FDA delays Lantheus’ Ga-68 edotreotide approval over third-party manufacturing deficiencies

Lantheus Holdings said the US FDA issued a Complete Response Letter (CRL) for its New Drug Application (NDA) seeking approval of LNTH-2501 (Ga-68 edotreotide), citing unresolved manufacturing-related conditions at a third-party drug product manufacturing facility. The agency raised no concerns regarding the clinical data, safety or efficacy of the PET imaging agent for somatostatin receptor-positive neuroendocrine tumors (NETs), but approval cannot be granted until the manufacturing issues are resolved.

The CRL was issued solely on the basis of unresolved third-party facility manufacturing-related conditions. The FDA explicitly stated that the letter did not identify any concerns with the clinical data submitted by Lantheus in support of the application, nor did it raise any issues related to the safety or efficacy of LNTH-2501. No additional clinical studies have been requested. The FDA had originally assigned a PDUFA action date of June 29, 2026, following a three-month extension that had been granted in March 2026.

The third-party manufacturing facility cited in the CRL is directly traceable to the infrastructure Lantheus acquired through its January 2025 acquisition of Evergreen Theragnostics, a New Jersey-based company that had developed its own Ga-68 edotreotide kit — branded OCTEVY — as an independent US supply chain alternative to the AAA/Novartis product. Lantheus announced the acquisition in January 2025 and completed it in April 2025, at a cost of $250 million upfront and up to approximately USD 752.5 million in additional development and sales milestones.

The Evergreen manufacturing facility and its CDMO capabilities were central to the strategic rationale for the acquisition, providing Lantheus with an integrated US-based supply chain for Ga-68 edotreotide. The FDA’s finding of unresolved facility inspection-related conditions at the site now makes manufacturing readiness the critical path to approval for LNTH-2501.

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LNTH-2501 is a two-vial Gallium-68 edotreotide PET imaging kit that enables radiopharmacies to prepare the imaging agent on-site. Edotreotide binds to somatostatin receptors, particularly SSTR2, which are highly expressed in many neuroendocrine tumors, allowing PET imaging to localize disease.

The LNTH-2501 NDA was filed under the 505(b)(2) regulatory pathway. The molecule, Ga-68 edotreotide, has an established regulatory precedent in other major markets. Novartis subsidiary Advanced Accelerator Applications (AAA) received European Medicines Agency approval for its Ga-68 edotreotide kit, SomaKit TOC, in December 2016, and the FDA approved the first Ga-68 DOTATOC kit in 2019. LNTH-2501 is not currently approved by the FDA and is not available for commercial sale in the United States.

Mary Anne Heino, Executive Chairperson and Chief Executive Officer of Lantheus, said the company remains confident in LNTH-2501 and is committed to bringing the imaging agent to NETs patients as soon as possible. Lantheus is working closely with its manufacturing partner and the agency to address the facility manufacturing-related conditions. Lantheus has not publicly disclosed a resubmission timeline or a revised PDUFA target date.


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