Little pharma.

With the VISION trial making headlines this year, many people are asking: whose court is this ball in? Among 131 US radiation oncologist respondents to a survey on the subject, about half (48%) prescribe at least one radiopharmaceutical—mostly Radium-223 (40%), Iodine-131 (18%), or Yttrium-90 (13%)—with a mean monthly case number of 4 (range: 1-5). Consistent with ASTRO’s scope of practice survey, prescribers were more likely to be in non-academic settings. So, as the stewards of therapeutic radiation, why don’t all rad oncs do this? According to this survey, the biggest barriers are treatment infrastructure (44%), inter-specialty relations (41%), lack of training (23%), and financial considerations (16%). Re: infrastructure and financial considerations, it’s important to recognize the need for near- or onsite “hot” labs that require considerable capital investment that would call for sufficient patient volume. | Shukla, Adv Radiat Oncol 2021