Repurposing Industrial Spaces into Cutting Edge Targeted Radiotherapy Facilities

What if you had to design a manufacturing facility for a product that isn’t fully defined yet? One that must be produced, tested and delivered to a patient within hours, while also carrying both life-saving potential and inherent radioactive risk?

That is the reality of targeted radiotherapy (TRT) facility design.

These facilities sit at the intersection of advanced oncology research, nuclear safety and pharmaceutical manufacturing. They operate as tightly orchestrated systems in which time, precision and compliance must align. When layered onto the decision to repurpose an existing industrial space, the complexity increases significantly. Unlike traditional pharmaceutical projects, TRT facilities are often designed while the science itself is still evolving. Clinical trials continue, manufacturing processes mature and equipment definitions shift — yet the facility must still be delivered on schedule.

The result is a fundamentally different design problem that demands coordination and a willingness to design for what is not yet fully known. Navigating that challenge requires examining how these facilities are planned, the systems that ultimately define them and the real-world constraints that shape their delivery.

Designing for Uncertainty & Speed

In conventional pharmaceutical design, the process leads, and the building follows. In many TRT projects, that sequence is blurred. The facility may take shape while the drug, workflow and equipment are still being defined, creating a constant state of change. Spaces shift, equipment footprints expand, utility demands increase and regulatory expectations evolve.

To respond, the facility must be conceived not as a fixed solution, but as a flexible platform capable of absorbing change without compromising performance. That flexibility begins with infrastructure, where systems are sized with growth in mind to accommodate increasing demands for power, cooling, exhaust and specialty gases as processes mature. This extends just as critically into how the facility is organized. Spatial planning must reinforce adaptability, with adjacencies that incorporate intentional buffer zones — areas capable of shifting function over time without disrupting critical operations. This allows the facility to evolve in place as workflows develop, rather than requiring large-scale reconfiguration.

Within this framework, modularity becomes a key enabler. Clean-room environments, in particular, benefit from repeatable planning grids and standardized utility connections that support incremental change. But true flexibility isn’t only physical, it’s procedural. Project teams must treat iteration as an expected part of delivery, supported by clear change-control processes that allow adjustments to be managed deliberately rather than reactively.

Layered onto this need for adaptability is a non-negotiable operational constraint: the drug must move from production to patient within hours. This requirement transforms the facility into a time-sensitive system, where every step — from synthesis to quality control to final dispatch — must occur within a tightly coordinated sequence. Even minor delays can render doses unusable and disrupt patient care. Meeting this demand requires a precise and disciplined approach to layout and flow. Critical functions must be positioned in close proximity to minimize travel distance and handoff time, while movement through the facility follows clear, unidirectional paths that reduce contamination risk and operational overlap. The goal is not simply efficiency, but consistency, ensuring that each step occurs predictably within a compressed timeframe.

That same emphasis on predictability carries through to system reliability. In an environment where even small disruptions can compromise an entire production cycle, redundancy becomes foundational. Backup power, resilient HVAC strategies and well-considered contingencies are essential to maintaining continuity. In this context, speed is not achieved through shortcuts, but rather is the product of flexibility, precision and reliability — all brought together through a carefully aligned relationship between workflow and space.

Engineering the Core Systems

At the center of TRT manufacturing is the hot cell — a heavily shielded enclosure where radioactive materials are handled using remote manipulators. Hot cells serve as the organizing elements of the facility, shaping structural systems, mechanical infrastructure and overall spatial layout. Their influence begins with their physical demands. The weight of these units often necessitates reinforced foundations, while their operation depends on tight tolerances for alignment and vibration control. They also drive key building systems, particularly those related to air management. Exhaust strategies must be carefully designed, typically incorporating dedicated, monitored and filtered systems to safely handle radioactive emissions without compromising surrounding environments.

The implications of the hot cell extend well beyond these technical requirements. They introduce a layer of operational complexity that must be addressed early, from rigging and installation sequence, maintenance access and decontamination procedures to eventual replacement. This complexity is compounded by the fact that hot cells are typically custom-fabricated (often by international vendors), resulting in long lead times and uncertainty of on-site delivery and coordination. 

Designing around the hot cell, therefore, is not simply a matter of accommodating its footprint, but of anticipating its full lifecycle within the facility. That lifecycle becomes most apparent at the points where the hot cell connects to the rest of the operation. Material transfer, particularly between hot cells and clean rooms, represents one of the most sensitive aspects of the design. These interfaces must simultaneously maintain radiation containment, aseptic conditions and pressure differentials, placing them at the intersection of architectural detailing, process engineering and equipment fabrication.

As a result, even minor misalignments in dimensions or tolerances can create significant installation challenges or operational risks. Successful designs approach these transfer points as integrated systems rather than isolated components, requiring early coordination across disciplines. Their performance must also align with the broader clean-room environment, ensuring that pressure cascades remain intact and that materials can withstand rigorous cleaning and decontamination protocols. Mockups and testing — whether physical or digital — are often essential to validating these conditions before installation.

From there, the process moves into its final stage of verification. Every dose in TRT manufacturing passes through quality control, making it a defining and time-sensitive part of the workflow. Because testing occurs within the same compressed timeframe as production, QC must operate in close coordination with manufacturing while maintaining its independence. This creates a careful balance in how these spaces are planned. QC functions must be close enough to enable rapid and secure sample transfer, yet sufficiently separated to preserve testing integrity. The environments themselves must support highly sensitive analytical processes, requiring stable power, tightly controlled temperature and humidity, and protection from vibration. At the same time, they must accommodate robust data management and documentation practices as therapies progress toward regulatory approval.

In many ways, quality control serves as the final checkpoint between manufacturing and patient care. Its design must reflect both urgency and precision, ensuring that speed and accuracy are not competing priorities, but tightly aligned outcomes within the overall system.

Delivering Within Real-World Constraints

Repurposing a precast industrial space offers clear cost and schedule advantages, but it also introduces a fundamental mismatch between the existing structure and the demands of a clean manufacturing environment. Warehouses are designed for volume and flexibility, not for controlled conditions. They lack the airtightness, environmental control and infrastructure required for ISO-classified spaces.

To bridge this gap, designers often adopt a “building within a building” strategy, inserting independent clean-room enclosures inside the warehouse shell. In this approach, the existing structure serves primarily as a protective outer container, while the facility’s true performance is defined by what is constructed within it. This allows controlled environments to function independently of the warehouse envelope, while accommodating the specialized systems required for radiopharmaceutical production.

Implementing this strategy introduces its own set of considerations. Interstitial spaces and mechanical mezzanines are often required to support the extensive ductwork and filtration systems that clean-room environments demand. At the same time, the existing slab may need to be upgraded to address flatness, hot-cell weight and vapor control, while core building systems, such as electrical service, fire protection and drainage, frequently require significant modification to meet the operational needs of TRT manufacturing.

Layered on top of these physical constraints is an equally complex regulatory environment. TRT facilities must navigate overlapping frameworks in which pharmaceutical manufacturing standards intersect with radiation safety requirements, hazardous materials regulations and clinical trial protocols. Each brings its own expectations and approval processes, and without careful alignment, conflicts can emerge late in the project. Addressing this complexity requires a multi-layered strategy. Successful teams establish a clear regulatory roadmap early, identifying governing authorities, mapping approval pathways and documenting design decisions in a way that ties them directly to risk mitigation and operational intent. As both the process and the facility evolve, this framework must remain active, adapting alongside them to maintain alignment.

Ultimately, however, the defining challenge of TRT facility delivery is not any single constraint, but the fact that all of them are in motion at once. The building, the equipment and the process are developed concurrently, creating a highly interdependent system in which decisions in one area can quickly cascade into another. Misalignment can lead to rework, delays or compromised performance. In this environment, coordination becomes the central discipline. It must be structured and continuous, supported by clear decision tracking, disciplined change-control processes and shared digital models that enable real-time alignment across teams. Design milestones must be tied to procurement realities — particularly for long-lead equipment — while construction expertise is brought in early to ground feasibility decisions.

Uncertainty cannot be eliminated from these projects, but it can be managed. And in many cases, success depends less on any single design move than on how effectively the team coordinates the many moving parts required to deliver the facility.

Building for Both Now and Next

Designing a targeted radiotherapy facility within a repurposed industrial space is, at its core, an exercise in designing for change. These environments must operate with precision under extreme constraints while accommodating evolving science, shifting regulatory expectations and advancing technologies — all at once. They are required to deliver for today, supporting clinical trials and time-sensitive production, while remaining adaptable enough to scale and evolve as therapies mature. When done well, these facilities move beyond their immediate function, becoming platforms for innovation that can support new processes, new treatments and new models of care as they emerge.

This dual demand — performance in the present and flexibility for the future — defines the challenge, and raises a larger question: As therapies become more personalized, time-sensitive and complex, are we designing facilities that can truly evolve alongside them, or are we still building for a moment that has already passed?

The answer will shape not only the success of individual projects, but also the trajectory of how care is delivered in the years ahead.