image: Proton Therapy Center 2 at MD Anderson
Credit: The University of Texas MD Anderson Cancer Center
- 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 2025 American Society for Radiation Oncology (ASTRO) Annual Meeting, researchers from The University of Texas 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 Phuoc Tran, M.D., Ph.D., chair of Genitourinary Radiation Oncology. “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 — bringing us closer to truly personalized prostate cancer care.”
- MD Anderson presentations: Abstracts 358, 231 , 338, 359, 3121 (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 Steven Frank, M.D., executive director of technology innovations and deputy division head of strategic programs for Radiation Oncology. “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 1093, 2744, 2375, 2442, 2331
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 Jia Wu, Ph.D., associate professor of Imaging Physics and Thoracic-Head & Neck Medical Oncology. “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 1056, 3591, 3679, 178, 355, 233
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 Comron Hassanzadeh, M.D., assistant professor of Radiation Oncology. “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 Gabriel Sawakuchi, Ph.D., professor of Radiation Physics. “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.”