ASTRO 2026: Top 4 abstracts advancing radiation therapies

At the 2026 American Society for Radiation Oncology (ASTRO) Annual Meeting, UT MD Anderson experts will showcase the latest research focused on improving outcomes and quality of life for cancer patients undergoing radiation therapy.

I’m most excited about the data from our randomized clinical trials and translational studies that will impact patient care and lead to further research.

Out of the many presentations and abstracts that will be presented at this year’s meeting, here are four that I believe are advancing the field of radiation therapy.

1. Stereotactic body radiotherapy may be safer treatment option for recurrent head and neck cancer patients.

When head and neck squamous cell carcinoma returns after radiation therapy and surgery is not an option, the main potentially curative treatment option is reirradiation.  However, this carries the risk of cumulative side effects from radiation.

As a result, there has been a growing interest in how we can reduce the impacts of reirradiation. One approach that has been explored is using stereotactic body radiotherapy (SBRT), which delivers a high dose of radiation to a highly targeted area. However, there is a lack of high-quality data showing whether this approach is safe and effective.

In the Phase 2 SOAR-HN trial led by Jack Phan, M.D., Ph.D., researchers compared SBRT to standard reirradiation to see if SBRT could provide similar outcomes with fewer serious side effects.

Results show that at two years, patients treated with conventional radiation were significantly more likely to experience Grade 3 or higher radiation-related toxicity than patients treated with SBRT. Overall survival outcomes did not differ significantly between the groups. Another advantage of SBRT is that it is often a shorter treatment course than traditional radiation, which took several weeks in this study compared to just two weeks for the SBRT arm.

“Reirradiation for recurrent head and neck cancer is one of the more challenging areas in oncology,” explains Phan. “Results suggest that in carefully selected patients, SBRT can provide a much shorter treatment course with fewer serious side effects and no apparent compromise in disease control. Larger Phase 3 studies are needed to confirm these findings.”

Liam Spurr, M.D., will present this study on Tuesday, Sept. 29, 2026.

2. Preventive bone reinforcement does not reduce fracture risk in high-risk patients after SSRS.

Stereotactic spine radiosurgery (SSRS) is a type of precise radiation therapy that uses high-dose beams to target tumors while sparing normal surrounding tissue. SSRS treatment is often given to patients whose disease is not expected to or did not respond to conventional radiation, or who are not eligible for surgery due to the stage of the cancer.

While SSRS is extremely effective at controlling tumor growth, it carries a risk of weakening the vertebrae near tumors. In some cases, this can lead to fracturing, causing pain and instability for patients, which is often a limitation of SSRS. This study focused on patients at high-risk for fractures who had not yet been treated with radiation.

One way patients with this condition are treated is by injecting bone cement into the vertebrae for stability. Research led by Amol Ghia, M.D., looked at whether bone cement could help prevent spinal fractures if given at the time of radiosurgery.

Even though the procedure was generally safe, results from the trial found that preventive cement did not significantly reduce the overall risk of fractures. While some patients treated with SSRS alone later needed stabilization procedures, the researchers did not find enough evidence to recommend routine preventive cement treatment for all high-risk patients.

“Preventive cement shouldn't be routine,” says Ghia. “A fracture can usually be addressed, whereas tumor regrowth at the treated site often cannot be, so the priority in spine radiosurgery remains optimizing tumor control in well-selected patients.”

Amol Ghia, M.D., will present results from this trial on Wednesday, Sept. 30, 2026.

3. Combination therapy helps recurrent non-small cell lung cancer patients live longer.

In 2020, the Phase 2 I-SABR trial, led by Joe Chang, M.D., Ph.D., was the first to show that adding the immunotherapy drug nivolumab to SBRT treatment for non-small cell lung cancer could improve outcomes even for earlier disease stages.

At six years, the results continue to hold up, with the overall survival (70% to 56%) still higher compared to SABR alone.

Researchers also found evidence explaining why the combination worked. Patients who received both treatments showed changes in blood protein patterns over time and increased activity of cancer-targeting CD8+ T cells.

These findings continue to suggest that combining immunotherapy with SABR may be a promising treatment approach for certain lung cancer patients.

“Future studies should emphasize biologically informed patient selection, optimized sequencing, and longitudinal immune monitoring,” says Chang. “Ultimately, AI-based integration of data may personalize immunotherapy after SABR.”

Joe Chang, M.D., Ph.D., will present this study on Sunday, Sept. 27, 2026.

4. Monitoring blood cell changes during radiation therapy may identify at-risk patients.

Clonal hematopoiesis of indeterminate potential (CHIP) is not cancer, but the condition can progress to blood cancer. It occurs when blood stem cells develop mutations that allow them to reproduce faster than normal blood cells. It is common in patients with solid tumors, and radiation therapy has been shown to increase risk for the condition.

CHIP has also been associated with poorer outcomes for radiation patients, but what was not known is whether there was a difference in the associated risk if CHIP developed before or after radiation treatment.

In a study led by Kevin Nead, M.D., which won an ASTRO Annual Meeting Basic Translational Award in the Biology category, researchers looked at blood samples taken before and after radiation treatment. They compared DNA mutations commonly linked to CHIP, such as TP53, PPM1D and CHEK2.

“This is potentially a significant finding because now we know that CHIP that develops during radiation treatment is what affects outcomes,” Nead says. “Monitoring these mutations could potentially help clinicians identify patients at higher risk and tailor treatment strategies in the future. This also highlights the importance of radiation planning.”

Kevin Nead, M.D., will present these findings on Sunday, Sept. 27, 2026.

Learn more about UT MD Anderson’s research at the 2026 ASTRO Annual Meeting.