SNMMI 2019: Overview of the Meeting and Roadmap to the Future of Radionuclide Therapy

Las Vegas, Nevada ( Concluding this meeting, Dr. Daniel Pryma gave a brief overview of the important topics that were covered in the meeting. These were described in 11 distinct points:

  1. Radionuclide therapies do not fit neatly into any existing treatment delivery workflows. There is a need to be thoughtful and creative in working out new workflows. It is important to understand these will not be perfect in the beginning, but with time and experience, they will greatly improve.
  2. Authorized user as the nuclear oncologist – It is important to understand that it is not a one-size-fits-all model. The evolving role of the nuclear medicine physician to a nuclear oncologist is changing and will vary from place to place. There is a need to be thoughtful and creative in its integration into the treatment team. It is clear that there are many barriers, including logistic, financial, conceptual, and lack of sufficient time for the evolution of nuclear oncologist. Despite all these barriers, this process needs to be done to advance the role of nuclear oncologist and to improve patient outcomes.
  3. Clinical trial data is currently limited. There is a great need for more nuclear oncology- led-clinical trials. These evolving trials need to incorporate endpoints that are specific to radionuclides.
  4. No matter the physician workflow and other details, nuclear technologists play a central and critically important role – The technologists need to be integrated and treated as valued team members. They also need to come to these professional meetings and be involved in the ongoing conversation.
  5. The nurse navigator or an equivalent role is incredibly helpful and should be also integrated into the treatment team. It is critical to invest in this developing new role as it will greatly enhance the treatment given to patients and the logistics of this newly developing field.
  6. Regulations are important and can be quite deterring. It is important that regulations are conveyed to everyone in a clear and easily understandable manner. The radiation safety officer needs to be convinced of the benefits to weigh against the risks. An example is creative shielding options that can be made in a relatively easy manner and satisfy safety requirements.
  7. Specific workflows vary but all have common elements. All treatment team members need to communicate between them and see one another as an integral and equal part of the team, focusing on the patient at the center.
  8. Coding is very important – the bureaucratic and administrative perspective of this field of nuclear oncology is important and needs to be understood and utilized correctly by all parties involved. This is required to allow correct and appropriate inflow of finances.
  9. The Nuclear regulatory commission (NRC) generally avoids medical judgments but will strive to ensure patient, physician and public safety.
  10. Understanding the role of the authorized user is important and the required training and certifications that are mandated.
  11. The rules for industry/marketing are very different from the rules for medical decision making. Physicians have significant leeway in making decisions in the perceived best interests of patients. All these decisions need to be justified, documented and given informed consent to by the patients.

Presented by: Daniel Alexander Pryma, MD, Associate Professor of Radiology at the Hospital of the University of Pennsylvania

Written by: Hanan Goldberg, MD, Urology Department, SUNY Upstate Medical University, Syracuse, New York, USA, Twitter: @GoldbergHanan at the 2019 SNMMI Therapeutics Conference: Therapies, Theranostics, and Building Your Radionuclide Clinical Practice, October 25-27, 2019 in Las Vegas, Nevada