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WCLC 2025 | Safety and efficacy outcomes of SMART-based SABR in ultracentral NSCLC
Crispin Hiley, MBChB, PhD, University College London, London, UK, comments on results from a retrospective analysis evaluating stereotactic MR-guided adaptive radiotherapy (SMART) for ultracentral non-small cell lung cancer (NSCLC). SMART enabled daily plan adaptation and real-time tracking, reducing planning target volume size and overlap with critical thoracic structures compared with conventional SABR. Treatment demonstrated favorable local control with no severe toxicity, alongside promising progression-free and overall survival outcomes. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
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Transcript
Yeah, so this is a poster looking at MR-guided treatment of metastatic non-small cell lung cancer in what’s called an ultra-central location. So this is lesions right up against the proximal bronchial tree. And these are some of the hardest lesions to treat with stereotactic radiotherapy. I work with a company called GenesisCare in the UK who have several of these MR-guided radiotherapy platforms to treat these really difficult areas...
Yeah, so this is a poster looking at MR-guided treatment of metastatic non-small cell lung cancer in what’s called an ultra-central location. So this is lesions right up against the proximal bronchial tree. And these are some of the hardest lesions to treat with stereotactic radiotherapy. I work with a company called GenesisCare in the UK who have several of these MR-guided radiotherapy platforms to treat these really difficult areas. And what we found is that you can treat these lesions with really high precision, really good safety, no severe toxicity signals, excellent local control. And I think what we’ve seen from a lot of the presentations at this conference about the management, for example, of EGFR mutation-positive non-smoking-associated lung cancer is that, yes, we have some evolving systemic therapies, but there’s a huge role for local therapies to manage resistance and oligoprogression in patients with non-smoking-associated lung cancer. And MR-guided radiotherapy is an excellent tool for the most difficult-to-treat lesions.
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