European recommendations - Health System Readiness

What can we do to better integrate radioligand therapy into cancer care in Europe?

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. The 2020 policy report Radioligand therapy: realising the potential of targeted cancer care identified six barriers that need to be addressed in order to realise the potential of radioligand therapy across Europe.

Radioligand Therapy Readiness Assessment Framework

Low awareness and understanding

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.

Limited professional capacity, training and workforce planning

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.

Unclear models of 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.

Inadequate physical capacity and resourcing

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.

Evolving legislation and policy

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.

Lack of data and research

Representative clinical data on radioligand therapy are limited, contributing to significant variation in how the approach is integrated into cancer care across Europe.

Policy priorities for radioligand therapy in Europe

Policymakers and decision-makers

Incorporate radioligand therapy into national, regional and local cancer plans.
Ensure adequate hospital capacity and resources for delivery of radioligand therapy to meet current and future demand.
Develop clear processes and patient pathways for care in each national context.
Invest in real-world data on radioligand therapy to better understand patient outcomes and cost-effectiveness.
Establish clear, consistent regulatory frameworks for the use of radioisotopes spanning approval, funding and reimbursement.
Ensure continued supply and appropriate disposal policies.

Nuclear medicine specialists and professional societies

Increase awareness of radioligand therapy and the role of nuclear medicine among decision-makers, people with cancer and the clinical cancer community.
Harmonise education and training standards across Europe on radioligand therapy for nuclear medicine specialists.
Develop clear processes and patient pathways for care in each national context.
Invest in real-world data on radioligand therapy to better understand patient outcomes and cost-effectiveness.
Identify and share best practices to optimise and standardise care.

Cancer specialists and professional societies

Increase awareness of radioligand therapy and the role of nuclear medicine among decision-makers, people with cancer and the clinical cancer community.
Harmonise education and training standards across Europe on radioligand therapy for all members of the multidisciplinary cancer team.
Develop clear processes and patient pathways for care in each national context.

Hospital management

Ensure that nuclear medicine specialists have adequate capacity to participate in multidisciplinary cancer care processes.
Ensure adequate hospital capacity and resources for delivery of radioligand therapy to meet current and future demand.
Develop clear processes and patient pathways for care in each national context.
Identify and share best practices to optimise and standardise care.

Patients and patient advocacy groups

Increase awareness of radioligand therapy and the role of nuclear medicine among decision-makers, people with cancer and the clinical cancer community.

Research community

Invest in real-world data on radioligand therapy to better understand patient outcomes and cost-effectiveness.
Identify and share best practices to optimise and standardise care.

Industry

Invest in real-world data on radioligand therapy to better understand patient outcomes and cost-effectiveness.
Identify and share best practices to optimise and standardise care.

More information

For more information about each of these barriers and policy recommendations, please read Radioligand therapy: realising the potential of targeted cancer care.

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