Radiotherapy for more efficacious novel anticancer drugs: a position paper from the European Society for Radiotherapy and Oncology (ESTRO) focus group on novel systemic therapies and radiotherapy

Radiotherapy and systemic therapies have revolutionised cancer treatments and improved survival, with generally acceptable toxicity. Modern radiotherapy techniques offer precision in targeting tumours, while minimising harm to the surrounding tissues. Novel systemic therapies represent opportunities for combining innovative treatments with radiotherapy. New agents are increasingly more tumour-specific than chemotherapy, and new rational combinations with radiotherapy are emerging, allowing for a more personalised approach. The European Society for Radiotherapy and Oncology (ESTRO) has formed a focus group to explore the integration of innovative agents with radiotherapy. This Policy Review highlights the potential of combining radiotherapy with novel drugs, while addressing current evidence gaps and unmet needs in cancer care. The group emphasises a collaborative approach involving multiple stakeholders to drive sustainable improvements in oncological therapies, suggesting careful selection of combinations based on robust preclinical data. Key insights and proactive strategies can shape future clinical practices, particularly with the early introduction of radiotherapy in the development of novel agents.