Each radioligand therapy requires significant patient testing and eligibility requirements before administration. Radioligand therapies for cancer treatment are not the first course of action and generally require the patient to have undergone other previous treatments and many diagnostic imagings (i.e. seeing if specific receptors/antigens exist) to determine the benefit vs. adverse effect of undergoing the radioligand therapy.
For example, the PSMA radioligand therapy (Pluvicto) requires the patient to have end-stage prostate cancer that has metastasized in other organs, the PSMA ligand (confirmed through diagnostic imaging), and gone through hormonal therapies and chemotherapies. For patient eligibility to get Lutathera radioligand therapy the patient must have disease progression despite receiving somatostatin analog therapy (octreotide or lanreotide), have a locally advanced, inoperable, or metastatic well-differentiated disease, and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.