Joint ESMO EANM course:
improving awareness and collaboration
within the radioligand therapy team

Radioligand therapy is a specialised treatment that requires multidisciplinary collaboration to be delivered effectively. In 2021, ESMO and EANM hosted their first course on diagnostic and therapeutic applications of nuclear medicine in oncology.^{1 2} The course was developed to help build awareness of theranostics, including radioligand therapy, and foster its collaborative delivery between the different stakeholders: oncologists, nuclear medicine physicians, radiation oncologists and physicists.³ The hope was that entire teams would attend the course together.³

The course is particularly targeted at oncologists as there is currently limited awareness of radiopharmaceutical therapies among this group. As oncologists are often responsible for referring people with cancer for treatment, increasing their awareness of how these therapies fit into wider diagnostic and treatment planning is essential to make them available to patients.⁴ This will become increasingly important as the demand for radioligand therapy increases with potential future approvals for wider use, for instance in cancers predominantly treated in community settings.

The course covers:

• current applications of theranostics in cancer
• basic information about theranostics and their application in thyroid cancer, neuroendocrine neoplasms and prostate cancer
• the principles of nuclear medicine and systemic cancer therapies
• the interaction between oncology and nuclear medicine experts.^{1 2}

A core component of the two-day 2022 course held in Essen, Germany, was the inclusion of practical sessions.^{3 5} Attendees listened to case presentations and took part in a simulated multidisciplinary team meeting to discuss the potential use of radioligand therapy.⁶ These practical sessions allowed attendees to engage and ask more questions, something that was noted as missing during the virtual 2021 course.³

The 2022 course was attended by 31 delegates from 12 countries, and was 60% oncologists, 30% imaging specialist and/or nuclear medicine physicians and 10% medical professionals in training.^{4 6} By increasing awareness of radioligand therapy among a number of stakeholders, particularly within the oncology community, it is hoped that more centres will offer the treatment and more people will be referred for it.³

Feedback from attendees was positive with many intending to apply what they have learnt from the course. In the evaluation attendees gave highest scores to both the content and the organization.⁴ 100% of attendees answered that they would recommend colleagues to attend that course.^{4 7} Most attendees said they agreed with the statement ‘I intend to change my practice as a result of what I have learnt’.⁷ The changes attendees said they would make included: enhancing collaboration between medical oncologists and the nuclear medicine department; starting to use radioligand therapy for people with prostate cancer; implementing gallium PSMA PET/CT as a new imaging modality in their hospital; and considering radioligand therapy more frequently for neuroendocrine neoplasms.⁷

The course is in its early years and organisers are assessing and refining the topics covered based on feedback from attendees and scientific advancements in the field. For instance, attendees have suggested that the use of  theranostics for thyroid cancer does not need to be included as it is already well established.³ Instead, future applications may be covered if the course is continued in 2023 and beyond.³

It is hoped that the course will be replicated in other centres across Europe in the future, increasing knowledge sharing and learning.³