technologiesTechnologyStandard of care

SBRT / SABR (stereotactic radiotherapy)

Very high, very precise radiation doses in 1-5 sessions that can ablate a tumour like surgery.

Standard for inoperable early lung cancer, oligometastatic disease (SABR-COMET showed overall survival benefit), liver, spine, and brain metastases (radiosurgery). Enables 'metastasis-directed therapy' and pairs with immunotherapy for abscopal effects.

Schematic · not to scale

Ablative dose, 1-5 fractions · Converging beams

How it works

Multiple non-coplanar beams converge with sub-millimetre accuracy; steep dose gradients.

Strengths

Ablative doses with minimal recovery
Outpatient

Limitations

Size and location limits
Late toxicity near central airways

Latest papers

Literature trend1,057 papers in the last 12 months+2% vs prior 12How this is computed

Latest papers · live from Europe PMC

Open in Europe PMC

Query for this technology: (TITLE:"stereotactic body radiotherapy" OR ABSTRACT:"stereotactic body radiotherapy" OR TITLE:"stereotactic ablative radiotherapy" OR ABSTRACT:"stereotactic ablative radiotherapy" OR TITLE:"SBRT" OR ABSTRACT:"SBRT" OR TITLE:"SABR" OR ABSTRACT:"SABR"). Results are unfiltered search hits about SBRT / SABR (stereotactic radiotherapy), not a curated reading list.

Connected

cancers

12

Adrenocortical carcinoma Biliary tract cancer (cholangiocarcinoma)Colorectal cancer Glioma & glioblastoma Hepatocellular carcinoma HER2-positive breast cancer Melanoma Non-small-cell lung cancer Pancreatic ductal adenocarcinoma Prostate cancer Renal cell carcinoma Small-cell lung cancer

fronts

1

Radiation Therapy

technologies

8

In situ vaccination Lattice and GRID radiotherapy Palliative radiotherapy Partial nephrectomy, ablation & active surveillance of small renal masses Prophylactic cranial irradiation vs MRI surveillance Proton arc therapy Radiodynamic therapy and radiosensitising nanoparticles Radiotherapy treatment planning and QA software

companies

2

Brainlab Elekta

institutions

26

Aarhus University Hospital American Society for Radiation Oncology Apollo Hospitals (Apollo Cancer Centres)Atrium Health Wake Forest Baptist Comprehensive Cancer Center Canadian Cancer Trials Group (CCTG)Centre Oscar Lambret Champalimaud Foundation – Champalimaud Clinical Centre Comprehensive Cancer Center Freiburg (CCCF)European Society for Radiotherapy and Oncology Fundación Arturo López Pérez Hacettepe University Cancer Institute Hadassah Medical Center Harold C. Simmons Comprehensive Cancer Center, UT Southwestern HealthCare Global Enterprises Hokkaido University Hospital Hospital Universitari i Politècnic La Fe IRCCS Humanitas Research Hospital Koo Foundation Sun Yat-Sen Cancer Center Rajiv Gandhi Cancer Institute and Research Centre Shandong Cancer Hospital and Institute Stanford Health Care / Stanford Cancer Institute Sunnybrook Odette Cancer Centre TROG Cancer Research UMC Utrecht Cancer Center University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center Velindre Cancer Centre

pathways

7

cGAS–STING innate sensing Cold tumours: immune deserts and exclusion Double-strand break repair: HR versus end joining Organ tropism: seed and soil The blood–brain barrier & brain metastasis The cancer-immunity cycle The metastatic cascade

terms

10

Abscopal effect Hallmark: activating invasion and metastasis HER2-positive brain metastases Lobectomy Oligometastatic disease Oligoprogression Radiotherapy Stereotactic body radiotherapy (SBRT / SABR)Stereotactic radiosurgery (SRS)Systemic versus local therapy

pairings

1

Radiotherapy + immunotherapy

roadmaps

1

Paths to cures: interception, eradication, control

ideas

19

A neutral platform trial for radiotherapy plus immunotherapy combinations A regulatory pathway for new radiotherapy techniques modelled on drug development A statutory minimum share of public trial money for surgery and radiotherapy A test to tell true oligometastatic disease from hidden widespread spread Biopsy the one lesion that is growing while the others shrink Core-funded radiotherapy trials infrastructure with central quality assurance Coverage-with-evidence registries for MR-guided and adaptive radiotherapy Kill drug-tolerant persisters through ferroptosis Make one-week radiotherapy the default in overloaded systems MRI surveillance replaces prophylactic cranial irradiation in SCLC Pay per course of radiotherapy, not per session, so short courses are not penalised Pick the radiation dose that switches the immune alarm on, not off Prizes for unpatentable surgical and radiotherapy techniques proven in trials PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer Radiotherapy for everyone who needs it by 2040 Systemic-first management of HER2-positive brain metastases Treat brain metastases as a disease with its own trials programme Turn one tumour into a vaccine to treat all the others When the blood test is positive, hunt for the lesion with sensitive imaging

people

5

Albert C. Koong Amar U. Kishan Maximilian Diehn Theodore S. Hong Theodore S. Lawrence

bottlenecks

3

Metastasis is understood least and studied last Surgery and radiotherapy cure most, get least The brain: barrier and sanctuary