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At this year¡¯s American Society for Radiation Oncology (ASTRO) Annual Meeting, MD Anderson experts will showcase their pacesetting research and latest advances in radiation oncology, including techniques to alleviate pain in patients with spinal metastases and less-invasive treatment options to improve quality of life for some lung cancer patients.

I am most excited to see the latest innovations in radiation oncology, particularly the clinical and translational studies that have the potential to advance cancer care.

Our researchers will be presenting dozens of studies at this year¡¯s meeting. Here are four abstracts that have significant potential to inspire additional research and advance care for cancer patients.

1. Long-term study finds radiation is comparable to surgery for some lung cancer patients?

Long-term data presented by Joe Chang, M.D., Ph.D., and Troy?Kleber, M.D.,?demonstrated that a type of radiation therapy known as?stereotactic body radiation therapy (SBRT), also called stereotactic ablative radiotherapy (SABR), has similar survival outcomes to surgery for early-stage non-small cell lung cancer patients.

This study is the first to compare ten-year outcomes of SBRT to surgery. The initial findings on survival continue to hold up, and there are some notable advantages for quality of life for SBRT patients that have been subsequently observed.?

Many patients aren¡¯t eligible for surgery, so a non-invasive option is an immediate advantage for those patients. Additionally, radiation therapy is less invasive and usually has an easier recovery, even for patients who are eligible for surgery. While this approach may not apply to all early-stage non-small cell lung cancer patients, it does emphasize the importance of a multi-disciplinary care team to consider all options for their patients.

2. Addition of metastasis-directed therapy may enhance standard-of-care drug therapy for oligometastatic disease?

s team will present results from the Phase II EXTEND trial, the largest randomized trial of oligometastatic disease to date. It examined which tumor types may benefit the most from adding metastasis-directed therapy to the standard of care drug therapy. Metastasis-directed therapy involves direct local treatment of metastatic lesions through surgery or radiation, with the goal of killing all cancer cells in that location. Metastasis-directed therapy in the EXTEND trial mostly consisted of high-dose stereotactic body radiation therapy.?
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Response to metastasis-directed therapy for oligometastatic disease varies across tumor types; the EXTEND trial was created to detect which cancers may benefit the most from this additional therapy.?

Results showed that by adding metastasis-directed therapy to the standard of care for pancreatic and prostate cancer patients, progression-free survival significantly improved, meriting evaluation in a Phase III clinical trial. , is leading the ongoing Phase III EXPAND trial of metastasis-directed therapy for patients with oligometastatic pancreas cancer.

3. Genomic profiling could tailor pain relief for patients with spinal metastases?

Stereotactic spine radiosurgery (SSRS) is a highly effective, non-surgical treatment strategy for alleviating pain in patients with spinal metastases. This technique delivers high-dose radiation using dozens of precisely targeted beams, allowing for accurate tumor control while minimizing damage to surrounding tissue.??

Medical student Areeba Al-Sharfeen, from MD Anderson¡¯s Department of Central Nervous System Radiation Oncology, will present research conducted under the guidance of principal investigators , and , examining the relationship between primary tumor mutations and clinical outcomes following SSRS. The study provides important insights into the genetic factors that may influence overall survival and local control.

In particular, primary tumor site mutations in TP53 and KRAS were associated with shorter overall survival and reduced local control, respectively, whereas FGFR2 mutations correlated with improved local control. These findings highlight the potential role of genomic profiling in guiding SSRS treatment, helping to refine dose regimens based on tumor-specific genetic characteristics and advancing personalized therapeutic strategies for patients with spinal metastases.

4. Magnetic resonance fingerprinting could produce more detailed imaging and precise treatment for head and neck cancers

From MD Anderson¡¯s Fuller Laboratory, ?Medical Physics Ph.D. student Lucas McCullum will present results from a study that examined the feasibility of using 1.5T MRI/linear accelerator (MR-Linac) machines for a novel imaging technique called magnetic resonance fingerprinting (MRF). ?

Magnetic resonance fingerprinting holds significant promise because of its potential ability to deliver more informative and more accurate information to clinicians. However, if the research required to make MRF possible on the 1.5T MR-Linac machines isn¡¯t studied, a significant amount of scan time will be required to generate the same valuable information.? In this study, the authors validated that magnetic resonance fingerprinting is feasible on a 1.5T MR-Linac, paving the way for wider and faster adoption of this technology and its potential benefits. With its ability to simultaneously extract several levels of data in a single scan, there is the potential for a significant decrease in the time that patients spend in MRI machines while also benefiting from more personalized treatment plans.?

, is division head and chair of Radiation Oncology at MD Anderson.

Learn more about MD Anderson¡¯s research at the 2025 ASTRO Annual Meeting.

• Major themes include advances in actionable biomarkers in pancreatic cancer, proton therapy, artificial intelligence and theranostics
• MD Anderson researchers will present more than 65 abstracts, including several providing breakthroughs within these themes

Recent advances in radiation oncology have led to shorter treatment times, increased early disease detection, and artificial intelligence applications that continue to improve cancer care. Ahead of this week's , researchers from Â鶹ӳ»­ MD?Anderson Cancer Center shared updates on expected key trends.

The search for actionable biomarkers in prostate cancer

• Topline: Prostate cancers have a wide variety of potential treatment options, but aggressive prostate cancers are known to develop rapidly, underscoring the importance of putting patients on the right treatment plan as quickly as possible. Thus, the search for actionable biomarkers is critical to determine which patients are likely to benefit from which treatments and to evaluate if those treatments are working as quickly as possible.
  
  
• MD Anderson insights: ¡°The investigation of actionable biomarkers is one of the most important frontiers in prostate cancer, and there are some really promising leads in a number of the studies being presented at this year¡¯s ASTRO meeting,¡± said . ¡°We¡¯ll be presenting our work with NRG Oncology, where we helped establish how genomic tools like the Decipher test can guide treatment decisions. The NRG GU006 trial represents a continuation of this impactful effort to better define which patients benefit from intensified therapy and which patients may safely avoid it ¡ª bringing us closer to truly personalized prostate cancer care.¡±
  
  
• MD Anderson presentations: Abstracts , , , , (Note: Tran¡¯s presentations were conducted at the University of Maryland prior to his arrival at MD?Anderson.)

Proton therapy under the microscope

• Topline: MD Anderson pioneered the use of intensity modulated proton therapy (IMPT) in 2008 and continues to lead clinical trials to define the benefits of proton therapy in cancer care.? While proton therapy isn't new, its use has rapidly expanded over the last several years, with cancer centers across the country either opening or expanding proton therapy centers. Proton therapy offers several potential benefits to patients, but there is not extensive data from Phase III trials to clarify which patients are most likely to benefit.
  
  
• MD Anderson insights: "This is truly a pivotal time for proton therapy. We're starting to really see some late-stage clinical trials across the country that are defining which patients are likely to benefit and, just as importantly, which patients aren't,¡± said . ¡°MD Anderson recently completed a Phase III trial of 440 oropharyngeal cancer patients comparing IMPT to traditional radiation, and initial data?showed comparable disease control with the benefit of fewer high-grade toxicities in the proton group. We look forward to the survival data from that trial being published soon."?
  
  
• MD Anderson presentations: Abstracts , , , ,
  

The real impact of artificial intelligence and data science

• Topline: Artificial intelligence (AI) has transformed many industries, but impactful advances continue to be made on several fronts in radiation oncology. Data science and AI tools are making their way to the clinic to help clinicians make more informed decisions around everything from imaging to treatment planning.
  
  
• MD Anderson insights: ¡°We¡¯ve been training AI to be as good as clinicians at identifying cancer in medical imaging, but AI tools are quickly eclipsing clinicians. For example, these tools are enabling earlier detection of occult lymph node metastases, in which cancer spreads to the lymph nodes but is missed by current diagnostic techniques,¡± said . ¡°A new vision-language model developed at MD Anderson will be among the many AI and data-based tools discussed at ASTRO. These tools can identify certain elements in imaging and other contextual data that, once validated, could make them extremely effective at reducing the risk of recurrence and making better treatment decisions.¡±
  
  
• MD Anderson presentations: Abstracts , , , , ,

Looking into the pipeline of theranostics

• Topline: Theranostics are a relatively new class of drugs that aims to more precisely deliver radiation in the body. The first and only theranostic approved by the Food and Drug Administration (FDA) is Pluvicto (lutetium Lu 177 vipivotide tetraxetan), which was first approved in 2022 for specific types of prostate cancer. Since then, researchers have continued investigating its effectiveness to potentially expand its indications, and other radiopharmaceuticals have continued to advance through the pipeline.
  
  
• MD Anderson insights: ¡°The FDA approval of Pluvicto was a breakthrough moment for radiopharmaceuticals and we continue to evaluate combinations and other methods to bring its benefits to more patients,¡± said . ¡°The LUNAR study, evaluating a Pluvicto combination therapy with radiation for patients with oligorecurrent prostate cancer, is really a cutting-edge trial that will add to our understanding of how this class of therapies works alongside metastasis-directed therapy.¡±
  
  ¡°We¡¯re starting to see some initial data come in on other radiopharmaceuticals, which is exciting because these have the potential to really expand the use of radiation,¡± said . ¡°Conventional radiotherapy is primarily used to treat local tumors. Radiopharmaceuticals expand the use of radiation to target systemic disease including metastases, micro-metastases and circulating tumor cells that right now cannot be detected by imaging.¡±

As a radiation oncologist and physician-scientist, I spend my days caring for patients and running a lab dedicated to understanding the biology of gastrointestinal cancers to discover new ways to treat them. I studied engineering in college, but after graduation, I became interested in medical research and enrolled in medical school.?

I completed my M.D./Ph.D. through a U54 Partnership between the University of Puerto Rico School of Medicine and MD Anderson UTHealth Houston Graduate School before becoming a radiation oncology resident and Holman Research Pathway Fellow. Now I¡¯m an assistant professor at MD Anderson, specializing in gastrointestinal radiation oncology. My residency here at MD Anderson was such an important part of what I do today.

Here are a few things I learned during my radiation oncology training.

Large cancer centers offer opportunities to unlock advances and new treatments

We tell our patients that where you go matters, and it¡¯s true for researchers and trainees as well. ?As the world¡¯s largest cancer center, MD Anderson provides unparalleled opportunities to learn and collaborate. The breadth of cases we see allows us to pursue important questions in cancer care and research, guided by faculty who bring deep expertise in every subspecialty. As a resident and now a physician-scientist, I¡¯ve found it remarkable to train and work in an environment that offers such unique access to knowledge, mentorship and innovation.

Mentoring and support prepared me to lead my own lab

My mentors supported me unconditionally, both professionally and personally. ?I went to their children¡¯s softball games and family barbecues, and they were there to celebrate my wedding. At every turn, I was met with more opportunities to connect both in and outside of MD Anderson. It sounds clich¨¦, but it really did feel like a family. On top of that, the residency program, led by radiation oncologist , is so robust that they really had time to cater to each one of us.?

The mentorship I received was particularly important when setting up my lab. My mentor, Cullen Taniguchi, M.D., Ph.D., was an MD Anderson radiation oncologist and researcher who passed away two years ago. He gave me the resources and freedom to explore meaningful questions. This support allowed me to generate the preliminary data needed to secure external funding and establish my lab.

The residency program also supported my participation in the Holman Research Pathway, a special training track created by the American Board of Radiology that provides critical protected research time for aspiring physician scientists. Another mentor gave me a framework for scientific rigor and collaboration that continues to shape how I run my lab. Without this network of mentorship and institutional support, I would not be in the position I am today as a physician-scientist leading my own laboratory.

Team science is a critical part of MD Anderson¡¯s culture

Team science is a critical part of MD Anderson¡¯s culture. You hear about collaboration everywhere, but at MD Anderson, it truly defines how we work.

Throughout my training and now as faculty, I¡¯ve had opportunities to build partnerships across disciplines, supported not only by colleagues eager to collaborate but also by a strong institutional commitment to early career investigators. Within Radiation Oncology,?, our division head, has been instrumental in fostering this environment, and across MD Anderson, our Chief Scientific Officer,?, has championed the structures that make these collaborations possible. I can walk down the hall, catch up with a colleague, and, before long, we¡¯re sketching out a new project together.

Artificial intelligence will complement radiation oncology, not replace it.

Currently, artificial intelligence (AI) is being used in radiation oncology to support treatment planning. It helps us define where radiation should and should not be delivered to, allowing for treatment plans that are both safe and effective. These tools are improving precision and efficiency, but they are not a substitute for human expertise. Radiation oncologists will always be essential to guide decisions, interpret complex clinical scenarios and ensure that technology is applied in the best interest of each patient.

There¡¯s so much innovation in the field of radiation oncology. From FLASH therapy to combinatorial strategies that integrate radiation with systemic therapies such as targeted agents and immunotherapies, this field is so motivated to make advances that benefit our patients. If we can find ways to help our patients, we have to do it.

Learn about the radiation oncology residency at MD Anderson.