Alpha Tau Medical Ltd. (DRTS) Investment Analysis
1. Executive Summary:
Alpha Tau Medical Ltd. (DRTS) is an Israeli-based clinical-stage oncology therapeutics company fundamentally transforming the localized treatment of solid tumors through its proprietary Alpha DaRT (Diffusing Alpha-emitters Radiation Therapy) platform. The company's technology represents a paradigm shift in radiation oncology, effectively delivering the high-potency, short-range cell-killing capabilities of alpha particles to the interior of solid tumors—a task previously constrained by the physical limits of alpha radiation.[1, 2] By utilizing a novel diffusion mechanism where radioactive daughter atoms travel several millimeters through the tumor mass, Alpha Tau has overcome the historical "range problem" of alpha emitters, allowing for precise, conformal, and highly destructive radiation that leaves surrounding healthy tissue largely unscathed.[3, 4, 5]
The company's primary market segments are defined by its target clinical indications, which include high-unmet-need areas such as cutaneous squamous cell carcinoma (cSCC), pancreatic ductal adenocarcinoma (PDAC), glioblastoma multiforme (GBM), and recurrent head and neck squamous cell carcinoma (HNSCC).[6] While the company is currently pre-revenue in major markets like the United States, it generates early-stage revenue through commercial operations in Israel and is positioned for a transformative 2026 following marketing approval in Japan.[7, 8, 9] Revenue is generated through the sale of specialized radioactive metal sources (seeds) impregnated with Radium-224 and the proprietary, ultra-minimally invasive applicators required for their interstitial implantation.[10, 11] The company also anticipates future revenue streams from treatment planning software and automated manufacturing services.[10]
Alpha Tau’s core products consist of the Alpha DaRT seeds and a suite of indication-specific applicators designed for use across different anatomical areas, including the skin, oral cavity, prostate, and internal organs via endoscopic ultrasound (EUS) or robotic guidance.[1, 3, 12] Primary customer types include large academic medical centers, specialized cancer hospitals, and private oncology practices that currently utilize traditional external beam radiation therapy (EBRT) or beta-emitting brachytherapy.[13, 14, 15] The most important end markets are the United States, Japan, and Europe, with Japan recently granting marketing approval for HNSCC in February 2026.[8, 9]
Customers choose Alpha Tau over existing alternatives because Alpha DaRT offers a superior therapeutic index. Traditional radiation often fails in hypoxic or radiation-resistant tumors and frequently causes collateral damage to healthy organs at the tumor's margin.[1, 13, 16] Alpha DaRT, by contrast, causes direct and irreparable double-strand DNA breaks that are independent of cell cycle stage or oxygenation, making it effective where other therapies fail.[1, 3, 16] Furthermore, the therapy is designed to be "equipment-light," requiring no heavy capital expenditure like linear accelerators or proton therapy systems, and can be administered in an outpatient setting, often under local anesthesia.[4, 11]
Innovative Alpha Radiotherapy Pioneer.
2. Business Drivers & Strategic Overview:
Product and Service Detail: The Mechanics of Alpha DaRT
The foundational business driver for Alpha Tau is its proprietary Alpha DaRT technology, which solves the historic problem of delivering alpha radiation to solid tumors. Alpha particles, while having high linear energy transfer (LET) and the ability to destroy cancer cells regardless of oxygen levels, have a range in tissue of less than 100 microns.[1, 3, 4] Alpha Tau’s solution involves the use of Radium-224 ($^{224}$Ra) fixed to a metal tube.[8, 9] As the radium decays (half-life of ~3.6 days), it releases radioactive daughter atoms—specifically Radon-220 ($^{220}$Rn)—which diffuse approximately 5 mm through the tumor.[1, 4, 13] These atoms subsequently decay, emitting alpha particles directly within the tumor microenvironment.[4, 8]
The commercial product is a sterile, disposable kit comprising:
* Active Sources: Small stainless steel or titanium seeds (approximately 1 cm in length) coated with $^{224}$Ra.[8, 13] These are "sealed" in specialized packaging to prevent radon escape until they are ready for use.[11]
* Applicators: Proprietary delivery devices, often modeled after standard biopsy needles or "injection guns," that allow physicians to place seeds with sub-millimeter precision.[1, 3, 10]
* Treatment Planning System (TPS): An AI-integrated software suite that uses CT, MRI, or ultrasound imaging to create a 3D dosimetry map, ensuring that the diffusion radii of multiple seeds overlap to cover the entire tumor volume.[10]
The service component of the business involves on-demand manufacturing and "just-in-time" logistics. Because of the 3.6-day half-life, the company must manufacture and ship sources from a hub near the customer to ensure they arrive with sufficient radioactive activity.[4, 17] This logistical requirement creates a high barrier to entry but also a recurring service relationship with clinical sites.
Moat Analysis: Barriers to Entry and Sustained Competitive Advantage
Alpha Tau has constructed a multi-layered moat that combines physical science, intellectual property, and logistical complexity.
| Moat Type |
Detail and Strategic Relevance |
| Intellectual Property |
The company holds over 150 granted patents and 200+ pending applications. Crucially, the "IP fortress" includes indication-specific patents (e.g., for pancreatic cancer and GBM) that extend protection out to 2045, even after core technology patents expire.[6, 10] |
| Regulatory & Clinical |
Alpha Tau is the first and only company to secure marketing approval for a diffusing alpha-emitter device. The years spent in clinical validation (with 100% response rates in some pilot trials) represent a "clinical moat" that competitors would take a decade to replicate.[3, 9, 18] |
| Logistical & Supply Chain |
The short half-life of $^{224}$Ra makes the supply chain an "intrinsic moat." Competitors cannot simply manufacture a generic version and warehouse it; they would need a global network of manufacturing hubs, radioactive licenses, and specialized courier relationships.[4, 7, 17] |
| Switching Costs |
Integrating Alpha DaRT requires clinical training for urologists, neurosurgeons, and radiation oncologists. Once a facility has installed the TPS, calibrated its imaging for $^{224}$Ra, and trained its staff, the cost and effort of switching to a hypothetical competitor are substantial.[11, 13] |
| Ecosystem Advantage |
The therapy’s ability to act as a "local radiopharmaceutical" that triggers the "abscopal effect" (systemic immune response) allows Alpha Tau to potentially bundle its treatment with immunotherapies like pembrolizumab, creating a synergistic ecosystem.[6, 10, 18] |
TAM / Market Opportunity Analysis
The total addressable market for Alpha DaRT is massive, as it is potentially agnostic to tumor type. The company’s immediate strategy targets high-unmet-need indications where standard radiation or surgery often fails.
| Indication |
Market Data & Unmet Need |
| Cutaneous SCC |
1.8 million cases annually in the U.S. Many are unresectable or recurrent, providing a significant high-margin opportunity for localized treatment.[6] |
| Pancreatic Cancer |
66,000 annual U.S. cases. Current five-year survival is <10%. Alpha DaRT’s ability to be delivered via EUS-guided needles provides a unique path for inoperable tumors.[6, 19] |
| Glioblastoma (GBM) |
A 93% five-year mortality rate. Alpha DaRT has Breakthrough Device Designation here, targeting recurrent cases that have exhausted all other radiation options.[3, 5, 6] |
| Prostate Cancer |
Over 300,000 new cases in the U.S. annually. Alpha DaRT targets the 15% of patients who experience local recurrence after initial EBRT.[7, 13] |
| HNSCC |
54,000 annual U.S. cases. The Japan approval specifically addresses this cohort, which often has very poor quality of life due to the inability to swallow or speak after radical surgery.[6, 9] |
Competitive Landscape: Position and Momentum
Alpha Tau is currently gaining ground as it transitions from a "science experiment" to a commercial entity.
- Legacy Radiation (Elekta, Varian/Siemens): These incumbents dominate EBRT. Elekta holds 32-34% of the market.[14, 15] Alpha Tau is positioned as a complement to their ecosystems (e.g., used when tumors recur after EBRT) or a replacement in specific niches where EBRT toxicity is too high.[11, 13]
- Systemic TAT (RayzeBio, Fusion, Actinium): These companies use antibodies to deliver alpha particles systemically. While they target metastatic disease, they face "off-target" toxicity in kidneys and marrow.[16, 20] Alpha Tau's localized delivery is superior for bulky, primary solid tumors, as it avoids systemic exposure.[3, 18]
- Beta-emitting Brachytherapy (Perspective, Sirtex): These utilize beta particles (electrons), which have a longer range but lower "kill power." Alpha particles are 100-1,000 times more lethal and effective against hypoxic tumors that beta radiation cannot kill.[4, 16, 20, 21]
Alpha Tau’s momentum is accelerating, evidenced by the Japan MHLW approval in February 2026 and the FDA’s expansion of the IMPACT trial size and scope in April 2026.[8, 9, 19] The company is moving from "defensive" clinical trials to "offensive" commercial expansion.
Strategically Positioned Disruptor.
3. Financial Performance & Valuation:
Latest Quarterly Performance (Q4 2025)
Alpha Tau reported its fourth-quarter and full-year 2025 results on March 9, 2026.[7, 22]
- Financial Results: The company reported a net loss for the year ended December 31, 2025, of $42.6 million, or $0.53 per share.[7] This compares to a net loss of $31.8 million, or $0.45 per share, in 2024.[7, 23]
- Expectations: The Q4 2025 EPS was -$0.14, missing the consensus analyst estimate of -$0.13 by approximately 7.7%.[22, 24, 25]
- Revenue: The company remains pre-revenue in terms of major commercial sales, though it reported minor revenue (likely from its limited Israel operations) of $0.06M in Q4 2025.[22]
- Guidance: While Alpha Tau does not provide specific quarterly revenue guidance, management updated its clinical milestones, including the expectation to finish recruitment for the U.S. ReSTART trial in mid-2026 and the U.S. IMPACT trial in Q3 2026.[7, 19, 26]
- Management Commentary: CEO Uzi Sofer emphasized the "slew of meaningful announcements" and the "laser focus on execution" following the Japan approval. CFO Raphi Levy highlighted the company's $76.9 million cash balance, which provide significant runway for clinical advancement and commercial preparation.[7, 26]
Financial Drivers and Impact
The latest earnings announcement did not result in a significant immediate stock price crash, despite the EPS miss, because investors are primarily focused on clinical milestones rather than short-term losses. Shares actually rose slightly in the days following the announcement as analysts focused on the Japan approval (announced just weeks prior) and the New Hampshire manufacturing license.[27, 28, 29]
| Expense Category |
2025 ($M) |
2024 ($M) |
% Change |
Primary Drivers |
| Research & Development |
$32.1 |
$27.0 |
+18.7% |
Higher trial enrollment, raw material costs, and clinical site fees.[7, 23] |
| Marketing |
$1.9 |
$2.3 |
-20.8% |
Reduced travel and focused conference participation.[7, 23] |
| General & Admin |
$8.4 |
$6.7 |
+25.3% |
Increased headcount and share-based compensation.[7, 23] |
| Financial (Net) |
$0.2 (Exp) |
$4.3 (Inc) |
N/A |
Reduced interest income from lower bank rates and remeasurement of warrants.[7, 23] |
Valuation Drivers and Consensus
Valuation for Alpha Tau is currently derived from its pipeline probability-weighted Net Present Value (NPV) rather than earnings multiples.
- Revenue Trajectory: Analysts project average 1-year revenue at ~$0.96M, 2-year at ~$7.7M, and a significant jump to $73.4M by 3 years out as U.S. commercialization begins.[30]
- Manufacturing Scale: The New Hampshire facility’s nameplate capacity of 400,000 sources (sufficient for ~14,000 cases annually) provides a tangible "ceiling" for near-term revenue potential.[4, 7]
- Analyst Price Targets: The consensus target is $8.67 (approx. 7% upside from current price), with a high of $12.00 (H.C. Wainwright) and a low of $5.00 (Piper Sandler).[30, 31, 32]
- Cash Runway: With a $26.7M operating cash burn in 2025 and $76.9M in cash, the company has roughly 24-30 months of runway, which is sufficient to reach the next set of binary clinical outcomes.[7, 23]
Execution-indexed Clinical Value.
4. Risk Assessment & Macroeconomic Considerations:
Company-Specific Execution Risks
- Clinical Success Concentration: Alpha Tau’s value is heavily tied to the success of its lead indications. A failure in the pivotal ReSTART trial (cSCC) would be catastrophic for the valuation, as it is the "proof of concept" for the entire platform's regulatory viability.[33, 34]
- Manufacturing and Quality Control: Handling $^{224}$Ra is extremely delicate. Any failure in the robotic loading systems or a contamination event at the Jerusalem or New Hampshire facilities could result in an immediate regulatory shutdown.[4, 10, 17]
- Early Warning Sign: A delay in recruitment for the ReSTART trial or a request from the FDA for additional modules in the PMA process would indicate execution friction.[33, 34]
Competitive & Industry Structure Risks
- Targeted Alpha Therapy (TAT) Competition: While Alpha Tau is localized, systemic TAT players (e.g., RayzeBio) are backed by massive pharma resources (BMS). If systemic therapies achieve high local control with lower procedural complexity, the demand for "needle-based" Alpha DaRT could diminish.[16, 20]
- Reimbursement Barriers: Even with FDA approval, Alpha Tau must secure specific CPT codes and favorable reimbursement from CMS. If payers classify it as "experimental" or "too costly" relative to EBRT, adoption will be limited.[35, 36, 37]
Regulatory & Legal Risks
- Radioactive Licensing: The company operates under strict NRC and state-level licenses. Changes in nuclear safety regulations or a loss of license in New Hampshire would sever access to the U.S. market.[4, 7, 17]
- Patent Challenges: As the company grows, it becomes a target for IP litigation. A loss of the core "diffusion" patents would destroy the company's moat.[10]
Balance Sheet & Capital Allocation Risks
- Dilution Risk: To move from 400,000 sources to a global scale, Alpha Tau will need hundreds of millions in capital. Unless the company achieves early revenue from Japan/Israel, it will likely need to raise equity by late 2027, potentially diluting current holders by 20-30%.[7, 23]
- Capital Intensity: Building manufacturing hubs is expensive. Each new facility costs millions and takes years to license, creating a high "capital burn" phase.[23]
Macroeconomic & Geopolitical Risks
- Israel Geopolitical Risk: With headquarters and primary manufacturing in Jerusalem, the company is sensitive to regional conflict. Disruptions to the "cold chain" or the Jerusalem airport would halt global supply.[27, 38, 39]
- Isotope Supply Chain: Thorium-228 is sourced from Oak Ridge National Lab. Any geopolitical decision to restrict nuclear material exports or a shutdown of ORNL processing would halt Alpha Tau’s production.[4, 40]
Binary Clinical Logistics Risk.
5. 5-Year Scenario Analysis:
Financial Assumptions & Context
Current Share Price (May 1, 2026): $8.54.[31, 41]
Shares Outstanding: ~80 Million (Estimated from Market Cap).[39, 42]
High Case: The "New Standard of Care" (Probability: 20%)
In this scenario, Alpha Tau achieves FDA approval for cSCC in late 2026 and Pancreatic cancer in 2028. Adoption is rapid because the EUS-guided delivery becomes the standard for inoperable pancreatic tumors. The NH plant hits its 400,000 source capacity and the company breaks ground on a second U.S. facility.
* Year 5 Revenue (2031): $350 million. (Assuming 35,000 cases annually at $10k per case).
* Margins: 35% Net Margin (High operational leverage on software/IP).
* Valuation Multiple: 12x Revenue (High-growth MedTech premium).
* Projected Share Price: $52.50.
* Total Return: 514.8% (Annualized: 43.8%).
Base Case: Measured Commercial Growth (Probability: 60%)
Alpha Tau secures cSCC approval in 2027. Pancreatic and GBM trials remain in pilot/pivotal stages but show positive data. Japan commercialization is successful, providing high-margin royalties.
* Year 5 Revenue (2031): $150 million. (Assuming 15,000 cases annually at $10k per case).
* Margins: 20% Net Margin (Significant reinvestment in pipeline).
* Valuation Multiple: 7x Revenue.
* Projected Share Price: $13.12.
* Total Return: 53.6% (Annualized: 8.9%).
Low Case: Regulatory and Logistical Stagnation (Probability: 20%)
The FDA rejects the cSCC PMA due to insufficient long-term data. The NH manufacturing facility faces persistent licensing delays. Systemic TAT therapies capture the market for recurrent tumors.
* Year 5 Revenue (2031): $25 million. (Limited to Japan and Israel).
* Margins: Negative (Ongoing cash burn).
* Valuation Multiple: 3x Revenue.
* Projected Share Price: $0.94.
* Total Return: -89.0% (Annualized: -35.8%).
5-Year Scenario Table
| Scenario |
Revenue (Year 5) |
Net Margin |
Val. Multiple |
Current Price |
Implied Price |
5-Yr Total Return |
Annualized |
Prob. |
| High |
$350M |
35% |
12x Rev |
$8.54 |
$52.50 |
514.8% |
43.8% |
20% |
| Base |
$150M |
20% |
7x Rev |
$8.54 |
$13.12 |
53.6% |
8.9% |
60% |
| Low |
$25M |
-10% |
3x Rev |
$8.54 |
$0.94 |
-89.0% |
-35.8% |
20% |
| Weighted |
$165M |
17% |
7.2x |
$8.54 |
$18.56 |
117.3% |
16.8% |
100% |
High-Beta Clinical Execution.
6. Qualitative Scorecard:
- Management Alignment: 9/10
CEO Uzi Sofer owns 13.1% of the company, and top 25 shareholders own over 35%. There has been substantial insider buying (9 insiders, $9.6M) in the last 12 months, indicating strong confidence from those with the most information.[41, 43]
- Revenue Quality: 2/10
Currently very low quality as revenue is non-recurring and comes from a pre-commercial phase. This will only shift once multi-year hospital contracts are signed.[22, 29]
- Market Position: 8/10
They are the clear leader in localized alpha-emitter therapy. The Japan approval acts as a massive "seal of approval" that elevates them above peer-stage biotech firms.[9]
- Growth Outlook: 9/10
The indication expansion (prostate, brain, lung, pancreas) provides a clear and massive runway. The platform is truly a "pipeline in a product".[6, 44]
- Financial Health: 7/10
Low debt (0.08 D/E) and $76.9M in cash provide a comfortable buffer, though the company is currently a "cash consumer".[7, 23, 31]
- Business Viability: 8/10
The 100% response rates in skin cancer and the EUS-guided delivery feasibility in pancreas suggest a highly viable product that solves real clinical problems.[3, 12, 18]
- Capital Allocation: 7/10
Management has focused capital on manufacturing (New Hampshire) and the most promising pivotal trials (cSCC).[7, 26]
- Analyst Sentiment: 6/10
A "Hold" consensus ($8.67 target) reflects caution about the upcoming binary FDA decisions, though some analysts see 100%+ upside.[30, 31, 45]
- Profitability: 1/10
Pre-profit. High losses are expected for at least 3-4 more years.[7, 23]
- Track Record: 7/10
Since 2016, they have successfully moved from a university concept to a multi-national clinical program and a marketing approval in Japan—this is a high-velocity track record for MedTech.[8, 9, 44]
Blended Score: 6.4/10
High-Conviction Speculative Play.
7. Conclusion & Investment Thesis:
Alpha Tau Medical (DRTS) is at a critical inflection point. The company has successfully transitioned from a specialized physics theory to a clinically validated medical technology with proven marketing approval in Japan.[8, 9] The investment thesis rests on the Alpha DaRT platform’s unique ability to deliver high-LET alpha radiation to deep-seated solid tumors while maintaining a safety profile that exceeds current standards for radiotherapy.[1, 3, 16]
Key catalysts for the next 12 months include the results of the U.S. ReSTART skin cancer trial, the commencement of commercial sales in Japan, and the continued data readouts from the pancreatic IMPACT trial.[7, 19, 26] If Alpha Tau can demonstrate that its localized approach is both safer and more effective than traditional EBRT in the U.S. market, it could capture a multi-billion dollar share of the oncology treatment landscape.[6, 18]
While the risks related to the 3.6-day half-life logistics and FDA regulatory timelines are significant, the company’s strong cash position and high insider ownership suggest it is well-prepared to navigate these hurdles.[4, 7, 43] For investors, Alpha Tau offers a unique exposure to the "Alpha Revolution" in oncology without the systemic toxicity risks of traditional radiopharmaceuticals.
Unlocking Alpha Potency.
8. Technical Analysis, Price Action & Short-Term Outlook:
Alpha Tau (DRTS) is exhibiting strong bullish behavior, reaching a new 52-week high of $8.80 in May 2026.[31] The stock is trending significantly above its 200-day moving average of $5.99 and 50-day moving average of $7.36, supported by a 57% year-to-date surge fueled by the Japan approval and expanded pancreatic trial scope.[27, 31, 41] Short-term sentiment remains bullish as investors anticipate the ASCO annual meeting in late May, with support levels identified at $8.22 and $7.93.[41, 46]
Bullish Technical Breakout.
- Alpha DaRT | Alpha Radiation Cancer Treatment, https://www.alphatau.com/alpha-dart-radiotherapy
- Alpha Tau Medical: Alpha Radiation Cancer Treatment, https://www.alphatau.com/
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- Press release dated April 27, 2026. - SEC.gov, https://www.sec.gov/Archives/edgar/data/1871321/000121390026047783/ea028769001ex99-1.htm
- Novel alpha particle therapy holds promise in prostate, bladder cancer - Urology Times, https://www.urologytimes.com/view/novel-alpha-particle-therapy-holds-promise-in-prostate-bladder-cancer
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- Alpha Tau Medical (DRTS) 44th Annual J.P. Morgan Healthcare Conference Summary, https://quartr.com/events/alpha-tau-medical-ltd-drts-44th-annual-j-p-morgan-healthcare-conference_FeeJBPbd
- Alpha Tau Announces FDA Approval of IDE Supplement to Expand Alpha DaRT ® IMPACT Trial to Patients with Pancreatic Cancer Receiving Gemcitabine with Abraxane ® (Nab-Paclitaxel) - SEC.gov, https://www.sec.gov/Archives/edgar/data/1871321/000121390026046897/ea028745101ex99-2.htm
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- Global comparison of targeted alpha vs targeted beta therapy for cancer: In vitro, in vivo and clinical trials - PubMed, https://pubmed.ncbi.nlm.nih.gov/29482781/
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- Annual Report for Fiscal Year Ending December 31, 2025 (Form 20-F) - Public Technologies (PUBT), https://www.publicnow.com/view/5B7A2BA4B05A0E42BF4530DA93BA1032394A0DD6?1773089308
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- DRTS (Alpha Tau Medical Ltd. Ordinary Shares) posts narrower Q4 2025 loss than estimates, shares rise 0.75 percent today. - Low Growth, https://ors3.cxc.org/aticles-market/DRTS-Alpha-Tau-Medical-Ltd-Ordinary-Shares-posts-narrower-Q4-2025-loss-than-estimates-shares-rise-075-percent-today-9-3948
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- Costs and Complications After a Diagnosis of Prostate Cancer Treated With Time-Efficient Modalities: An Analysis of National Medicare Data - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC7395481/
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- Cost effectiveness of prostate cancer radiotherapy - PMC - NIH, https://pmc.ncbi.nlm.nih.gov/articles/PMC6043746/
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- Supply Chain Under Radioactive Pressure: The Current State of Radiopharmaceuticals, https://www.thebrackengroup.com/blog/supply-chain-under-radioactive-pressure-the-current-state-of-radiopharmaceuticals
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- Alpha Tau Issues Letter to Shareholders: Five Concurrent Trials in the U.S. with Multiple Significant Value-Driving Milestones Ahead, https://www.alphatau.com/single-post/alpha-tau-issues-letter-to-shareholders-five-concurrent-trials-in-the-u-s-with-multiple-significan
- DRTS Forecast — Price Target — Prediction for 2027 - TradingView, https://www.tradingview.com/symbols/NASDAQ-DRTS/forecast/
- Alpha Tau abstract accepted at ASCO annual meeting in May - Investing.com, https://www.investing.com/news/company-news/alpha-tau-abstract-accepted-at-asco-annual-meeting-in-may-93CH-4638967