With radioligand therapy, there is always the risk of damage to non-cancerous surrounding tissues along with radioisotope toxicity which is always a challenge in determining how to administer and create the radioligand. Furthermore, the radioligand vial is only viable for a limited time and under specific conditions which challenges transport and storage along with feasible application to the patient. 
Another limitation is the lack of centers that have trained personnel and equipment for radioligand therapy. Furthermore, individual characteristics affect the exact radiosensitivity to the therapy (thus affecting dosimetry) and are hard to predict without radiobiological models.