Session

Overview: This interdisciplinary pitch session will examine the key barriers preventing biologically guided radiotherapy from moving from concept to routine clinical implementation. Starting from the clinical rationale for biologically guided dose prescription, speakers will address the current evidence, the limitations imposed by tumour and normal tissue biology, and the regulatory and practical challenges of clinical implementation. The session will then explore the role of biomarkers in biologically guided radiotherapy, with particular focus on imaging biomarkers, including their definitions, the most promising and clinically feasible candidates, and the key translational challenges related to biological validation, technical validation, and standardisation across centres. Further discussion will focus on the difficulties in defining the CTV, especially for nodal CTV-N for head and neck cancer and on the relative patient’s individual risk estimation. Finally on the RTT perspective, highlighting workflow, QA, training, infrastructure, and multidisciplinary coordination needed to make biologically guided radiotherapy clinically actionable.