Molecular Targeted Radiosensitizers: Opportunities and Challenges

Abstract: The practice of radiation oncology is currently primarily based on precise technical delivery of highly conformal, image-guided radiation treatments. The precision medicine revolution has provided radiation oncologists with tremendous opportunities to enhance the anti-tumor effects of radiation therapy, potentially with less normal tissue toxicity than traditional chemotherapeutic radiosensitizers. However, a tremendous body of pre-clinical research and clinical investigations on radiosensitizers has not yet translated into any meaningful number of FDA-approved combinations of radiation with targeted radiosensitizers +/- chemotherapy. There exist distinct challenges to clinical translation of radiation/drug combinations that the field is only beginning to appreciate. These considerations have served as motivation for this Volume, which provides a comprehensive review by experts in the field of key pre-clinical research components required to identify effective and safe (chemo-)radiosensitizing drugs. Readers will be provided with a detailed and timely insight into the framework of targeted radiosensitizer research coupled with recent developments in immuno-oncology. Ultimately, this Volume will support the identification of appropriately validated and biomarker-directed targeted drug/radiation combinations that will have a higher likelihood than in the past to be incorporated into standard management of human cancers. These developments, coupled with the increasing technical power of radiation therapy to safely increase local control for many solid tumors, are expected to improve survival outcomes and cure rates for our patients.