The EFOMP policy statement n° 19: Moving Towards Personalised Molecular Radiotherapy

Molecular radiotherapy refers to the use of radioactive drugs or medical devices for medical treatment. First introduced in the 1930s, the field is now rapidly expanding with many new agents for an increasing number of indications. Currently, most treatments are delivered according to a “one size fits all” paradigm, whereby patients are treated with a fixed amount of radioactive drug, and with limited room for personalisation. 

Yet, for most radioactive drugs there are now methods available for monitoring its distribution in each patient, to evaluate the irradiation delivered by the radiotherapeutic procedure (a.k.a. dosimetry), and to optimise and personalise the treatment. This optimisation is required by The European Council Directive 2013/59/EURATOM of 5 December 2013 that states in its article 56 (Optimization) : “For all medical exposure of patients for radiotherapeutic purposes, exposures of target volumes shall be individually planned and their delivery appropriately verified taking into account that doses to non-target volumes and tissues shall be as low as reasonably achievable and consistent with the intended radiotherapeutic purpose of the exposure“.

To support the transition from administrations of fixed amounts of radioactive drugs to personalised treatments based on patient-specific dosimetry, EFOMP presents several recommendations including:

• increased networking between centres and disciplines to support data collection and development of codes-of-practice;
• resourcing to support an infrastructure that permits routine patient dosimetry;
• research funding to support investigation into individualised treatments;
• inter-disciplinary training and education programmes; and
• support for investigator led clinical trials.

These recommendations were recently presented in the EFOMP policy statement n° 19: Dosimetry in nuclear medicine therapy – Molecular radiotherapy.

“The European Federation of Organisations for Medical Physics (EFOMP) is an umbrella organization for 37 National Member Organisations, which together represent around 10,000 medical physicists and clinical engineers working in medical physics. Within EFOMP, the Special Interest Group for Radionuclide Internal Dosimetry which operates under our Scientific Committee gathers professionals involved in nuclear medicine dosimetry. With Policy statement n° 19, EFOMP strongly supports the development of personalised treatments in molecular radiotherapy. This bears the promise of better treatments for patients.”

• Manuel Bardiès, chair of EFOMP's Special Interest Group for “Radionuclide Internal Dosimetry”

The EFOMP policy statement NO. 19: Dosimetry in nuclear medicine therapy –Molecular radiotherapy. is available alongside other EFOMP Policy Statements on the EFOMP website here and as an open access publication in our journal Physica Medica here.