In this interview, Dr. Icro Meattini shares insights into what attendees to the clinical track in Vienna can look forward to, particularly the latest advancements in radiation oncology and emerging clinical research.

1. What clinical topics or challenges are receiving the most attention in the submitted abstracts?
The ESTRO 2025 clinical track highlights several key themes, including:

• personalisation of radiotherapy: topics such as predictive molecular signatures, biomarkers for radiation response, and adaptive radiotherapy strategies feature heavily;
• integration of novel systemic therapies: there will be a dedicated session on this topic (run with the European Society for Medical Oncology as ESTRO-ESMO), which suggests a strong focus on multimodality treatments;
• optimisation of treatment for early breast cancer: this remains a major area of discussion, with sessions focusing on de-escalation strategies and technical innovations;
• reirradiation and adaptive radiotherapy: there are multiple sessions on reirradiation strategies, motion management, and online adaptive techniques;
• artificial intelligence (AI) and automation: several sessions discuss AI’s role in radiotherapy planning, segmentation, and treatment verification; and,
• radiotherapy for older patients and organ preservation: special emphasis is placed on the management of older patients and avoidance of overtreatment.

 

2. Are any transformative trends or therapies gaining traction in clinical research this year? How might they impact patient care?

• FLASH radiotherapy: as this therapy moves from experimental to clinical applications, it will be discussed in dedicated sessions.
• Online adaptive radiotherapy: advancements in cone-beam CT (CBCT)-based and MRI-guided adaptive radiotherapy could significantly improve precision and reduce toxicity.
• AI in radiation oncology: AI is being explored for automation in contouring, quality assurance, and treatment planning.
• Radioligand therapy and interventional radiology: the collaboration between ESTRO, the European Association of Nuclear Medicine and the Cardiovascular and Interventional Radiological Society of Europe underscores the growing role of radiopharmaceuticals in oncology.
• Optimisation strategies in breast and rectal cancer: strategies for treatment de-escalation and organ preservation are gaining traction.
• Multimodal and combined treatments: enhanced collaborations between radiotherapy and systemic treatments, especially in lung and gastrointestinal (GI) cancers, indicate a shift toward integrative oncology.

 

3. How are clinical trials shaping the programme for the clinical track in 2025?

• Late-breaking clinical trials: multiple sessions are dedicated to new clinical trial results, underscoring their impact on shaping treatment guidelines.
• Trials of breast cancer treatments: given the dedicated symposia, major trials in the fight against breast cancer will likely be a highlight.
• Radiotherapy in GI, non-small-cell lung cancer and prostate cancer: trials that are focused on treatment intensification and systemic therapy integration in GI, lung and prostate cancers will likely influence practice.
• Radiotherapy optimisation and tailored trials: there is increasing emphasis on trials assessing in what situations radiotherapy can be safely optimised or tailored.
• AI in clinical trials: the inclusion of AI-driven trial methodologies suggests a shift toward technology-enhanced trial designs.

 

4. Why is the clinical track a must-attend for radiation oncologists this year?

• Cutting-edge innovations: the track will provide insights into game-changing innovations such as FLASH therapy, AI integration, and personalised radiotherapy.
• Comprehensive coverage of disease sites: from breast and lung cancers to sarcomas and paediatrics, the track covers a wide range of malignancies.
• Focus on multidisciplinary care: sessions on the integration of systemic therapies, optimisation of workflow and multidisciplinary tumour boards provide holistic perspectives on patient management.
• Opportunity for hands-on learning: contouring workshops, meet-the-expert sessions, and debates offer practical insights beyond traditional lectures.
• Global collaborations: joint symposia such as those run by ESTRO and ESMO, and by ESTRO with the International Association for the Study of Lung Cancer (IASLC), enhance knowledge exchange across specialties.

 

5. Can we expect the presentation of clinical trials in the track, and if so, what areas will they focus on?
Yes, clinical trials are prominently featured in the programme. Key areas of focus are:

• late-breaking clinical trials, which will be presented in dedicated sessions;
• breast cancer treatment trials on radiation omission, hypofractionation, and technical innovations;
• lung cancer treatment trials that have explored the use of stereotactic body radiation therapy, immunotherapy integration and targeted therapy interactions;
• prostate cancer treatment trials that are assessing local treatment intensification and systemic therapy combinations;
• trials of the use of adaptive radiotherapy that evaluate online adaptation and motion management;
• reirradiation studies, addressing strategies for patients who require repeat radiation treatment; and
• trials of the use of radiotherapy for palliative and supportive care, which are focused on quality-of-life-driven strategies.

 

6. How does this year’s clinical track stand out compared with previous editions?

• Stronger focus on personalisation and AI: more sessions on AI-driven treatment planning, automation, and adaptive radiotherapy.
• Increased emphasis on systemic therapy integration: collaborations with ESMO and other oncology groups highlight the growing intersection between radiotherapy and medical oncology.
• Expansion of consideration of adaptive and reirradiation strategies: novel approaches to online adaptation and reirradiation are featured more prominently than before.
• Greater focus on treatment optimisation: sessions dedicated to radiation optimisation in breast, rectal, and other cancers highlight evolving treatment paradigms.
• More global collaboration: increased participation from international societies (e.g., ESTRO with the American Society for Radiation Oncology, ESTRO-IASLC) reflects a broader, multidisciplinary approach to oncology.

Overall, the ESTRO 2025 clinical track offers an exciting and transformative agenda, which makes it an essential meeting for radiation oncologists who are at the forefront of innovation.

Icro Meattini, MD, Associate professor

Department of Experimental and Clinical Biomedical Sciences "M. Serio" - University of Florence

Head of Breast Unit, Florence University Hospital, Florence, Italy

Consultant, Radiation Oncology Unit, Oncology Department, Florence University Hospital

ESTRO board member - ESTRO breast focus group & guidelines committee

EORTC breast cancer group steering committee and Radiation Oncology Science Council

E-mail: icro.meattini@unifi.it