A key operational challenge in radiopharmaceutical development is the need for a reliable supply of radionuclides for fresh, just-in-time labeling before dosing. This contrasts sharply with conventional drugs that can be manufactured in bulk and stored, adding significant logistical complexity.
Unlike traditional drug development, cell therapy logistics require extremely close, integrated relationships with contract research (CRO) and manufacturing (CDMO) organizations. Due to the direct line from patient to manufacturing and back, these partners function as critical extensions of the core team to ensure timeliness and safety.
Unlike small-molecule drugs, biologics manufacturing cannot be simply scaled up on demand because "the process is the product." A superior manufacturing and supply chain capability is not a back-office function but a key market differentiator that commercial teams must leverage to win customers and outpace competitors.
A Complete Response Letter (CRL) from the FDA due to manufacturing issues can destroy a biotech. CEO Ron Cooper warns leaders to invest heavily in Chemistry, Manufacturing, and Controls (CMC) early, even when the cost exceeds the clinical trial spend. This early investment in professionalizing CMC is critical to de-risk the company's future.
Radiopharmaceuticals can use the same molecular scaffold for diagnosing a tumor with one radionuclide and treating it with another. This "theranostic" strategy improves patient stratification and accelerates the transition from diagnosis to effective therapy.
Unlike a drug that can be synthesized to a chemical standard, most vaccines are living biological products. This means the entire manufacturing process must be perfectly managed and cannot be altered without re-validation. This biological complexity makes production far more difficult and expensive than typical pharmaceuticals.
The increasing volume of new therapies requires pharma companies to stop treating each launch as a unique event. Instead, they must develop a scalable, repeatable, and excellent launch capability to handle the future pipeline efficiently and consistently.
Resolution Therapeutics' CEO warns that manufacturing process changes cannot wait for pivotal trials in cell therapy. The drug product used in a Phase 1/2 study must be highly comparable to the final commercial version to avoid extremely costly delays and extensive comparability studies later in development.
To overcome production bottlenecks, Legend Biotech employs a diversified manufacturing strategy. They operate their own large facilities in the US and Belgium while also contracting with pharmaceutical giant Novartis to produce their CAR T therapy. This enables a rapid scale-up to a planned 10,000 annual doses.
A significant real-world barrier to radioligand therapy is that the dose expires the day after its planned administration. This extremely tight window means that any patient travel issue, weather delay, or simple scheduling conflict can directly lead to a completely wasted, expensive dose, complicating treatment delivery.
The commercial launch of Kymriah, the first CAR-T therapy, faced a unique logistical hurdle: Novartis, a pharma company, had to create a certification program to approve top-tier US medical centers like Dana-Farber, ensuring they could properly administer the complex treatment. This was an unprecedented requirement for a major pharma company interacting with renowned hospitals.