CONVERGE-01: A Patient’s Guide to Ac-225 Rosopatamab Tetraxetan (CONV01-α)
Understanding the realities of the next-generation alpha-emitting radioantibody for PSMA-positive mCRPC Prepared by Stephen L. Pendergast • IPCSG Member • April 2026 Bottom Line Up Front (BLUF) CONV01-α (Ac-225 rosopatamab tetraxetan, formerly 225Ac-J591) is an investigational radioantibody that delivers the alpha emitter Actinium-225 to prostate cancer cells via a monoclonal antibody targeting PSMA. It represents a fundamentally different approach from Pluvicto (Lu-177-PSMA-617): instead of a small-molecule ligand carrying a beta emitter, it uses a full-sized antibody carrying an alpha emitter. This matters because (1) alpha particles are far more destructive to cancer DNA than beta particles, and (2) the antibody is too large to penetrate salivary glands, kidneys, and small bowel—the organs that take the worst beating from small-molecule PSMA therapies. Across Phase I trials at Weill Cornell Medicine enrolling over 120 patients, CONV01-α produced PSA declines...