ESTRO 2025 Congress report

Pre-meeting course and sessions report
By the ESTRO systemic therapy focus group

 The pre-meeting course titled “Practical Guide to Combine Novel Systemic Therapies and Radiation Therapy” proved to be dynamic and educational. It drew the active participation of over 140 attendees.

The morning sessions were focused on the fundamental rationale behind such combinations, thoroughly presented from the perspectives of a clinical oncologist with expertise in radiotherapy and a medical oncologist with a pharmacology background. Key factors such as timing of administration and radiation fields were discussed, along with areas that remain under investigation and were noted as part of ongoing studies and projects.

Case-based presentations showed examples of combining treatments in various tumour types, including breast, lung, and head-and-neck. These presentations gave attendees actionable clinical insights grounded in the latest evidence and experience.

The other sessions discussed novel clinical applications to enhance local control and organ preservation, particularly in tumours in which the maintenance of function is critical, and in oligometastatic disease, depicting tumour-agnostic approaches that target specific genetic alterations regardless of tumour origin.

Additional sessions addressed emerging clinical contexts, including geriatric oncology, and explored technical and clinical strategies to prevent or manage adverse events. One of the highlights was the presentation of the INTERACTION Project, which is investigating the management of unplanned combinations of systemic therapies and radiotherapy. The last presentation offered a glimpse into novel radiotherapy modalities, which are envisioned to be part of this already composite landscape.

This pre-meeting course combined foundational knowledge with cutting-edge insights, and reinforced the importance of cross-disciplinary collaboration in modern oncology.

The ESTRO2025 meeting offered several interesting inputs with high clinical impact. Examples were the presentations of late-breaking papers, such as the primary endpoint results of practice-changing trials (e.g., STORM/PEACE-V for oligorecurrent prostate cancer in pelvic nodes, and PORTEC-4a, which incorporates molecular classification into treatment-decisions for endometrial cancer). These were followed by expert discussions.

Besides these outstanding sessions, several additional messages were delivered across the whole congress, such as those from the discussion of “transformative combined modality treatment strategies”. One such message came from a subgroup analysis from the phase III LAURA trial, which showed the risks associated with some characteristics of developing radiation-induced-pneumonitis during chemo-radiation and the impact on subsequent treatment with osimertinib.

In the same session, an interesting study was presented regarding a biomarker-based model that had been developed to predict unnecessary chemoradiotherapy in patients with locally advanced non-small-cell lung cancer, based on the overall mortality risk at one year.

Overall, and once again, the ESTRO congress was confirmed to be an engaging, educative moment and an invaluable opportunity to meet colleagues from across the world.

Antonio Angrisani, MD

Capoclinica, Radiation Oncology

Istituto Oncologico della Svizzera Italiana, EOC

Viale A. Gallino 12

6500 Bellinzona

Tel: +41 (0)91 811 96 82

 

Radiation oncologist
Oncology Institute of Southern Switzerland, EOC
Bellinzona, Switzerland
Member of the ESTRO systemic therapy focus group