Clinical development of new drug–radiotherapy combinations

Ricky A. Sharma, Ruth Plummer, Julie K. Stock, Tessa A. Greenhalgh, Ozlem Ataman, Stephen Kelly, Robert Clay, Richard A. Adams, Richard D. Baird, Lucinda Billingham, Sarah R. Brown, Sean Buckland, Helen Bulbeck, Anthony J. Chalmers, Glen Clack, Aaron N. Cranston, Lars Damstrup, Roberta Ferraldeschi, Martin D. Forster, Julian Golec, Russell M. Hagan, Emma Hall, Axel-R. Hanauske, Kevin J. Harrington, Tom Haswell, Maria A. Hawkins, Tim Illidge, Hazel Jones, Andrew S. Kennedy, Fiona McDonald, Thorsten Melcher, James P. B. O'Connor, John R. Pollard, Mark P. Saunders, David Sebag-Montefiore, Melanie Smitt, John Staffurth, Ian J. Stratford, Stephen R. Wedge

In countries with the best cancer outcomes, approximately 60% of patients receive radiotherapy as part of their treatment, which is one of the most cost-effective cancer treatments. Notably, around 40% of cancer cures include the use of radiotherapy, either as a single modality or combined with other treatments. Radiotherapy can provide enormous benefit to patients with cancer. In the past decade, significant technical advances, such as image-guided radiotherapy, intensity-modulated radiotherapy, stereotactic radiotherapy, and proton therapy enable higher doses of radiotherapy to be delivered to the tumour with significantly lower doses to normal surrounding tissues. However, apart from the combination of traditional cytotoxic chemotherapy with radiotherapy, little progress has been made in identifying and defining optimal targeted therapy and radiotherapy combinations to improve the efficacy of cancer treatment. The National Cancer Research Institute Clinical and Translational Radiotherapy Research Working Group (CTRad) formed a Joint Working Group with representatives from academia, industry, patient groups and regulatory bodies to address this lack of progress and to publish recommendations for future clinical research. Herein, we highlight the Working Group's consensus recommendations to increase the number of novel drugs being successfully registered in combination with radiotherapy to improve clinical outcomes for patients with cancer.