The Radioligand Therapy Readiness Assessment Framework is a tool to evaluate the extent to which radioligand therapy is currently integrated into a health system, focusing on five key areas. It can be applied to establish what is needed to successfully integrate radioligand therapy into cancer care.
Despite progress in many areas of cancer care, important gaps remain. Many people do not have effective treatment options, particularly for aggressive or rare forms of cancer.2 Radioligand therapy may help address some of these challenges. It has shown to significantly improve survival and quality of life for people with certain types of neuroendocrine neoplasms, lymphoma and prostate cancer.3-9 Current use of radioligand therapy is variable, so integrating it into every aspect of a health system is essential to ensuring its availability.
With many new therapies on the horizon, we need to prepare for the future of cancer care while also improving use of existing treatments. We must look at all relevant pillars of the health system to effectively plan for a full integration of radioligand therapy into cancer care.
The framework has been initially applied in the US and the UK. We hope it can be used by researchers, clinicians and patient organisations to encourage evidence-based planning for radioligand therapy within other national contexts.
Radioligand therapy has evolved from targeted radioisotope therapies, well established as a treatment option for thyroid cancer10 11 and bone metastases due to prostate cancer,12 among other clinical indications. While targeted radioisotope therapies offer organ-level precision, radioligand therapy enables precision at the cellular level.
Radioligands bind to certain types of cancer cells wherever they are located in the body, and can be used for diagnosis and treatment. Radioligand therapy is currently licensed for use for certain types of neuroendocrine neoplasms and lymphoma.13-15 It also looks promising in other cancers, such as metastatic castration-resistant prostate cancer,8 as well as non-cancer conditions.
A radioligand is made of two parts: a ligand, which can find cancer cells that have a particular surface molecule, and a radioisotope, which emits therapeutic radiation to kill cancer cells. The ligand can target radiation to specific cells anywhere in the body.
The radioligand can be customised for diagnostic (imaging) or therapeutic (treatment) purposes by changing the type of radioisotope. Combining the diagnostic and treatment processes is known as theranostics.1 16 Alternatively, changing the ligand can allow targeting of different types of cancer or even other diseases. Sometimes the ligand used is an antibody, in which case the approach is known as radioimmunotherapy.
The readiness assessment project has been led by The Health Policy Partnership, an independent research organisation, with input from three multidisciplinary Expert Advisory Groups at the international, UK and US levels. The project aims to create greater awareness of, and readiness for, radioligand therapy as an innovative component of cancer care. The Expert Advisory Groups had full editorial control over content of all materials, which reflect consensus among the group. All members provided their time for free. The outputs of this project are intended for educational purposes only and do not relate to any particular product.
This project was supported with funding from Advanced Accelerator Applications, a Novartis company, with additional support from Nordic Nanovector.