Highlights from SNMMI 2026
Nearly 8,000 attendees made the trip to Los Angeles, California, this year to attend the Society of Nuclear Medicine and Molecular Imaging (SNMMI)’s 2026 meeting (30 May–2 June). The large audience of physicians, scientists, technologists, imaging specialists, and leading pharma companies came together to discuss advances in molecular imaging, targeted radionuclide therapies, and theranostics. The event featured over 150 scientific sessions and 19 satellite symposia. PSI’s attendees included Caleb Benitone, Therapeutic Area Lead in Specialized Study Support Services and Jason Vilardi, Therapeutic Area Director, RLT. Amid the broad range of scientific advances, several clear themes emerged; read on for PSI’s highlights of SNMMI, and what we expect sponsors will need to remain competitive in this rapidly maturing field.
PSMA imaging is entering a competitive phase
One of the most visible themes was the continued prominence of PSMA PET imaging, particularly the growing competition between Lantheus’ Pylarify (piflufolastat F-18) [1, 2] and Blue Earth Diagnostics’ Posluma (flotofolastat F-18) [3, 4].
Several presentations and industry discussions focused on comparative performance and positioning, reflecting a field that appears poised for long-term head-to-head evaluation. Beyond diagnostic performance alone, both companies are increasingly positioning their agents as companion diagnostics for radioligand therapy programs, highlighting the strategic importance of imaging assets across the whole timeline of a clinical trial (from therapy development to patient selection, and beyond).
Imaging agents are no longer being viewed as standalone products. Their value increasingly lies in how effectively they support therapeutic pipelines, trial recruitment, and precision medicine strategies.
Beyond established isotopes: Innovation
The second major theme of SNMMI 2026 was the influx of new companies bringing a diverse range of isotopes, including Ac-225, Cu-64, Pb-212, Tb-161, and Ga-68.
Many discussions focused less on clinical data and more on the practicalities of development (manufacturing, isotope supply, logistics, regulatory needs, and operational challenges). Multiple sessions highlighted a recurring issue: New entrants continue to approach radiopharmaceutical development through the lens of conventional drug development, underestimating the unique manufacturing, distribution, and clinical execution requirements of radioactive products.
The growing complexity of the development ecosystem reinforces the importance of specialist partners, with expertise spanning traditional drug development and radiopharmaceutical-specific operational requirements. This is becoming a competitive advantage in its own right; industry’s next winners may be determined by how efficiently they can move programs from concept to patient.
Established isotopes continue to drive innovation
Despite excitement surrounding newer radionuclides, presentations from the British Nuclear Medicine Society (BNMS) underscored the importance of established isotope platforms. The ongoing UK efforts are focused on expanding research in well-characterized isotopes (In-111, I-131, Zr-89) while also reviewing developments across Lu-177-based targeted radionuclide therapy (TRT), and peptide-receptor radionuclide therapy (PRRT). Their main takeaway is that innovation in radiopharmaceuticals is not dependent on novel isotopes – significant opportunities remain to optimize established platforms through improved strategies, new indications, and combination approaches.
New disease areas are creating opportunities beyond oncology
Although oncology continues to dominate radiopharmaceutical research (with many SNMMI attendees making their way straight from ASCO 2026’s meeting, held at the same time in Chicago), several presentations highlighted growing momentum in non-oncology indications. Researchers from Yale, Brigham and Women’s Hospital, Washington University, and Hannover Medical School in Germany highlighted advances in imaging applications for cardiac amyloidosis and inflammation, fibrosis, collagen formation, and arrhythmogenic substrates. While neurodegenerative diseases remain an important area of focus, these diverse presentations demonstrated innovation is spreading to multiple disease settings.
This broadening of the opportunity landscape opens new development and commercialization pathways. Non-oncology indications are not yet crowded with radiopharmaceuticals and represent a large untapped potential for sponsors seeking differentiated pipelines and new partnerships. Those sponsors who move first will have the advantage.
Combination therapies: The next frontier for radiopharmaceuticals
Preclinical research is moving beyond monotherapy approaches. A collaborative presentation (involving Fred Hutch Cancer Center, Johns Hopkins, UCLA, UCSF, and the University of Washington, among others) highlighted that future development programs may increasingly focus on therapeutic combinations, rather than traditional diagnostic-therapy pairings that have dominated to date. Preclinical findings suggest that combination approaches may improve tumor control while potentially allowing lower exposure to chemotherapy or radionuclide therapy, though clinical validation remains limited.
- Chemotherapy may improve radiopharmaceutical effectiveness by improving tumor penetration, sensitizing cells to radiation-induced damage, or increasing expression of the molecular target of the radiopharmaceutical
- Radiopharmaceuticals can take some anti-tumor burden; similar or improved tumor control could be achieved with lower cumulative chemotherapy exposure and fewer chemotherapy-related AEs
Several groups presented strategies pairing β-emitters with α-emitters, either sequentially or through closely timed administration schedules.
- β-emitters, such as Lu-177, are better at treating larger tumors, but can lead to off-target radiation damage, and are less potent
- α-emitters, such as Ac-225, are extremely potent and effective on an individual cell basis, but pose significant toxicity challenges
The rationale is to exploit complementary mechanisms of action while potentially increasing efficacy, without proportionally increasing toxicity (perhaps even reducing the dose of the α-emitter therapy).
We are moving beyond the “one agent, one target” paradigm. The future competitive advantage may not be from developing the next radionuclide, but from identifying the right combination of therapies, complementary isotopes, and treatment sequencing. We expect to see more studies pairing standard of care imaging agents with targeted therapies.
Infrastructure and isotope supply remain critical industry priorities
A bootcamp session featuring Bayer, PharmaLogic, Telix, ITM, and the US Department of Energy highlighted another important industry reality: Many newer companies remain unfamiliar with the practical foundations required for successful radiopharm development.
While much of the content covered fundamental topics, one important takeaway was the growing recognition that isotope supply remains a strategic bottleneck. The US Department of Energy outlined ongoing efforts to collaborate with universities and industry partners to improve isotope production capacity and streamline distribution networks.
As radiopharmaceutical pipelines continue to expand, reliable isotope access will remain a key determinant of development timelines, manufacturing scalability, and commercial success. While the Department of Energy’s efforts are good news for supply chains, an experienced CRO will be needed to overcome initial hurdles in radiopharmaceutical trials and keep on top of developments impacting ongoing trial feasibility.
AI is becoming integral to radiopharmaceutical operations
Presentations from MIT, Yale, and the Martinos Center explored the application of AI to imaging analysis and post-scan workflows. Rather than focusing solely on image interpretation, many efforts are targeting operational inefficiencies associated with image processing, analysis, and data management. Tackling persistent staffing challenges across imaging centers and hospitals with AI automation could reduce administrative burden and become increasingly important enablers of radiopharmaceutical adoption at scale.
Several groups also explored AI applications in quantitative imaging and image interpretation, although operational workflow optimization appeared to be the most immediately deployable use case.
This opportunity extends beyond improving productivity – AI may help sites manage growing imaging volumes without requiring proportional increases in specialist personnel. Helping sites focus on patient care enables them to do more with limited resources.
Emerging priorities for radiopharmaceuticals: Final thoughts
SNMMI 2026 reinforced that radiopharmaceuticals are transitioning from an emerging specialty to a mainstream precision-medicine platform. Alongside continued competition in PSMA imaging, the congress highlighted growing interest in novel isotopes, combination strategies, AI-enabled workflows, and expansion to non-oncology indications.
Most importantly, the meeting demonstrated that operational expertise, manufacturing capabilities, and isotope supply infrastructure are becoming as strategically important as the underlying science itself. As radiopharmaceuticals mature, success will increasingly depend on sponsors’ ability to integrate scientific innovation with the unique reality of radiopharmaceutical development and commercialization.
Partner with PSI, your specialist radiopharmaceutical CRO, for expert developmental support
Abbreviations
AE, adverse event;
ASCO, American Society of Clinical Oncology;
BNMS, British Nuclear Medicine Society;
MIT, Massachusetts Institute of Technology;
PET, Positron emission tomography;
PRRT, Peptide Receptor Radionuclide Therapy;
PSMA, Prostate-Specific Membrane Antigen;
SNMMI, Society of Nuclear Medicine and Molecular Imaging;
TRT, Targeted Radionuclide Therapy;
UCLA, University of California, Los Angeles;
UCSF, University of California, San Francisco.
References
1. Morris, M.J., et al., Diagnostic Performance of (18)F-DCFPyL-PET/CT in Men with Biochemically Recurrent Prostate Cancer: Results from the CONDOR Phase III, Multicenter Study. Clin Cancer Res, 2021. 27(13): p. 3674–3682.
2. Voter, A.F., et al., Piflufolastat F-18 ((18)F-DCFPyL) for PSMA PET imaging in prostate cancer Expert Rev Anticancer Ther, 2022. 22(7): p. 681–694.
3. Fleming, M.T., et al., True-Positive (18)F-Flotufolastat Lesions in Patients with Prostate Cancer Recurrence with Baseline-Negative Conventional Imaging: Results from the Prospective, Phase 3, Multicenter SPOTLIGHT Study. J Nucl Med, 2024. 65(7): p. 1080–1086.
4. Surasi, D.S., et al., Diagnostic Performance and Safety of Positron Emission Tomography with (18)F-rhPSMA-7.3 in Patients with Newly Diagnosed Unfavourable Intermediate- to Very-high-risk Prostate Cancer: Results from a Phase 3, Prospective, Multicentre Study (LIGHTHOUSE). Eur Urol, 2023. 84(4): p. 361–370.
