A Phase 1/2 Study of [225Ac]-FPI-1434 Injection

Inclusion Criteria:

1. Pathologically documented, definitively diagnosed, advanced solid tumour that isrefractory to all standard treatment, for which no standard treatment is available,or it is contraindicated, or the patient refuses standard therapy.

2. Measurable or evaluable disease in accordance with RECIST 1.1.

3. Eastern Cooperative Oncology Group (ECOG) Performance status of 0 or 1.

4. Life expectancy of greater than 3 months as judged by the treating physician.

5. Available tumour tissue (either archival or fresh biopsy) for IGF-1Rimmunohistochemistry. Submission of the tissue is not required prior to enrollment.

6. Adequate heart, kidney, and liver function

7. Adequate bone marrow reserves

8. Ability to understand and the willingness to sign a written informed consentdocument. Phase 2 Specific

9. Histologically and/or cytologically documented diagnosis of locally advanced,inoperable, metastatic, or recurrent solid tumour types: endometrial, cervical,ovarian, TNBC, HER 2-negative breast, HNSCC, ACC, or uveal melanoma.

10. Have measurable disease per RECIST 1.1 Failure to respond to standard systemictherapy, or for whom standard or curative systemic therapy does not exist or is nottolerable. Imaging Eligibility

11. Prior to the initial [225Ac]-FPI-1434 cycle: Sufficient target expression in atleast 1 lesion following [111In]-FPI-1547 and SPECT imaging.

Exclusion Criteria:

1. Systemic therapeutic radiopharmaceutical within 6 months prior to enrollment intothis study.

2. Contraindications to or inability to perform the required imaging procedures in thisstudy (e.g., inability to lay flat during scan time)

3. Uncontrolled brain metastasis, including but not limited to the need for treatmentwith steroids, surgery or radiation therapy.

4. Anticancer therapy (including investigational agents) or external beam radiationtherapy within 14 days of the dosing of [111In]-FPI-1547

5. Has known additional malignancy that is progressing or has required active treatmentwithin the past 3 years. Patients with basal cell carcinoma of the skin, squamouscell carcinoma of the skin or carcinoma in situ (e.g., breast cancer, cervicalcancer, prostate) that have undergone potentially curative therapy are not excluded.

6. Residual CTCAE ≥ Grade 2 side effects of prior therapy, with the exception ofresidual grade 2 alopecia.

7. Prior organ transplantation, including stem cell transplantation.

8. Any prior treatment with nitrosoureas or actinomycin-D.

9. Clinically relevant levels of protein in the urine

10. Known or suspected allergies or contraindications to the Investigational Products orany component of the investigational drug formulation.

11. Uncontrolled intercurrent illness including, but not limited to, ongoing or activeinfection, symptomatic congestive heart failure, unstable angina pectoris, cardiacarrhythmia, diabetes, or psychiatric illness/social situations that would limitcompliance with study requirements.

12. Received > 20 Gy prior radiation to large areas of the bone marrow