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. Author manuscript; available in PMC: 2020 Jul 17.
Published in final edited form as: Lancet Oncol. 2020 Mar;21(3):e146–e156. doi: 10.1016/S1470-2045(19)30821-6

Table 2:

Challenges in developing clinical radiotheranostics: reasons and possible solutions

Solution
Technical or organisational challenges
Absence of interdisciplinary treatment teams Create multidisciplinary disease teams
Small workforce Revise training programmes; implement e-learning tools
Bottlenecks in radioisotope availability Scale-up through commercial vendors
Uneven global availability Scale-up through commercial vendors
Regulatory challenges ..
Economic challenges
High development cost ..
Reimbursement ill-defined ..
Insufficient access to funding with decreased research budgets ..
Competing technologies Prospective comparative multicentre trials
Global differences Cost-benefit analysis in low and middle-income countries
Biomedical challenges
Few available drugs Explore new nuclides to target ligands and indications
Absence of large-scale prospective trials Multicentre prospective clinical trials; design and conduct clinical trials (expertise, training, and sites)
Combination treatments largely unexplored Prospective clinical trials (based on preclinical evidence)