast, actinium-225 (225Ac)—the core radionuclide underpinning next-generation targeted alpha-particle therapy—continues to face severe constraints stemming from global supply chain bottlenecks, yet it has already become a strategic focal point for multinational pharmaceutical corporations vying for competitive edges in the field. Second, regarding clinical translation, radiopharmaceutical conjugates (RDCs) have not only solidified their proven efficacy advantages in conventional tumor types but also pioneered innovative dual-targeting strategies tailored for refractory subtypes such as neuroendocrine differentiated prostate cancer (NEPC). Moreover, RDCs are demonstrating burgeoning exploratory potential in non-oncological domains, including cardiovascular disorders and neurodegenerative diseases. Third, on the industrial ecosystem front, China has initially constructed a comprehensive full-chain layout encompassing isotope production, drug research and development, and global trade cooperation, with its domestic market witnessing exceptionally robust growth rates. Nevertheless, the industry is confronted with pressing challenges, most notably the acute shortage of highly skilled professional talents, which demands urgent resolution. Grounded in the core development philosophy of “breaking bottlenecks, consolidating strengths, and addressing shortcomings”, this paper puts forward targeted recommendations for future development: efforts should be concentrated on establishing a stable and resilient radionuclide supply system, expanding the clinical application scenarios of RDCs across multiple disease categories, intensifying the cultivation of interdisciplinary talents, and leveraging policy guidance and resource integration to accelerate the transition toward a new era of individualized precision stratified therapy, which is underpinned by the integration of multi-omics technologies.
LI et al. (Wed,) studied this question.