Education Strategies and Evidence Interpretation Surrounding RLE Terminology

Dr. El-Haddad recommends a 2-level approach to promoting RLE terminology adoption. Internally, multidisciplinary tumor boards are the optimal venue for establishing shared vocabulary across specialties including medical oncology, nuclear medicine, radiation oncology, surgery, pharmacy, and advanced practice providers. Although single tumor board sessions will not achieve immediate adoption, consistent use of the terminology over time creates institutional familiarity. At the broader level, professional societies, including the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the North American Neuroendocrine Tumor Society (NANETS), the European Association of Nuclear Medicine (EANM), and oncology societies such as ASCO, should incorporate RLE terminology into educational programs, guidelines, and scientific discussions at annual meetings and symposia to reach the widest possible audience.

Dr. Hendifar addresses how clinicians should approach evidence interpretation for RLEs compared to reference products. The data package supporting an RLE will not resemble a new drug application; it will consist of bridging studies and pharmacokinetic and biodistribution data rather than direct clinical efficacy trials. Clinicians will need to develop comfort with inferring class-wide efficacy while evaluating the bridging evidence that demonstrates comparable tumor uptake and pharmacokinetics. Nuclear medicine physicians, already experienced in dosimetry and biodistribution analysis, will likely lead this evidence interpretation for their multidisciplinary teams. The key principle is that reliance on published literature and bridging data, rather than head-to-head clinical trials, is the defining feature of this evidence model.