Highlights
- •Immune checkpoint inhibitors and targeted agents are new classes of anticancer drugs.
- •Targeted agents include cell signalling pathway, cell cycle and DNA damage response modulators.
- •New agents have led to overall survival improvements in many advanced cancers.
- •Significant and clinically important interactions with palliative radiotherapy occur.
- •Stereotactic ablative radiotherapy may further improve prognosis.
Abstract
The new systemic therapies for cancer are having major impacts on the prognosis of
patients with advanced cancers, some achieving long-term survival with targeted therapy
or immune checkpoint inhibitors. Interactions of radiotherapy with the new systemic
therapies are reviewed. Many agents increase radiosensitivity and particular caution
is required combining BRAF inhibitors and radiotherapy because of significant toxicity.
Most new systemic therapies can be used safely with palliative doses of radiotherapy,
but it is important to be aware of overlapping toxicities depending on the site treated.
DNA damage response modulators increase radiosensitivity and may potentially increase
radiation toxicity but are at an earlier stage of development. Stereotactic ablative
radiotherapy may produce further survival gains in patients responding to targeted
therapy and immunotherapy.
Key words
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Article Info
Publication History
Published online: August 27, 2020
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© 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
