Evidence map›Paper›PMID 41759225›Full record

SynthesisESMO open2026

ESMO-ESTRO consensus statements on the safety of combining radiotherapy with EGFR, ALK, or BRAF/MEK inhibitors.

E S M van Aken, S M O'Cathail, A K Gandhi, J Bussink, L Castelo-Branco, J G Eriksen, G Argilés, C T Hiley, V Atkinson, J Kaźmierska and 21 more

Abstract readConsensus StatementSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. European lung cancer congress 2026 - the thoracic radiation oncologist's view.Clinical and translational radiation oncology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

E S M van AkenDepartment of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: interaction@nki.nl.
S M O'CathailSchool of Cancer Sciences, University of Glasgow, Glasgow, Scotland; CUH/UCC Cancer Centre, Cork University Hospital, Cork, Ireland.
A K GandhiDepartment of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
J BussinkDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
L Castelo-BrancoOncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
J G EriksenExperimental Clinical Oncology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
G ArgilésMemorial Sloan Kettering Hospital, New York, USA.
C T HileyCancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
V AtkinsonPrincess Alexandra Hospital, Greenslopes Private Hospital, University of Queensland, Brisbane, Queensland, Australia.
J KaźmierskaRadiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland; Electroradiology Department, University of Medical Sciences, Poznan, Poland.
A CallesMedical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
K KonopaDepartment of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland.
E Le RhunDepartment of Medical Oncology and Hematology, Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland.
F McDonaldRoyal Marsden Hospital, London, UK.
G Mountzios4th Oncology Clinic and Clinical Trials Department, Henry Dunant Hospital Center, Athens, Greece.
P M PutoraHOCH, Cantonal Hospital St. Gallen, Department of Radiation Oncology, St. Gallen, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
B MuoioDivision of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
U RicardiDepartment of Oncology, University of Turin, Turin, Italy.
C B WestphalenDepartment of Medicine III, University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany.
A WronaDepartment of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland.
P BootDepartment of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
G PentheroudakisScientific and Medical Division, ESMO - European Society for Medical Oncology, Lugano, Switzerland.
C BelkaDepartment of Radiation Oncology, University of Munich LMU, Munich, Germany.
F LordickDepartment of Medicine II, University of Leipzig Medical Center, Cancer Center Central Germany (CCCG), Leipzig, Germany.
C A M MarijnenDepartment of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
D Martins-BrancoScientific and Medical Division, ESMO - European Society for Medical Oncology, Lugano, Switzerland.
D De RuysscherRadiation Oncology Department, Maastro Clinic, Maastricht, The Netherlands; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J BarriusoDepartment of Medical Oncology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (Imas12), Madrid, Spain.
B DevnaniRadiation Oncology Department, All India Institute of Medical Sciences, Jodhpur, India.
M C de JongDepartment of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
A PrelajOncologia Medica Toracica Department, Fondazione IRCCS - Istituto Nazionale Dei Tumori, Milan, Italy.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundCombining radiotherapy (RT) with targeted agents may lead to improved treatment outcomes across various tumor types. However, there is a risk of increased toxicity. Unfortunately, high-quality toxicity data are scarce, contributing to a lack of evidence-based guidelines.

designESMO and ESTRO launched a series of systematic literature reviews and evidence-based, multidisciplinary Delphi consensus recommendations on the safety of combining RT with targeted agents. The current paper addresses the safety of combining EGFR, ALK, and BRAF/MEK inhibitors with RT, regardless of (solid) tumor histology. During the two Delphi consensus rounds with 19 international experts, 57 clinical scenarios were evaluated by systematically covering different drug classes and irradiated areas. Based on the systematic literature reviews, safety statements were developed for all scenarios.

resultsDuring the systematic literature review process for EGFR, ALK, and BRAF/MEK inhibitors, 2745 records were screened, and 110 reports were included in the final literature reviews and the database. Over the course of the subsequent Delphi consensus rounds, agreement was reached on all 57 scenario-specific safety statements.

conclusionsFor most scenarios, concurrently combining RT with targeted agents may lead to increased toxicity. Therefore, we recommend a drug interruption, a drug dosage reduction, or a major RT adaptation in various scenarios.

Indexed as

NeoplasmsProtein Kinase InhibitorsAnaplastic Lymphoma KinaseDelphi TechniqueErbB ReceptorsHumansProto-Oncogene Proteins B-rafALK protein, humanAnaplastic Lymphoma KinaseBRAF protein, humanEGFR protein, humanErbB ReceptorsProtein Kinase InhibitorsProto-Oncogene Proteins B-rafconsensus statementsradiotherapysystematic reviewtargeted therapytoxicity

Identifiers

PMID41759225
PMCPMC12955645

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.