Radioligand therapy is currently approved for a small number of cancers, but it may have wide applications and could become an important pillar of treatment for many types of cancers and other diseases. As an innovative mode of treatment using nuclear medicine, there are some barriers that need to be addressed in order to realise the potential of radioligand therapy.
Healthcare professionals may have limited understanding of radioligand therapy and therefore may not refer all patients who could be eligible. Patients may also have low understanding of the therapy and its risks and benefits.
There is a shortage of personnel trained and experienced in radioligand therapy. Educational initiatives for multidisciplinary teams are often lacking or not aligned with the latest requirements for care. This leads to limited integration of radioligand therapy and nuclear medicine into cancer care.
Use of radioligand therapy varies considerably from one hospital to another – as well as from one country to another. This is due to a lack of harmonised and up-to-date guidelines, as well as diverging protocols and patient pathways for delivering therapy. The issue of safe disposal of radioactive waste is also a challenge.
Due to the equipment and storage requirements for radioisotopes, radioligand therapy is mainly provided in inpatient settings, usually in a small number of specialist centres. As a result, access to care varies significantly, depending on a patient’s proximity to a centre that offers radioligand therapy.
Legal and policy frameworks relevant to radioligand therapy are not always clear or appropriate, and may need adapting. There is a lack of guidance for radioactive waste disposal and inconsistencies between approval and reimbursement processes for diagnosis and therapy.
Representative clinical data on radioligand therapy are limited, contributing to significant variation in how the approach is integrated into cancer care across Europe.
For more information about each of these barriers and policy recommendations, please read Radioligand therapy: realising the potential of targeted cancer care.