Belgium expects demand for radioligand therapy (RLT) to double by 2027, introducing key reforms to ensure patients can access these targeted cancer treatments on time.
The country already produces 20–25 per cent of the world’s medical radioisotopes, a crucial component of RLT, with peaks reaching 65 per cent during high-demand periods. In 2021 alone, isotopes made in Belgium were used to treat more than 10 million patients worldwide.
“The growth of RLT treatments is not a temporary growth. It is a structural evolution of health care against cancer that requires vision, coordination and strategic planning,” said Sarah Baatout, Deputy Institute Director of Nuclear Medical Applications at the Belgian Nuclear Research Centre, SCK CEN.
New reforms
On 13 October, Belgium unveiled four structural reforms under the national RLT action plan, developed jointly by hospitals, research centres, patient organisations, and government agencies united through the RLT4BE coalition.
The new measures include a ten-year investment strategy, a proposal for a reimbursement convention to cover all steps of therapy, a national communication and training programme, and the creation of a clinical trials network to accelerate patient access to innovation.
Together, these actions are designed to make RLT part of standard cancer care and will feed into Belgium’s next National Cancer Plan (2026–2030), currently being prepared by Health Minister Frank Vandenbroucke.
Keeping pace with innovation
The reforms come as radioligand therapy moves from niche treatment to one of the fastest-growing areas of oncology worldwide.
Radioligand therapy offers new hope for patients whose cancers no longer respond to surgery, chemotherapy, radiotherapy or immunotherapy. By linking a radioactive isotope to a molecule that recognises and binds to cancer cells, the treatment delivers targeted radiation that destroys tumours while largely sparing healthy tissue.
“Radioligand therapy is especially beneficial for patients for whom no other options are available,” said Ingrid Maes, Managing Director at Inovigate and Coordinator of the RLT4BE national action plan.
“It uses radiopharmaceuticals to very selectively destroy cancer cells. It is really targeted therapy, and the advantage is that it attacks single cancer cells without many side effects. Today, it is a last-line treatment, but it will probably become a standard treatment in the future, in addition to surgery, external radiotherapy, chemotherapy and immunotherapies.”
According to Clarivate’s 2025 Radioligand Innovators report, the global radiopharmaceutical market could exceed $13 billion within a decade.
Blockbuster therapies have demonstrated both the clinical and commercial viability of RLTs, prompting billion-dollar acquisitions by Novartis, AstraZeneca, Bristol Myers Squibb and Eli Lilly. The report highlights that rising cancer incidence, technological breakthroughs in nuclear medicine, and surging clinical research activity are fuelling a renaissance in radioligand innovation.
But as demand accelerates, short-lived isotopes require just-in-time manufacturing, and hospitals, regulators and payers struggle to keep pace with the technology.
“Radioligand therapy represents one of the most promising advances in modern oncology, and to fully exploit its potential, significant and sustained investments will be necessary,” Baatout said. “To guarantee rapid and quality treatment for each patient, long-term investment is not only important, it is essential. We must prepare and act now.”
Infrastructure investment plan
To translate its radioligand ambitions into practice, Belgium will invest heavily in specialised hospital infrastructure over the coming decade. The infrastructure investment plan, coordinated by the Belgian Nuclear Research Centre (SCK CEN), will expand and modernise treatment rooms, upgrade imaging equipment for diagnostics and follow-up, and strengthen domestic radiopharmaceutical production capacity.
“We project over ten years, taking into account the rising incidence of cancer, the arrival of new therapies, and earlier use in the treatment pathway. At the same time, we are already working to make more efficient use of existing treatment rooms in Belgian hospitals, so that no patient or clinical study has to wait,” said Baatout.
Reimbursement reform
A second milestone focuses on accessibility. Many RLT treatments remain only partially reimbursed, leaving gaps in coverage for several crucial steps in the care pathway.
The RLT4BE coalition has proposed a dual approach: reforming the medical nomenclature, updating tariffs for the various acts performed during treatment, and creating a new reimbursement convention that brings all treatment steps together under one framework.
According to the coalition, the correct reimbursement of the different steps in the RLT treatment will now and in the future have a major impact on the accessibility of these therapies for all patients.
Communication and training
Ensuring that patients and healthcare professionals are well-informed about radioligand therapy is essential for timely access. RLT4BE has launched a national communication and training plan to raise awareness among clinicians and educate patients on eligibility and treatment options.
Dedicated information pages have been published, and new courses are being offered for nurses, technologists and future healthcare professionals.
To strengthen Belgium’s leadership in radioligand research, the RLT4BE partners are establishing a Belgian Radioligand Therapy Clinical Trials Network (CTN). The network will connect hospitals, researchers, companies and patients through regional clusters coordinated by a national secretariat.
Acting as a single point of contact for sponsors, the CTN aims to increase standardisation, streamline trial setup, and expand patient participation in innovative therapies.
By accelerating translation from research to care, the CTN will help more Belgian patients gain access to next-generation therapies, ensuring that the country remains at the forefront of Europe’s shift toward precision oncology.
[VA, BM]
