Best Practices for Treatment Team Collaboration in the Use of Radiopharmaceutical Therapy in the United States

Radiopharmaceutical therapy (RPT) is transforming cancer care through the targeted delivery of radiation directly to tumor cells and the surrounding tumor microenvironment. As the clinical use of RPT expands, effective collaboration between nuclear medicine and radiation oncology departments is increasingly essential to delivering efficient and patient-centered care. This review outlines best practices for interdisciplinary collaboration in the implementation and delivery of an RPT program in the United States. We explore the regulatory landscape and requirements governing radiopharmaceuticals, and the associated radiation safety standards that must form the basis of RPT administration. Infrastructure considerations, such as shielding, radiopharmaceutical handling, and emergency preparedness, are discussed, with particular attention paid to how this can be approached from the perspective of a collaborative treatment team. Authorized users, nuclear medicine technologists, radiation safety officers, physicists, nurses, radiopharmacists, and clinical coordinators each play distinct roles in RPT delivery, but there are opportunities for sharing roles that may relieve staff shortages and promote cross-training and high-quality continuity of care. We emphasize the value of regular interdisciplinary meetings and standardized, co-created protocols to align clinical decision making and enhance communication. Training and education are foundational to sustaining high-quality RPT programs. We advocate for institutions to develop integrated curricula that leverage the strengths of nuclear medicine, radiology, and radiation oncology departments while aligning with national certification standards. Collaborative research efforts and shared clinical trial infrastructure further support innovation and access. By fostering a culture of collaboration, health care institutions can establish strong treatment teams able to meet the growing demand for RPT, with the aim of improving patients' experience and clinical outcomes.