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In an interview with CancerNetwork®, William Kennedy, MD, a neuroradiation oncologist at the Ivy Brain Tumor Center, provided expert insights into the current state of radiosurgery for central nervous system (CNS) tumors. Highlighting a diverse array of available radiosurgery platforms, he explained that institutions such as the Ivy Brain Tumor Center frequently use noninvasive surgical techniques with complex monitoring systems.

Kennedy further underscored the critical importance of having a nuanced understanding of each technology's capabilities and limitations as well as those of the practicing oncologist. Emphasizing a high patient volume and a wide variety of cases at his own practice, he suggested that the expertise of the staff at the Ivy Brain Tumor Center positions them at the forefront of radiosurgery development.

According to Kennedy, novel therapeutic strategies under development at Ivy Brain Tumor Center include the investigational agent AZD1390, which is being assessed in combination with radiotherapy after surgery for patients with newly diagnosed or recurrent glioblastoma.

Despite the benefits that technology provides for research advancement and treatment, Kennedy posited that the multidisciplinary team is essential in ensuring the successful delivery of novel radiosurgery techniques. This integrated approach ensures that each patient benefits from an individualized plan that leverages the full potential of modern radiosurgery.

“Despite all the great technologies that we have here at Ivy, what I think makes this place great, what makes me proud to work here, and what means the most for our patients is how closely we providers communicate with each other and how closely knit of a team we are,” Kennedy stated. “Being available, showing up to the tumor board, always picking up the phone when your colleague calls to discuss a tough case, and never being afraid to ask for help—all those things I have learned since I have been in practice here. Those are what make the difference, more than anything.”

Ivy Brain Tumor Center

A dedicated, well-trained, and expert staff at the Ivy Brain Tumor Center enables the facility to be at the forefront of cutting-edge radiosurgery treatment.

Elucidating Noninvasive Radiosurgery Advancements in CNS Tumors

 visited Sibley Memorial Hospital of Johns Hopkins Medicine to speak with a variety of experts about therapeutic advancements and ongoing research initiatives across several different cancer fields. As part of each discussion, clinicians highlighted how collaboration across different departments has positively affected treatment planning, decision-making, and outcomes at their institution.

Rachit Kumar, MD, an assistant professor of radiation oncology and molecular radiation sciences at Johns Hopkins School of Medicine and a radiation oncologist specializing in genitourinary and gastrointestinal cancers at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center for Sibley Memorial Hospital and Suburban Hospital;

Michael J. Pishvaian, MD, PhD, director of gastrointestinal, developmental therapeutics, and clinical research programs and associate professor of oncology at Johns Hopkins School of Medicine;

Nina Wagner-Johnston, MD, a professor of oncology and the director of lymphoma drug development at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, director of Hematologic Malignancies National Capital Region, and codirector of clinical research for hematologic malignancies;

Valerie Lee, MD, an assistant professor of oncology at Johns Hopkins University School of Medicine and a medical oncologist at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital;

Armine Smith, MD, the director of urologic oncology at the Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital and an assistant clinical professor of urology at the Brady Urological Institute of Johns Hopkins University School of Medicine;

Pouneh Razavi, MD, the director for breast imaging in the National Capital Region and an instructor in radiology and radiological science; and

Curtiland Deville Jr, MD, medical director of the Johns Hopkins Proton Therapy Center and clinical director of radiation oncology at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital.

Altogether, their insights demonstrated how multidisciplinary teamwork has improved outcomes ranging from patient survival to health care resource utilization across a wide range of diseases, including breast cancer, gastrointestinal cancer, genitourinary cancer, and hematologic malignancies.

Experts from Sibley Memorial Hospital discuss how multidisciplinary work has enhanced outcomes such as survival and resource use at their institution.

Elevating the Quality of Cancer Care via Cross-Department Collaboration

CancerNetwork® spoke with John Paul Diaz, MD, about uterine transposition, a surgical technique aiming to preserve fertility in women undergoing radiotherapy for pelvic tumors. Diaz is the chief of gynecologic oncology, director of robotic surgery, director of the Center of Excellence in Minimally Invasive Gynecologic Surgery at Baptist Health, and lead physician for Clinical Trials in Gynecologic Oncology at Miami Cancer Institute.

Of note, Diaz discussed the outcomes associated with 2 procedures conducted at his practice, as well as challenges associated with the development and implementation of the procedure. Additionally, he spoke about the next steps in developing and raising awareness of the procedure.

Diaz foregrounded the discussion by highlighting the simplicity of the procedure, which he stated was similar to a hysterectomy. Unlike a hysterectomy, uterine transposition entails a temporary relocation of the uterus to the anterior abdominal wall, which preserves it for fertility while removing it from the radiation field.

Furthermore, Diaz described the collaboration between Baptist Health and Memorial Sloan Kettering Cancer Center, including a partnership with Mario M. Leitao, Jr., MD, FACOG, FACS, who holds the largest series in the United States in performing uterine transpositions. He explained that the collaboration was conducive for expanding patient populations that may benefit from this surgery.

Diaz then underlined outcomes related to 2 uterine transposition procedures he conducted at Baptist Health. He described a favorable outcome with one patient who had completed the procedure 3 months prior who may be able to become pregnant in the future. The second patient was undergoing radiotherapy, with plans to undergo the second stage of the surgery in following months.

Diaz then highlighted a distinction between uterine transposition and other fertility preservation measures in that it preserves the entire uterus so patients can still carry a child, whereas other radiation therapy techniques do not. He then highlighted patients who are eligible for this procedure, particularly among women who want to preserve their fertility with pelvic tumors requiring radiation that might otherwise sterilize the uterus.

Challenges related to the development and implementation of the procedure were discussed, with particular emphasis placed upon quality of life following treatment. Additionally, he emphasized the idea of patient-driven improvements in treatment outcomes, which he hoped could be applied to help more women preserve their fertility.

Diaz continued by emphasizing the novelty of the procedure, explaining that experiences with it are growing while surgery success rates increase with global collaboration and technique sharing. He followed by underscoring the primary goal of cancer eradication, stressing that treatment for progressing disease takes precedence over fertility, and in those situations, fertility may be compromised.

He further outlined key short-term outcomes in patients undergoing uterine transposition, particularly as they related to maintaining uterine perfusion and mitigating post-operative complications. For long-term outcomes, he highlighted the goal for patients to be disease-free and capable of carrying a live birth.

Additionally, Diaz underscored a challenge related to raising awareness for this procedure, highlighting efforts he has undertaken to inform surgeons in the colorectal cancer field about the availability of this procedure as an option for this patient population. He suggested that colleague identification of eligible patients, effective referral, and increased proliferation of procedure knowledge may be effective in overcoming this challenge.

Diaz concluded by highlighting next steps for the procedure as they relate to expanding access for patients, increasing knowledge of the procedure among physicians, and developing novel techniques for uterine preservation during radiotherapy. He highlighted the “exciting” development of this procedure, which he suggested might have been inconceivable a few years ago, in achieving better outcomes for young women diagnosed with pelvic tumors.

Uterine transposition, a surgical approach preserving fertility by moving the uterus out of the radiation field, may improve gynecologic cancer outcomes.

Uterine Transposition May Maintain Fertility Following Pelvic Radiotherapy

 spoke with Kamran Idrees, MD, MSCI, MMHC, FACS; Natalie A. Lockney, MD; and Milad Baradaran, PhD, DABR, about the potential utility of intraoperative radiation therapy (IORT) among patients with pancreatic cancer. The group detailed the design and mechanism, gradual technical advancements, and trial data supporting the application of this radiotherapy modality for this patient population.

Idrees is the chief in the Division of Surgical Oncology & Endocrine Surgery, an associate professor of surgery, an Ingram Associate Professor of Cancer Research, and director of Pancreatic and Gastro-Intestinal Surgical Oncology at Vanderbilt University Medical Center. Lockney is an assistant professor in radiation oncology and the program director for the radiation oncology medical residency at Vanderbilt University Medical Center. Baradaran is the head of quality assurance operations and assistant professor in the Department of Radiation Oncology at Vanderbilt University Medical Center.

As part of this discussion revolving around IORT, the group outlined the optimal conditions for using this technique depending on the extent of disease resectability in patients. Specifically, Idrees categorized patients as belonging to one of 3 major groups: those with metastatic disease, those with resectable disease, and those with borderline resectable or locally advanced disease. When considering these factors, patients with borderline resectable disease may be suitable to undergo IORT in combination with chemotherapy, radiotherapy, and surgery.

The conversation also focused on a particular case involving a patient with pancreatic cancer who received IORT at their institution. Based on the outcome of this case, they highlighted how multidisciplinary collaboration in combination with careful patient selection may offer surgical resection through IORT.

“[There] has to be a multidisciplinary team approach to carefully select these patients and [determine] who can benefit from this procedure,” Idrees said. “For the families and the physicians who are taking care of [patients with] pancreatic cancer, it’s valuable to obtain a second opinion, even if [the tumor is] initially deemed unresectable. What’s unresectable in one surgeon’s hands may be resectable in a different team,” he added.

Experts from Vanderbilt Medical Center review mechanisms, supporting data, and patient cases associated with the use of IORT in pancreatic cancer.

Advancing Pancreatic Cancer Care Through Intraoperative Radiation Therapy

, James B. Yu, MD, MHS, FASTRO, and Julian C. Hong, MD, MS, spoke about their study titled 

AI Use in Prostate Cancer: Potential Improvements in Treatments and Patient Care

which was published in the May issue of the journal 

Yu is a radiation oncologist in the Department of Radiation Oncology at Smilow Cancer Center Hospital at Saint Francis Hospital and an adjunct assistant professor of Medical Oncology at Yale School of Medicine. Hong is an assistant professor in the Department of Radiation Oncology of Bakar Computational Health Sciences Institute at the University of California, San Francisco (UCSF).

Yu and Hong focused on the growing overlap between the advancement of artificial intelligence (AI)–based tools and the prostate cancer treatment field. In their study, they detailed AI-based developments related to diagnostic image analysis, the ability to “predict” prostate cancer outcomes, evaluating prostate cancer histopathology, and defining tumors and normal tissue to help plan radiation oncology treatment strategies. Additionally, they reviewed how these tools make use of machine learning algorithms, a subset of AI in which computers can assess data and interact with users without explicit instructions.

“We’re trying to incorporate AI and machine learning into more trials to make these types of predictions because, at the end of the day, we’re trying to deliver better care and improve outcomes for patients…. It takes trials to figure those things out, so it’s a little bit of a work in progress.” Hong said, regarding potential next steps for improving the utility of these tools in the prostate cancer field.

According to the authors, pushing the boundaries of AI would need to involve building upon prior retrospective data with additional sources of information to affirm that such tools can impact patient care. Additionally, the discussion highlighted potential future implications related to data ownership or privacy and how patients and physicians interact with these programs as AI becomes more prevalent in medical practice.

“We’re not going to be replaced [by AI]. There will always be the need for the human connection any time there’s disease or cancer,” Yu said. “It’s a super exciting area, and the more people understand the limitations of AI rather than thinking of it as a panacea, the more the field will move forward.”

AI tools may show utility in areas such as prostate diagnostic imaging, pathology, and treatment outcome predictions.

Leveraging Artificial Intelligence Evolutions in Prostate Cancer Care

, Terence T. Sio, MD, MS, discussed how technological advancements in radiation oncology have impacted the modern treatment landscape for patients with non–small cell lung cancer (NSCLC).

Sio, a professor of radiation oncology at Mayo Clinic in Phoenix, Arizona, first outlined the use of immunotherapy and other systemic treatment options for this patient population. He detailed how the use of these modalities and other factors such as the risk of radiation-induced pneumonitis often inform the extent of subsequent radiotherapy. Treatment decision making may also involve collaboration with surgeons and medical oncologists as part of a multidisciplinary tumor board, which meets regularly at his institution to determine suitable strategies for those who require more than 1 course of therapy.

Additionally, Sio spoke about currently prevalent radiotherapy treatment strategies for patients with NSCLC as well as possible toxicities that may be associated with these modalities. In terms of novel technology in the field, he highlighted the development of proton beam radiotherapy and the potential advantages it may offer over other therapies.

According to Sio, use of proton beam radiotherapy may reduce excess radiation that usually extends beyond the targeted tumor, effectively lowering the risk of adverse effects (AEs) during treatment. Specifically, proton beam radiotherapy may benefit patient subgroups including those who have previously experienced a heart attack or those who are older and frailer. With an adequate treatment plan that encompasses the use of proton beam radiation, Sio stated that it may be possible to treat these subgroups with fewer AEs than those observed in patients who undergo standard radiotherapy.

“We can actually be helping some of the patients who otherwise may not be able to stand as intensive of a method of combining radiation and chemotherapy for their lung cancer treatments,” Sio said regarding the use of proton beam radiotherapy in this population. “Right now, we have shown that proton [beam radiotherapy] has a role in lung cancer treatments.”

Terence T. Sio, MD, MS, highlights advances such as proton beam radiotherapy that may improve outcomes for those with non–small cell lung cancer.

Optimizing NSCLC Outcomes Via Technological Advances in Radiation Oncology

 at John Theurer Cancer Center, Timothy Chen, MD, highlighted various novel treatment strategies that have impacted his care of patients with brain tumors and other types of cancer.

Chen, a board-certified radiation oncologist and medical director of the Central Nervous System Program at Jersey Shore University Medical Center and the director of Proton Therapy in the Department of Radiation Oncology at Hackensack Meridian Health, first discussed his use of the novel stereotactic radiosurgery modality ZAP-X for patients with brain tumors. According to Chen, this tool may allow for practices to administer radiation at submillimeter precision, which can spare normal tissue from receiving excess radiation.

Another technology that Chen highlighted included GammaTile, a radiation treatment that was developed for the management of brain tumors. He said that this collagen tile may help with administering strong radiation to precisely where the tumor is located, while also protecting healthy tissues to minimize the adverse effects from radiation therapy. Specifically, Chen stated that GammaTile may be beneficial for those with larger, difficult-to-treat tumors.

Finally, Chen discussed the potential applications of proton therapy and how it may improve outcomes in patients compared with standard radiotherapy. According to Chen, proton therapy serves a “great purpose” with what he described as a precise depth charge that can minimize toxicity during treatment.

Additionally, Chen described how proton therapy may help reduce the probability of developing mutations or secondary cancers among pediatric patients. He highlighted the potential benefit of this modality based on a specific case in which a pediatric patient with myxopapillary ependymoma experienced improvements in pain and urinary control following proton therapy.

Regarding these novel forms of therapy, Chen emphasized the notion of multidisciplinary care and said that practices should “work together as a team” when operating these technologies.

“[With] all this technology, it's not just used as it is; the technology brings us to work together,” Chen said. “I think multidisciplinary care is the future. People are no longer siloed…. We all work together.”

Timothy Chen, MD, highlights how technologies such as ZAP-X and proton therapy may improve outcomes for patients with cancer.


Applying Novel Radiotherapy Technology for Brain Tumors and Other Cancers

Combinations of anti-angiogenic therapy with chemoimmunotherapy may feasibly be shifted forward in real-world extensive-stage small cell lung cancer care.

Radiotherapy Plus Chemoimmunotherapy Improves Frontline ES-SCLC Prognosis

The Nuclear Medicine Clarification Act seeks to increase transparency in reporting potentially high-dose extravasations in administering radiation.

H.R. 2541: Examining Its Legislative Impact on Radiopharmaceutical Practice

Grade 3 or 4 AEs were experienced by 42.9% of patients who received cisplatin plus radiation compared with 15.3% of patients who received radiation alone.

CRT Does Not Improve RFS/OS, Confers High-Grade Toxicity in Cervical Cancer

Data from the phase 3 ROADS trial show significant gains in efficacy without increases in safety concerns following the use of GammaTile.

Collagen Implant May Improve Local Control of Metastatic Brain Tumors

Patients with full-thickness or outer full-thickness stromal invasion following surgery had improved PFS when treated with SIB radiotherapy.

Simultaneous Integrated Boost Radiotherapy Improves PFS in Cervical Cancer

Enhancing Radiotherapy Approaches Across Community Oncology Settings 

Potters 2

A new agreement intended to combine evidence-based radiotherapy protocols with an artificial intelligence (AI)-based platform may create “a rising tide” for all patients with cancer, according to Louis Potters, MD, FASTRO, FABS, FACR.

Potters, senior vice president, deputy physician-in-chief, and chair of the Department of Radiation Medicine at Northwell Health Cancer Institute, and a radiation oncology editorial advisory board member for 

 about the key implications stemming from a multi-year agreement between Lumonus and Northwell Health’s Smarter Radiation Oncology

 (SRO). The arrangement will pair Lumonus’ AI physician platform—a tool designed to automate administrative tasks like clinical preparation and documentation—with SRO directives for optimizing the delivery of radiotherapy to patients.

According to Potters, the agreement may enhance the care of patients who receive treatment outside of academic centers, as he touched upon issues related to access and technological limitations among those who reside in rural communities.

If you’re working in an academic center and you have internalized treatment approaches that are effective and work, that’s great. We’re not trying to compete with that. What we’re trying to do is enhance the care of patients who are treated outside of academic centers—which represents a majority of patients in the country—where physicians may see a complex head and neck [case] followed by a [patient with] lung cancer, followed by a [patient with] breast cancer. [We want to] be able to offer them a standard of care that reflects an academic cancer center approach that’s easily manifested through the Lumonus software.

Radiation oncology has—as you get into rural communities and whatnot—access issues [and] technology limitations. Then, there are the limitations associated with the staffing at some of these locations. The idea is to create a rising tide for all patients. The implications in an international arena are also significant; in third-world countries or less developed countries, to be able to provide state-of-the-art care and a standardized approach is appealing.

Lumonus announces transformative multi-year licensing agreement with Smarter Radiation Oncology® to bring evidenced-based directives to U.S. cancer centers. News release. Northwell Health; Lumonus. September 29, 2025. Accessed October 14, 2025. https://tinyurl.com/2s3wpsh7

A new partnership agreement involving AI use may help spread radiotherapeutic standards from academic centers to more patients in community-based practices.

Adaptive Treatment and Other Advances May Drive Radiotherapy Field Forward

Potters 3

, Louis Potters, MD, FASTRO, FABS, FACR, highlighted the next potential advances in radiation oncology that may improve outcomes for patients and drive the field forward. He spoke in the context of a new agreement between Lumonus and Northwell Health’s Smarter Radiation Oncology (SRO). Through this arrangement, collaborators seek to combine Lumonus’ artificial intelligence physician platform for streamlining administrative tasks with SRO’s consensus-based treatment protocols for optimizing the use of radiotherapy.

Potters, senior vice president, deputy physician in chief, and chair of the Department of Radiation Medicine at Northwell Health Cancer Institute and a radiation oncology editorial advisory board member for 

, noted the emergence of adaptive radiotherapy as a potential “paradigm change” in the specialty. Although the modality is still in its infancy, he stated that he is a “believer” in the efficiencies it may provide.

Additionally, Potters highlighted potential developments in the field based on research that was presented at the 

2025 American Society of Radiation Oncology (ASTRO) Annual Meeting

 in San Francisco, California. Of note, he described how radiation medicine may have a growing role in nonmalignant indications such as osteoarthritis and cardiac arrhythmias.

Within radiation oncology, there is a huge number of initiatives that are exciting and driving the field forward. Outside of everything that we’ve just been talking about, the whole concept of adaptive radiation therapy and being able to plan patients based on their anatomy daily does represent a paradigm change for the specialty. We are still in its infancy in terms of being able to provide this service and understand the efficiencies associated with it, as well as the clinical outcomes. I’m a believer in that aspect going forward.

There are other things within radiation oncology, in the context of radiation medicine, coming out of the recent ASTRO meeting in terms of nonmalignant indications.... Between osteoarthritis, cardiac arrhythmias, and a host of other conditions, this represents an exciting opportunity going forward for the specialty.

Lumonus announces transformative multi-year licensing agreement with Smarter Radiation Oncology to bring evidenced-based directives to U.S. cancer centers. News release. Northwell Health; Lumonus. September 29, 2025. Accessed October 14, 2025. https://tinyurl.com/2s3wpsh7

Recent findings presented at ASTRO 2025 suggest an “exciting opportunity” to expand the role of radiation oncology in different nonmalignant indications.

Examining the Full Scope of Future Advancements in Radiation Oncology

Pat Price, MD, MA, FRCR, FRCP, a leading contributor to a report on the current landscape of radiotherapy in cancer care, which was recently published around the time of the 

2025 American Society of Radiation Oncology Annual Meeting

 in San Francisco, California, spoke with CancerNetwork® about some of the most exciting emerging developments in radiotherapy.

Though radiotherapy has rapidly advanced in the 21st century, more advancements are necessary to make the modality available and more efficacious for more patients. The 3 avenues of growth Price highlighted were the development of new technologies, combinations with immunotherapy, and radioimmunotherapy, or the compounds that are attached to radiation.

The 3 most likely directions of radiotherapy advancements come from new technology, combinations with immunotherapy, and the incorporation of particle therapy.

Radiation Oncology

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