Institute Report
Succeeding with Innovation: The State of Radioligand Therapy Readiness in Europe
Dec 12, 2023

Report Summary

Radioligand therapy (RLT) is emerging as an essential pillar in cancer care. It is a targeted treatment approach that has shown clinical benefits in treating gastroenteropancreatic neuroendocrine tumors and advanced prostate cancer. It is also being researched as a promising treatment modality for several other advanced cancers. The scientific innovation in radioligand therapies is progressing rapidly; however, the healthcare system readiness for this treatment modality is lagging. There is a critical and urgent need to enhance the understanding of the current level of readiness for RLT across countries and to address issues impacting this in order to ensure patient access in a timely and equitable manner.

This report aims to further the discussion around RLT readiness in Europe by establishing key levers that should be tracked to assess overall capacity for this treatment. It also provides an initial set of data for these levers for four countries in Europe (France, Germany, Italy and Spain) to highlight the variation in identified capacity across countries and establish benchmarks that can be regularly assessed to prepare for the anticipated increase in radioligand therapy use.

Key findings:


Radioligand therapy capacity framework and key metrics
  • Building and sustaining a robust healthcare system that facilitates the use of radioligand therapy for cancer care for eligible patients in a timely manner requires planning across the complete patient journey, from diagnosis to referral to the RLT treatment.
  • RLT capacity (i.e., the total number of treatment slots available for RLT in a given year) is impacted by an interconnected set of components that support RLT delivery. The levers are diagnostic capacity, patient referral processes, number of RLT centres/beds, regulatory frameworks and hospital processes, and skilled workforce.

Number of identified diagnostic centres with PSMA capability and share of in-label patients (mCRPC post-ARPI post-taxane) receiving a diagnostic test, 2023
  • Three data points can be used to assess diagnostic capacity: Number of centres with appropriate imaging capability, time to diagnostic imaging and percentage of eligible patients receiving diagnosis.
  • These data points are used to highlight diagnostic capacity in the current treatment paradigm. As RLT begins to be used in other cancer settings, diagnostic capacity will vary.

Diagnosis to treatment time for lutetium (177 Lu) vipivotide tetraxetan
  • The time taken from diagnosis to the beginning of treatment serves as a proxy for the referral process. Minimizing the referral window is imperative in ensuring patients receive timely treatments, especially given the anticipated expansion of patients eligible for RLT treatment.
  • Referral processes can impact diagnosis to treatment time. Based on discussions with industry professionals, in France, this time period is estimated at three weeks while in Germany and Spain, it is closer to eight weeks.

Estimated capacity (treatment slots) of identified centres to treat patients using RLT per 100,000 people, 2023
  • Overall capacity and infrastructure needs to deliver RLT vary across countries.
  • Data on capacity levers from Germany, Spain, France, and Italy are examples and are reflective of disparities across countries in Europe.
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Succeeding with Innovation: State of Radioligand Therapy Readiness in Europe

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