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Abstract
The practice of radiation oncology is primarily based on precise technical delivery of highly conformal, image-guided external beam radiotherapy or brachytherapy. However, systematic research efforts are being made to facilitate individualised radiation dose prescriptions on the basis of gene-expressssion profiles that reflect the radiosensitivity of tumour and normal tissue. This advance in precision radiotherapy should complement those benefits made in precision cancer medicine that use molecularly targeted agents and immunotherapies. The personalisation of cancer therapy, predicated largely on genomic interrogation, is facilitating the selection of therapies that are directed against driver mutations, aberrant cell signalling, tumour microenvironments, and genetic susceptibilities. With the increasing technical power of radiotherapy to safely increase local tumour control for many solid tumours, it is an opportune time to rigorously explore the potential benefits of combining radiotherapy with molecular targeted agents and immunotherapies to increase cancer survival outcomes. This theme provides the basis and foundation for this American Society for Radiation Oncology guideline on combining radiotherapy with molecular targeting and immunotherapy agents.

Author information

Bristow RG1, Alexander B2, Baumann M3, Bratman SV4, Brown JM5, Camphausen K6, Choyke P6, Citrin D6, Contessa JN7, Dicker A8, Kirsch DG9, Krause M3, Le QT5, Milosevic M4, Morris ZS10, Sarkaria JN11, Sondel PM10, Tran PT12, Wilson GD13, Willers H14, Wong RKS4, Harari PM10.
1
Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada. Electronic address: robert.bristow@manchester.ac.uk.
2
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
3
OncoRay, Dresden, Germany.
4
Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada.
5
Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
6
Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
7
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA.
8
Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA.
9
Department of Radiation Oncology and Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA.
10
Department of Human Oncology, University of Wisconsin, Madison, WI, USA.
11
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
12
Department of Radiation Oncology and Molecular Radiation Sciences, Department of Oncology, and Department of Urology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
13
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, USA.
14
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.