Telix Pharmaceuticals has agreed to lead a merger with ITM Isotope Technologies Munich SE in a transaction valued at US$1.65 billion upfront on a cash-free/debt-free basis. The combination would create a vertically integrated radiopharmaceutical company spanning drug development, radioisotope production, manufacturing, distribution and commercialization. ITM is the only producer of globally scaled commercial-grade lutetium-177 (177Lu) and also produces actinium-225 (225Ac) and terbium-161 (161Tb). Its commercial isotope business generated US$273 million of revenue in 2025, with a 40% compound annual growth rate from 2021 to 2025, according to the announcement. Telix said the combined organization is expected to generate unaudited pro forma 2026 revenue and income exceeding US$1.3 billion, based on management estimates. ITM shareholders are expected to receive approximately US$1.25 billion in Telix shares, represented by 105.8 million shares priced at US$11.841 each, while Telix will assume US$302 million of net debt and account for US$96 million of management equity rollover and transaction expenses. The agreement also provides for up to US$700 million in contingent consideration tied to regulatory approvals and sales milestones for ITM-11, ITM’s 177Lu-edotreotide candidate for gastroenteropancreatic neuroendocrine tumors. ITM-11 has completed the Phase 3 COMPETE trial and fully enrolled the Phase 3 COMPOSE study, with an interim analysis expected in the first half of 2027. The transaction requires Telix shareholder approval, regulatory clearances and other customary closing conditions, with completion expected by the end of fiscal 2026. A Telix extraordinary general meeting is expected in November 2026. After closing, Telix shareholders would own about 76.3% of the combined company and ITM shareholders about 23.7%.