PT - JOURNAL ARTICLE AU - Prasad, Vikas AU - Kim, Hyun AU - Trikalinos, Nikolaos AU - Reimers, Melissa AU - Gay, Hiram AU - Picus, Joel AU - Pachynski, Russell AU - Michalski, Jeff AU - Dehdashti, Farrokh AU - Wahl, Richard TI - <strong>Impact of theranostics tumor board on clinical management of patients referred for radiopharmaceutical therapy</strong> DP - 2024 Jun 01 TA - Journal of Nuclear Medicine PG - 242589--242589 VI - 65 IP - supplement 2 4099 - http://jnm.snmjournals.org/content/65/supplement_2/242589.short 4100 - http://jnm.snmjournals.org/content/65/supplement_2/242589.full SO - J Nucl Med2024 Jun 01; 65 AB - 242589 Introduction: Radiopharmaceutical therapies (RPT) are increasingly being used in the management of prostate cancer (PCa) and neuroendocrine tumors (NET). However, in the setting of evolving and sometimes limited guidelines for the use of these RPT in real world, physicians are often left with difficult and uncertain choices. To help address these challenges, we established a multidisciplinary CME and CE accredited theranostics tumor board (TTB) at our center consisting of experts from the field of nuclear medicine, medical oncology, radiation oncology, and medical physics. Radiochemists, nuclear medicine technologists as well as nursing staffs are part of the TTB as well. Trainees in nuclear medicine, radiology and other disciplines are actively engaged as part of their educational programs. TTB at our institution is part of a larger collaboration between the disciplines of Nuclear Medicine and Radiation Oncology. The aim of the present study is to evaluate the impact of TTB on management of PCa and NET patients.Methods: After IRB approval, charts of patients referred to the TTB between July and December 2023 were retrospectively evaluated. In addition to the demographic data and pathology, data related to the radiopharmaceutical therapies (type of radiopharmaceutical, number of cycles), reasons for discussion and TTB recommendations were documented and recorded in a databank. Change in management (suitable for RPT or not suitable for RPT, clinical trial eligibility, dose reduction, suspending or delaying next treatment cycle) was imputed and reported.Results: Overall, 101 patients (13 female, 88 male) with mean age of 69±9 years were discussed at the TTB, out of which 98 (97%) were treated with or offered RPT: 68 (69.3%) were treated with Pluvicto (either as standard of care 65 or trial 3), 28 (28.6%) with Lutathera, 2 with other RPTs in clinical tria l. At the time of data evaluation, 62.5% of patient had completed three or more cycles of Lutathera whereas 60.3% had completed ≥ 3 or more cycles and 33.8% ≥4 cycles of Pluvicto. Reasons for discussion in tumor board for PCa patients were: 33 (48%) new cases, 20 (29.4%) on treatment, 5 (7.3%) for clinical trials, 10 (14.7%) after completion of all treatment cycles. Amongst NET patients, 13 (46.4%) were new patients whereas 15 (53.6%) were on treatment. Out of the 98 patients treated with RPT, TTB recommended dose reduction in 11 (11.2%) patients, not suitable for RPT in 3 (3%), to hold next RPT cycle in 3 (3%) patients and assessment for suitability in clinical trials in 7 (7.1%) patients. Nine (8.8%) patients died during the course of follow-up.Conclusions: Multidisciplinary theranostics tumor board is a powerful tool in management of patients referred for RPT. It contributed to a change in management in 24% of patients and may allow a higher percentage of patients to complete the intended number of RPT cycles