Interventional Radiology in the Era of Radiotheranostics: An Update for Interventional Radiologists!

Elhelf, Islam; Clemenshaw, Michael N.

doi:10.1055/s-0042-1759703

Semin intervent Radiol

2022

DOI: 10.1055/s-0042-1759703

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Interventional Radiology in the Era of Radiotheranostics: An Update for Interventional Radiologists!

Islam Elhelf

Michael N. Clemenshaw

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“…<5 years later, 177 Lu vipivotide tetraxetan (PLUVICTO, Advanced Accelerator Applications [Novartis]) was approved for the treatment of metastatic castration-resistant prostate cancer. [1][2][3] Establishing a radiotheranostics treatment center can be challenging, yet rewarding. In this article, we share our institutional experience to launch a radiotheranostic treatment center.Starting a radiotheranostic program requires more than just financial resources and administrative support.…”

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“…In 2018, the FDA approved lutetium-177 ( 177 Lu) DOTATATE (LUTATHERA, Advanced Accelerator Applications [Novartis]) for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. <5 years later, 177 Lu vipivotide tetraxetan (PLUVICTO, Advanced Accelerator Applications [Novartis]) was approved for the treatment of metastatic castration-resistant prostate cancer 1–3. Establishing a radiotheranostics treatment center can be challenging, yet rewarding.…”

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The Logistics of Starting a Radiotheranostics Center in An Academic Institution

Elhelf¹

2022

American Journal of Clinical Oncology

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R adiotheranostic therapies are increasingly integrated into modern clinical practice. In 2018, the FDA approved lutetium-177 ( 177 Lu) DOTATATE (LUTATHERA, Advanced Accelerator Applications [Novartis]) for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. <5 years later, 177 Lu vipivotide tetraxetan (PLUVICTO, Advanced Accelerator Applications [Novartis]) was approved for the treatment of metastatic castration-resistant prostate cancer. [1][2][3] Establishing a radiotheranostics treatment center can be challenging, yet rewarding. In this article, we share our institutional experience to launch a radiotheranostic treatment center.Starting a radiotheranostic program requires more than just financial resources and administrative support. This program is relatively expensive to establish and various factors must be considered before even deciding to create such a program. One of the main factors to consider is the degree of interest among clinicians, mainly medical and surgical oncologists as well as endocrinologists, in having an institutional program versus referring patients to outside treatment centers. This can be assessed by direct communication with clinicians and recording the number of diagnostic scans being ordered for neuroendocrine tumors and prostate cancer. In our institution, we have been reached by our oncology colleagues who expressed their need to have this program available. Also, we recorded an escalating number of diagnostic positron emission tomography/computed tomography scans (eg, 68 Ga DOTATATE scan for neuroendocrine tumors and F18-prostate-specific membrane antigen scans for prostate cancer) being ordered by our in-house clinicians.Another important consideration is to establish high-quality diagnostic scan protocols and have solid communication with referring physicians. In our experience, having a standardized reporting system and communicating the results to clinicians was critical to set up a strong relationship with our referring clinicians. For example, we constantly use the "Krenning Score" to rely on the degree of radiotracer uptake on 68 Ga DOTATATE scans. Krenning score of 3 or higher, reflecting higher radiotracer uptake than background liver activity, is one of the main eligibility requirements to consider 177 Lu DOTATATE therapy. 4 It is important to communicate and explain the value of this score to our clinical partners to create a common language for communication.Once a decision is made to build a radiotheranostics treatment center, it is critical to establish a multidisciplinary team to discuss the logistics of establishing a radiotheranostics center. In our institution, this group included nuclear medicine, medical oncology, endocrinology, surgical oncology, radiation safety, and nursing, in addition to finances and administration staff. It is very important to discuss every single aspect of the project and get a consensus, as much as possible, on how to proceed and who will be responsible for specific tasks. Multiple follow-...

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The Logistics of Starting a Radiotheranostics Center in An Academic Institution

Elhelf¹

2022

American Journal of Clinical Oncology

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Interventional Radiology in the Era of Radiotheranostics: An Update for Interventional Radiologists!

Cited by 1 publication

References 16 publications

The Logistics of Starting a Radiotheranostics Center in An Academic Institution

The Logistics of Starting a Radiotheranostics Center in An Academic Institution

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