ESTRO 2024 Congress Report

The advances that were discussed in the field of radiobiology and stereotactic body radiotherapy (SBRT) at the last ESTRO 2024 Congress and are highlighted here are studies on pancreatic cancer, radioresistance in breast cancer, possible treatments in symptomatic radionecrosis in brain metastases, the potential of combining radiotherapy and immunotherapy, and the challenges and benefits of hypofractionation.

Christelle Bouchart et al. have identified the way in which high isotoxic doses seem to be associated with basaloid and more classical pancreatic cancer molecular subtypes that show a better prognosis and are able durably to immunomodulate the tumour microenvironment. In addition, these researchers have observed increased cellularity and activation of pro-tumour pathways, and they stated that these factors could guide and aid the development of combined trials with SBRT. Monica Mangoni et al. have highlighted the importance of genetic background and timing in the response to preoperative radiosurgery in breast cancer. These researchers have identified the overexpression of coiled-coil-domain-containing 97 in radioresistant patients, which could become a suitable response modulation strategy, and it would be interesting to learn of continued research in this field. Paola Anna Jablonska et al. have studied the therapeutic potential of the inhibition of the signal transducer and activator of transcription 3 gene, which represents a promising strategy to ameliorate symptomatic radionecrosis in patients with brain metastases who undergo radiosurgery.

Regarding radioimmunotherapy studies, Harriet Gee et al. have discovered that pharmacological manipulation of DNA damage-response pathways at the appropriate time may increase the synergy between ablative doses and immunotherapy. Julia Gissibl et al. have identified that the use of Januskinase (JAK) inhibitor in the therapeutic regimens for oncological, haematological, and autoimmune diseases negatively affects the acute antitumour immune response during radioimmunotherapy. These experimental results caution against the simultaneous use of JAKi and radioimmunotherapy.

In addition, in the session on radiobiology and interdisciplinary aspects of hypofractionation, Paul J Keall explained the potential benefits and challenges of hypofractionation, the impact of the technology on clinically meaningful precision measurements including the dose delivered to the patient, and future trends in adaptive radiotherapy technology and image guidance that may improve patient outcomes.

Carolina de la Pinta Alonso, MD, PhD

Radiation oncology and principal investigator of the biomarkers and therapeutic targets group

IRYCIS, Hospital Universitario Ramón y Cajal

Madrid, Spain

cdelapintaa@gmail.com