Scott AM, Zeglis BM, Lapi SE, Scott PJH, Windhorst AD, Abdel-Wahab M, Giammarile F, Piaez D, Jalilian A, Knoll P, Korde A, Vichare S, Ayati N, Lee ST, Lyashchenko SK, Zhang J, Urbain JL, and Lewis JS
Although the promise of radionuclides for the diagnosis and treatment of disease was recognised soon after the discovery of radioactivity in the late 19th century, the systematic use of radionuclides in medicine only gradually increased over the subsequent hundred years. The past two decades, however, has seen a remarkable surge in the clinical application of diagnostic and therapeutic radiopharmaceuticals, particularly in oncology. This development is an exciting time for the use of theranostics in oncology, but the rapid growth of this area of nuclear medicine has created challenges as well. In particular, the infrastructure for the manufacturing and distribution of radiopharmaceuticals remains in development, and regulatory bodies are still optimising guidelines for this new class of drug. One issue of paramount importance for achieving equitable access to theranostics is building a sufficiently trained workforce in high-income, middle-income, and low-income countries. Here, we discuss the key challenges and opportunities that face the field as it seeks to build its workforce for the 21st century., Competing Interests: Declaration of interests Outside the submitted work: AMS reports trial funding from EMD Serono, ITM, Telix Pharmaceuticals, AVID Radiopharmaceuticals, Fusion Pharmaceuticals, and Cyclotek; research funding from Medimmune, AVID Radiopharmaceuticals, Adalta, Antengene, Humanigen, Telix Pharmaceuticals, and Theramyc; and payment for participation in advisory boards of Imagion and Immunos. BMZ reports research funding from Evergreen Theragnostics, equity in Summit Biomedical Imaging, and has licensed technologies to Clarity Pharmaceuticals. SEL reports research support from Navidea Biopharmaceuticals, Fusion Pharmaceuticals, Cytosite Biopharma, Viewpoint Molecular Targeting, and Genzyme Corporation, and has acted as an advisor for NorthStar Medical Radioisotopes and Trevarx biomedical. PJHS reports research support from Bristol Myers Squibb, Telix Pharmaceuticals, and Radionetics Oncology; has acted as an adviser to Synfast Consulting and Telix Pharmaceuticals; and holds equity in Bristol Myers Squibb, Telix Pharmaceuticals, and Novartis. ADW reports their role as Editor-in-Chief of Nuclear Medicine and Biology. JSL reports research support from Clarity Pharmaceuticals and Avid Radiopharmaceuticals; has acted as an adviser of Alpha-9 Theranostics, Clarity Pharmaceuticals, Earli, Evergreen Theragnostics, Inhibrix, Precirix, and Telix Pharmaceuticals; is a co-inventor on technologies licensed to Diaprost, Elucida Oncology, Theragnostics, CheMatech, Clarity Pharmaceuticals, and Samus Therapeutics; is the co-founder of pHLIP; and holds equity in Summit Biomedical Imaging, Telix Pharmaceuticals, Clarity Pharmaceuticals, and Evergreen Theragnostics. AMS is supported by National Health and Medical Research Council grant number 1177837. SEL is supported by the Department of Energy as part of the DOE University Isotope Network, under grant DESC0021269. PJHS is supported by grant R01 EB021155. JSL is supported by National Institutes of Health grant R35 CA232130. MA-W, AJ, AK, PK, SV, STL, SKL, DP, JZ, JLU, and FG report no competing interests. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)