The annual meeting of the American Society for Radiation Oncology (ASTRO) was recently held in San Francisco. ASTRO is a key event where radiation oncologists from around the world gather to share the latest research and advancements in using radiation therapy to treat cancer. Highlights from ASTRO 2025 offer a glimpse into cutting-edge research that could change how various cancers, including non-small cell lung and prostate cancers, are treated in the future.

New hope for bladder cancer patients: Radiotherapy reduces recurrence risk

The Bladder Adjuvant RadioTherapy (BART) trial shows that adding radiotherapy after surgery and chemotherapy significantly lowers the chance of bladder cancer returning in the pelvic area for patients with high-risk, locally advanced muscle-invasive bladder cancer. 

This new finding suggests that radiotherapy could become a new standard treatment option, similar to immunotherapy, offering a strong improvement in preventing the cancer from coming back. While some mild side effects like diarrhea were more common with radiation, serious side effects were not significantly different between those who received radiation and those who didn’t.

New lung cancer treatment regimen offers similar benefits with fewer side effects

Research from Roswell Park Comprehensive Cancer Center shows that a single dose of stereotactic body radiation therapy (SBRT, also called SABR) after surgery for non-small cell lung cancer provides the same control over the disease as the previously used five-week course, but with fewer side effects. This new approach could become the standard of care for patients with locally advanced lung cancer, offering a more tolerable treatment option without compromising effectiveness.

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SBRT and surgery for early-stage lung cancer: Similar outcomes, fewer side effects with radiation

New research shows that stereotactic body radiation therapy (SBRT, also called SABR), a precise type of radiation, offers similar long-term survival outcomes as surgery for patients with early-stage non-small cell lung cancer. This study, which followed patients for 10 years, found that while both treatments were effective, SBRT led to fewer immediate complications and potentially less financial strain for patients. This means that SBRT is a viable alternative for many patients, especially those who may not be eligible for surgery due to age or other health reasons, and should be considered as part of a personalized treatment plan.

AI contouring for prostate brachytherapy: Patient outcomes unchanged despite differences

A new study found that even though artificial intelligence (AI) software creates different outlines of CT scans compared to doctors after prostate brachytherapy, these differences don’t seem to affect patient outcomes. Brachytherapy is a type of internal radiation therapy where tiny radioactive sources are placed directly inside the body, into or near a tumor. Researchers compared AI-generated contours with those drawn by physicians for 100 patients and found no significant differences in important outcomes like cancer recurrence or survival, suggesting that focusing on patient results rather than the exact contour lines is most important when evaluating these new technologies. While more research is needed, it’s possible that AI tools could help save time for radiation oncologists in the future.

Shorter radiation therapy for prostate cancer reduces side effects but not disease control

For patients with intermediate-risk, localized prostate cancer, a new study shows that stereotactic body radiation therapy (SBRT, also called SABR) delivered in just five sessions led to fewer patient-reported side effects compared to longer courses of radiation. Patients who received this shorter regimen reported fewer reductions in bowel, urinary, and sexual functioning. While these patients were more likely to experience a rise in a marker called PSA, researchers noted that these elevations can sometimes be temporary and require longer follow-up to determine if they indicate actual disease progression. 

This means patients now have clearer information to help them decide between a more convenient treatment with better quality of life or a longer therapy that might offer stronger biochemical cancer control, depending on their personal priorities.

Personalized treatment for recurrent prostate cancer

A study found a new genomic test that can look at prostate tumor genes to predict which patients with recurrent prostate cancer will benefit most from adding hormone therapy to radiation after surgery. This is the first time such a predictive tool has been validated, allowing doctors to tailor treatment based on a tumor’s unique biology. Patients with a specific tumor type called luminal B saw a significant reduction in cancer recurrence and spread when hormone therapy (apalutamide) was combined with radiation. However, patients without this tumor type did not experience the same benefits, suggesting that hormone therapy might not be necessary for them, thus avoiding potential side effects. This advancement allows doctors to personalize treatment, ensuring that patients receive hormone therapy only if it is likely to help them.

New treatment delays progression for recurrent prostate cancer

A new clinical trial, LUNAR, found that people with a limited number of recurring prostate cancer metastases lived significantly longer without their disease progressing when they received an experimental radiopharmaceutical drug (77Lu-PNT2002, which targets prostate specific membrane antigen (PSMA)) before targeted radiation, compared with radiation alone. This is the first randomized study to show that a treatment typically used for later-stage prostate cancer can delay progression and the need for hormone therapy when added to stereotactic body radiation therapy (SBRT, also called SABR)  for patients with early metastatic disease. This approach may offer a meaningful improvement in progression-free survival while also improving patient quality-of-life by safely delaying hormone therapy, which can have significant side effects.

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