Perspective Therapeutics, Inc. · AMEX:CATX
Perspective Therapeutics — Investor Day (May 2026)
124 slides from Perspective Therapeutics's investor day presentation, May 4, 2026
Slide 1: Engineering the Alpha Advantage
Engineering the Alpha Advantage Analyst Event | May 4, 2026 my PERSPECTIVE THERAPEUTICS NYSE AMERICAN: CATX
Slide 2: Legal Disclaimers
Legal Disclaimers This presentation contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995. Statements in this presentation that are not statements of historical fact are forward-looking statements. Words such as “may,” “will,” “s
Slide 3: Agenda
Time Topic Presenter Platform, Pipeline and Production Overview Thijs Spoor Chief Executive Officer Clinical Perspective of Treating NETs Mary Maluccio, MD, MPH, FACS Louisiana State University Health Sciences Center VMT-a-NET Phase 1/2 Data and Next Steps Thijs Spoor Chief Executive Officer VMT-a-N
Slide 4: Thijs Spoor, Chief Executive Officer
My PERSPECTIVE THERAPEUTICS Thijs Spoor Chief Executive Officer
Slide 5: Engineering the Alpha Advantage in Targeted Oncology
Engineering the Alpha Advantage in Targeted Oncology
Slide 6: Optimizing the Entire System
Optimizing the Entire System
Slide 7: Expanding the Addressable Market
Expanding the Addressable Market
Slide 8: Unlocking New Treatment Options Across Solid Tumors
Unlocking New Treatment Options Across Solid Tumors:
Slide 9: Choosing The Right Isotope
Choosing The Right Isotope Lead (?12Pb) advantages over beta and other alpha emitters 212Db Advantage Better anti-tumor activity > Better safety profile > Cleaner decay chain > Better clinical profile Isotope access & scalability > Better patient management > Better patient selection “Daughter isoto
Slide 10: Optimizing Structural Chemistry
Optimizing Structural Chemistry:
Slide 11: Not All 212Pb Programs Are Created Equal
Not All ²¹²Pb Programs Are Created Equal
Slide 12: Advancing a Theranostic Approach
Advancing a Theranostic Approach:
Slide 13: A Decade of Deliberate, End-to-End Engineering
A Decade of Deliberate, End-to-End Engineering
Slide 14: Direct-to-Hospital Delivery through Integrated Isotope Production
Direct-to-Hospital Delivery through Integrated Isotope Production
Slide 15: Daily Production at Regional Sites Ensures Supply of Ready-to-Administer Product
Daily Production at Regional Sites Ensures Supply of Ready-to-Administer Product
Slide 16: Reaching the Largest Addressable Market with Regional Manufacturing
Reaching the Largest Addressable Market with Regional Manufacturing
Slide 17: Advancing a Diverse Wholly Owned 212Pb-Based Oncology Portfolio
Advancing a Diverse Wholly Owned 212Pb-Based Oncology Portfolio
Slide 18: Rapidly Advancing Best-in-Class Next Generation Radiopharmaceuticals
Rapidly Advancing Best-in-Class Next Generation Radiopharmaceuticals
Slide 19: Strong Financial Position
Strong Financial Position Funding into late 2027 Cash, cash equivalents and short-term investments as of March 31, 2026 ~$271 million Share count as of March 31, 2026 ~114.0 million Outstanding common stock warrants & options as of March 31, 2026 ~20.5 million Based on our current plans, we believe
Slide 20: Perspective Therapeutics
Perspective Therapeutics The only RPT company engineering every part of the radiopharma chain for commercial success The Right Radioisotope 212Pbh Optimized Structural Chemistry Theranostic Approach Manufacturing Network Improved Tumor Killing, Reduced Collateral Damage + Alpha therapy enables far h
Slide 21: Clinical Perspective of Treating NETs
Clinical Perspective of Treating NETs Mary Maluccio, MD, MPH, FACS Chief of Surgical Oncology & Medical Director, Louisiana Neuroendocrine Tumor Program, Louisiana State University School of Medicine
Slide 22: Theranostics in management of patients with neuroendocrine and other SSTR positive tumors
Theranostics in management of patients with neuroendocrine and other SSTR positive tumors
Slide 23: Objectives
1)! Objectives ¢ Describe the treatment landscape for neuroendocrine tumors Put treatment decisions in perspective Highlight medical decision making ¢ Patient examples Define the current/evolving paradigms of radioisotope treatment
Slide 24: Treatment landscape
Treatment landscape * Somatostatin receptor analogs ¢ Not mutually exclusive ¢ Liver directed therapies * Ablation ¢ Important variables: ¢ Embolization * Symptoms (carcinoid syndrome) * Surgical cytoreduction * Location (liver, mesentery, multiorgan * Chemotherapy site) * Cytostatic agents * Comorb
Slide 25: Adverse side effects
Adverse side effects * Surgical cytoreduction * Perioperative morbidity and mortality * SSA * Hyperglycemia/elevated A1C * Reactive hypoglycemia * Gallbladder issues * Cytotoxic chemotherapy *« Myelosuppression * Brain fog * Hand foot syndrome ¢ Liver directed treatment ¢ Liver function test abnorma
Slide 26: Other factors that drive treatment
Other factors that drive treatment
Slide 27: Survival expectations
Survival expectations ¢ Playing the long game >50% 10 year survival in metastatic midgut neuroendocrine tumors 50% 5 year survival in metastatic pancreatic neuroendocrine tumors * Drops to 28% in higher grade tumors 49%-68% 5 year survival in metastatic bronchopulmonary 55-70% 5 year survival in thy
Slide 28: Key Clinical Recommendations
Key Clinical Recommendations NCCN guidelines lity Criteria: Patients must have confirmed SSTR-positive tumors, typically verified through a gallium-68 PET/CT scan (e.g., DOTATATE). * Indications by Tumor Type: PRRT is recommended for various NETs, including: e Gastroenteropancreatic NETs (GEP-NETs):
Slide 29: Treatment decision making
Treatment decision making LC WG 4 7 8 : TD ys
Slide 30: Alpha particle PRRT
Alpha particle PRRT RS GP 12/2022 1/2026 laine es : ei? tS, 2/2028 3/2026
Slide 31: The evolution of the treatment continuum
The evolution of the treatment continuum
Slide 32: Summary
Summary ¢ PRRT is a standard of care option for patients with somatostatin receptor (SSR) avid tumors on PET imaging ¢ PRRT can be used alone or in combination with other therapies * Patients with low grade tumors live a long time * Most patients with SSR avid disease will be treated with PRRT durin
Slide 33: Thijs Spoor, Chief Executive Officer
My PERSPECTIVE THERAPEUTICS Thijs Spoor Chief Executive Officer
Slide 34: SSTR2+ Neuroendocrine Tumors is a Large, Growing Market with Significant Unmet Need
SSTR2+ Neuroendocrine Tumors is a Large, Growing Market with Significant Unmet Need
Slide 35: Ongoing Phase 1/2a to Establish Broad Therapeutic Window For VMT-a-NET in NETs
Ongoing Phase 1/2a to Establish Broad Therapeutic Window For VMT-⍺-NET in NETs
Slide 36: Significant Response After Single Dose of [212Pb] VMT-a-NET
Significant Response After Single Dose of [212Pb] VMT-a-NET Metastatic NET Pancreas with Adrenal Crisis— Maximum Intensity Projection (MIP) Tumor Before Treatment Tumor After 1 Dose * Ga-DOTA-NOC PET images at base line and post 1st dose of [2?2Pb]VMT-a-NET ¢ MIP suggesting strong reduction of inten
Slide 37: Patient with Confirmed PR After [212Pb]VMT-a-NET Treatment
Patient with Confirmed PR After [212Pb]VMT-α-NET Treatment
Slide 38: VMT-a-NET: Baseline Patient Characteristics in AACR 2026 Data Analysis
VMT-⍺-NET: Baseline Patient Characteristics in AACR 2026 Data Analysis
Slide 39: Patient Exposure and Follow-up with [212Pb]VMT-a-NET in AACR 2026 Data Analysis
Patient Exposure and Follow-up with [212Pb]VMT-α-NET in AACR 2026 Data Analysis
Slide 40: Best-in-class Safety Profile?
Best-in-class Safety Profile? [222Pb]VMT-a-NET remains well-tolerated with more patients (n=64) and longer follow up (median 45 weeks) No DLTs Most common (>15%) TEAEs No discontinuations due to AEs Fatigue | % Neoecte 4% Grade 23 TEAEs in 23 patients (36%) ‘Nausea 63% Oiarmea 42% No dysphagia Anema
Slide 41: Blood Creatinine During Follow-up for All Patients Treated (n=64)
Blood Creatinine During Follow-up for All Patients Treated (n=64)
Slide 42: VMT-a-NET: Durable Disease Control Across All Doses
VMT-⍺-NET: Durable Disease Control Across All Doses
Slide 43: Spider plot of tumor change over time by patient
Spider plot of tumor change over time by patient
Slide 44: VMT-a-NET Responses Deepen Over Time
VMT-α-NET Responses Deepen Over Time
Slide 45: VMT-a-NET's Compelling Profile Supports Potential Registration Study at Current Dose Level
VMT-α-NET’s Compelling Profile Supports Potential Registration Study at Current Dose Level
Slide 46: Why Frontloading?
Why Frontloading? * Tumor dosimetry demonstrates highest uptake values between 60 - 65% total for 1st and 2nd cycles ¢ Frontloading could change response kinetics and improve ORR at lower doses ¢ Administering the highest dose when the tumor sink is at the largest could result in a kidney sparing ef
Slide 47: Ongoing Phase 1/2a to Establish Broad Therapeutic Window For VMT-a-NET in NETs
Ongoing Phase 1/2a to Establish Broad Therapeutic Window For VMT-⍺-NET in NETs
Slide 48: Meningioma
Meningioma * To date, there is no systemic medical therapy demonstrating prolonged Progression Free Survival (PFS) or Overall Survival (OS) Description in patients with refractory or recurrent meningiomas and thus there is no approved systemic therapy for this indication* * Inaddition, about 15% of
Slide 49: VMT-a-NET: Potential First-in-Class 212Pb-Radioligand Therapy Targeting SSTR2
VMT-⍺-NET: Potential First-in-Class 212Pb-Radioligand Therapy Targeting SSTR2
Slide 50: Yusuf Menda, MD
My PERSPECTIVE THERAPEUTICS Yusuf Menda, MD Professor of Radiology Division of Nuclear Medicine, University of lowa
Slide 51: VMT-a-NET Post-Lutathera Indication Expansion
Added PERSPECTIVE THERAPEUTICS VMT-a-NET Post- Lutathera Indication Expansion Ralph Bundschuh MD Universitatsklinikum Carl Gustav Carus Dresden
Slide 52: [212Pb]Pb-VMT-a-NET after previous radio-ligand treatment
[212Pb]Pb-VMT--NET after previous radio-ligand treatment
Slide 53: Dresden VMT-a-NET compassionate use program
Dresden VMT--NET compassionate use program
Slide 54: Dresden VMT-a-NET compassionate use program
Dresden VMT--NET compassionate use program
Slide 55: Dresden VMT-a-NET compassionate use program
Dresden VMT--NET compassionate use program
Slide 56: Dresden VMT-a-NET compassionate use program
Dresden VMT--NET compassionate use program
Slide 57: First results - compassionate use program
First results - compassionate use program
Slide 58: First results - compassionate use program
First results - compassionate use program
Slide 59: First results - compassionate use program
First results - compassionate use program
Slide 60: First results - compassionate use program
First results - compassionate use program
Slide 61: Table 4. Adverse Events (Safety Population)
Table 4. Adverse Events (Safety Population).* Event Any adverse event Gastrointestinal disorders Nausea Vomiting Abdominal pain Diarrhea Distension General disorders Fatigue or asthenia Edema peripheral 177. u-Dotatate Group (N=111) Any Grade Grade 3 or 4 number of patients 105 (95) 46 (41) 65 (59)
Slide 62: First results - compassionate use program
First results - compassionate use program
Slide 63: First results - compassionate use program
First results - compassionate use program
Slide 64: Case Study
Case Study 66-year old male patient * CUP NET G2 (Ki67: 5 %) - Lymph node, bone and hepatic metastases * Tx: octreotide, partial resection, external beam radiotherapy, everolimus, [‘’’7LuJLu- DOTATATE (total 15.8 GBq), [??°AcJAc-DOTATATE (total 7.7 MBq) Universitatsklinikum oR Carl Gustav Carus ou W
Slide 65: Case Study
Case Study Months 0 1 19 21 i ro b, a bp, Ae 65 Prof. Dr. Dr. Ralph A. Bundschuh @& bivensirat aes KK O NCT = Www.uniklinikum-dresden.de DRESDEN Universitatsklinikum Carl Gustav Carus 24 4" cycle 123 MBq DIE DRESDNER.
Slide 66: Case Study
Case Study Fast progression of hepatic metastases before 15‘ cycle re-challenge ®8Ga-PET scan showing Posttherapy scan after Posttherapy scan after 68Ga-PET scan 12 weeks progression in the liver 1st re-challenge cycle 2nd re-challenge cycle later, CgA 53.4 ng/mL (116 MBq), 4 weeks later (123 MBq),
Slide 67: Case Study
Case Study Fast progression of hepatic metastases before 15‘ cycle re-challenge Posttherapy scan after 1st re-challenge cycle (116 MBq), 4 weeks later CgA 34.4 ng/mL ®8Ga-PET scan showing progression in the liver p TECHNISCHE * 67 Prof. Dr. Dr. Ralph A. Bundschuh CD inivensiat DRESDEN *DKTK C)NCI ®8
Slide 68: Imaging and dosimetry
Imaging and dosimetry In addition to pretherapeutic [2°°Pb]Pb-VMT-«-NET imaging, all patients got posttherapeutic imaging with [2'2Pb]Pb-VMT-a-NET and dosimetric assessment Results of comparing pretherapeutic dosimetry with 2°°Pb and posttherapeutic dosimetry with 2'2Pb are promising and will be pre
Slide 69: Conclusion
Conclusion In this context about all patients showed at least stable disease according to RECIST criteria and CgA- [2'2Pb]Pb-VMT-a-NET can be safely applied after [*77Lu]Lu-DOTATATE (Lutathera®) and even after other alpha-emitters! In 12 treated patients no grade 4 or 5 toxicity was found. ima serol
Slide 70: Thank you very much for your attention!
Thank you very much for your attention! Thank you to my interdisciplinary team * MDs: Dr. E. Michler, Dr. C. Brogsitter, Dr. J Volkenandt, Dr. A Popp, ... * Medical Physics: Dr. D. Kastner, Dr. R. Freudenberg, Dr. J. Muller, ... * Radiopharmacy: Dr. M. Pretze, Dr. F. Brandt, ... * Technicians, Nurse
Slide 71: How Biodistribution Informs Therapeutic Potential
How Biodistribution Informs Therapeutic Potential Elcin Zan, MD Chair, Department of Nuclear Medicine, Cleveland Clinic
Slide 72: How biodistribution informs therapeutic potential
How biodistribution informs therapeutic potential
Slide 73: Disclosures
Disclosures Consultancy, SAB (within last 3 years): RealNose Al, Gaiaso, Novartis, Swiss Rockets, Glytherix, Grafton, Astra Zeneca Research Support (within last 3 years): Astra Zeneca/Fusion, Ariceum, Novartis, NIH, Radiopharm Theranostics Stock ownership: GAIASO, RealNose.ai 73
Slide 74: Slide 74
Slide 75: PSMA vs DOTATATE
PSMA vs DOTATATE
Slide 76: PSMA vs DOTATATE
PSMA vs DOTATATE
Slide 77: PSMA vs DOTATATE
PSMA vs DOTATATE
Slide 78: Patient's journey from PSA>MRI>PSMA PET
Patient’s journey from PSA>MRI>PSMA PET
Slide 79: Receptor Targeted PET enabled a fundamentally different clinical trial design: Treat if you see it
Receptor Targeted PET enabled a fundamentally different clinical trial design: Treat if you see it
Slide 80: 68Ga/177Lu-PSMA Super vs Non-Responder
68Ga/177Lu-PSMA Super vs Non-Responder
Slide 81: 68Ga/177Lu-DOTATATE Super vs Non-Responder
68Ga/177Lu-DOTATATE Super vs Non-Responder
Slide 82: Radioligand Therapy Today
Radioligand Therapy Today “Science advances one funeral at a time” Max Planck
Slide 83: Radioligand Therapy Today
Radioligand Therapy Today “Science advances one funeral at a time” Max Planck
Slide 84: FAP is an Emerging Target
FAP is an Emerging Target FAP can be expressed on cancer FAP can also be primarily cells and stroma cells expressed only on tumor stroma and not on cancer cells Tumor cell Sarcoma Head-NeckCa Pancreatic Ca Ovarian Ca é Fibroblast L “ E ee _ 7 Thymus Ca Smallintestine Ca Prostate Ca Kratochwil et al.
Slide 85: Not every FAP is bio-identical
Not every FAP is bio-identical
Slide 86: Theranostics Short Half-lives for Long, Full Lives
Theranostics Short Half-lives for Long, Full Lives
Slide 87: FIH 203/212Pb Pb-VMT-a-NET Perspective Therapeutics
FIH 203/212Pb Pb-VMT-α-NET Perspective Therapeutics
Slide 88: FIH 203/212Pb Pb-VMT-a-NET Perspective Therapeutics
FIH 203/212Pb Pb-VMT-α-NET Perspective Therapeutics
Slide 89: Early, Medium and Late Biodistribution Should Inform Therapeutic Window
Early, Medium and Late Biodistribution Should Inform Therapeutic Window
Slide 90: Perspective's CCK2R81 in Medullary Thyroid Cancer Compared to FDG and Fluorodopa
Perspective’s CCK2R81 in Medullary Thyroid Cancer Compared to FDG and Fluorodopa
Slide 91: Development of PSV594 for CCK2R+ Tumor types
Development of PSV594 for CCK2R+ Tumor types
Slide 92: CCK2R: Implicated in Multiple Tumor Types With Major Unmet Needs
CCK2R: Implicated in Multiple Tumor Types With Major Unmet Needs
Slide 93: CCK2R is a Compelling Target for Cancers with Very-High Unmet Needs
CCK2R is a Compelling Target for Cancers with Very-High Unmet Needs First and best-in-class opportunity for multiple cancers CCK2R Perspective’s 4" clinical candidate has “pipeline in a drug” potential across a range of solid tumor types with significant unmet needs. 82K The current served market si
Slide 94: Closing Remarks
PERSPECTIVE THERAPEUTICS Closing Remarks Thijs Spoor Chief Executive Officer
Slide 95: Expanding the Addressable Market
Expanding the Addressable Market
Slide 96: Optimizing the Entire System
Optimizing the Entire System
Slide 97: A Decade of Deliberate, End-to-End Engineering
A Decade of Deliberate, End-to-End Engineering
Slide 98: Built Over a Decade: The Only Fully Integrated Radiopharmaceutical Platform
Built Over a Decade: The Only Fully Integrated Radiopharmaceutical Platform from Isotope to Patient 98 *As of May 1, 2026. Category defining radiopharmaceuticals Clinical proof-of-concept established 107 issued, allowed and pending patents* Regional network for direct to hospital delivery Proprietar
Slide 99: Q&A
my PERSPECTIVE’ THERAPEUTICS Q&A
Slide 100: Advancing a Theranostic Approach
Advancing a Theranostic Approach:
Slide 101: 212Pb is Our Isotope of Choice
212Pb is Our Isotope of Choice
Slide 102: Choosing The Right Isotope
Choosing The Right Isotope Lead (?12Pb) advantages over beta and other alpha emitters 212Db Advantage 102 Better anti-tumor activity Better safety profile Cleaner decay chain Better clinical profile Isotope access & scalability Better patient management Better patient selection “Daughter isotopes Le
Slide 103: Kinetics Matter: 212Pb Hits Hard and Fast For Strong Activity with Less Systemic Exposure
Kinetics Matter: 212Pb Hits Hard and Fast For Strong Activity with Less Systemic Exposure
Slide 104: Alpha-Particles Delivers More Potent, Targeted Tumor Killing vs. Beta-Particles
𝜶-Particles Delivers More Potent, Targeted Tumor Killing vs. β-Particles
Slide 105: 212Pb Further Enhanced by Proprietary Chelator for Targeted Delivery of Payload
212Pb Further Enhanced by Proprietary Chelator for Targeted Delivery of Payload
Slide 106: 212Pb Multi-Mechanistic Activity Drives Tumor Destruction and Anti-Tumor Immunity
212Pb Multi-Mechanistic Activity Drives Tumor Destruction and Anti-Tumor Immunity
Slide 107: Rationale for Synergy with Immune Checkpoint Inhibitors
Rationale for Synergy with Immune Checkpoint Inhibitors
Slide 108: 212Pb Uniquely Suited for Combination with Immune Check Point Inhibitors
212Pb Uniquely Suited for Combination with Immune Check Point Inhibitors
Slide 109: 212Pb Half-life Is More Convenient for Customers
212Pb Half-life Is More Convenient for Customers
Slide 110: 212Pb Isotope Decay Chain and Importance of the Pb-specific Chelator
212Pb Isotope Decay Chain and Importance of the Pb-specific Chelator Thorium Where the drug goes = where the 1sy alpha particle is deposited @) OH 2 Bj Bismuth 61m * Perspective’s proprietary chelator retains ~95% of 2128] after transition in drug formulation? * Generic chelators leak the 2?2Bi alph
Slide 111: 225Ac Isotope Decay Chain and Potential For Off-target Toxicity
225(\c Isotope Decay Chain and Potential For Off-target Toxicity 111 | Isotope Supply Production Therapy Bismuth | 46m A¥P1KO] 32310 1-440 404 [eHUDIOg Alpha-particle emission OH imparts sufficient “recoil” fe) energy to break chemical aN s~¢ bonds N A PERSPECTIVE" THERAPEUTICS
Slide 112: Isotope Decay Chain: Product Implications
Isotope: Decay Chain — Product Implications Post final radiolabeling and purification, alpha and beta emitting daughters of 2°Ac build up fast 225A) cay ghter Ingrowt! Dose Vial Unbound Isotopes m25Ac m221Fr mw 217At mi 2238) me 205T] m213Po 4x more unlabeled daughter activity in about 4 hrs l | 8 R
Slide 113: Advancing a Theranostic Approach
Advancing a Theranostic Approach:
Slide 114: Supply Chain and Manufacturing Infrastructure
Supply Chain and Manufacturing Infrastructure
Slide 115: End-to-End Manufacturing with Clinical Supply Secured and Commercial Scale Underway
End-to-End Manufacturing with Clinical Supply Secured and Commercial Scale Underway
Slide 116: Direct-to-Hospital Delivery through Integrated Isotope Production
Direct-to-Hospital Delivery through Integrated Isotope Production
Slide 117: Reliable, On-Demand 212Pb from 228Th and 224Ra
Reliable, On-Demand 212Pb from 228Th and 224Ra
Slide 118: Flexible Scalable 224Ra Supply Enables Regional Manufacturing
Flexible Scalable 224Ra Supply Enables Regional Manufacturing
Slide 119: Ideal for Regional Manufacturing
Ideal for Regional Manufacturing
Slide 120: On-Demand Fulfillment at Regional Sites for Finished Product Delivery
On-Demand Fulfillment at Regional Sites for Finished Product Delivery
Slide 121: Daily Production at Regional Sites Ensures Supply of Ready-to-administer Product
Daily Production at Regional Sites Ensures Supply of Ready-to-administer Product
Slide 122: Reaching the Largest Addressable Market with Regional Manufacturing
Reaching the Largest Addressable Market with Regional Manufacturing
Slide 123: Mature, Well-Established Distribution Networks
Mature, Well-Established Distribution Networks
Slide 124: Network Approach Chosen by Novartis
Network Approach Chosen by Novartis