UC San Francisco researchers and clinicians presented innovative research and treatment strategies at the American Society of Radiation Oncology’s 2025 Annual Meeting in San Francisco, which ran from Sept. 27 to Oct. 1. The 67th ASTRO annual meeting was centered around the theme of “Rediscovering Radiation Medicine and Exploring New Indications” and offered presentations and abstracts about the latest advances and technologies in radiation oncology.
This year’s program featured discussions by experts from UCSF Department of Radiation Oncology and the Helen Diller Family Comprehensive Cancer Center.
Mack Roach, III, MD, FACR, UCSF professor of Departments of Radiation Oncology & Urology, presented “Androgen Deprivation Therapy (ADT) and High Dose Definitive Radiotherapy (RT) +/- Whole Pelvic RT in Patients with Unfavorable Intermediate or Favorable High-Risk Prostate Cancer: Early Results of a Phase III Randomized Controlled Trial” during the “Clinical Trials” special session. This study was the largest phase III randomized trial conducted to date involving men with clinically localized prostate cancer with a primary endpoint of overall survival. Previous studies have shown that survival and progression free rates out to 15 years are comparable between surgery and radiation, but the sexual function and continence appear to be better with the latter. As a result, many men are choosing radiation as the definitive form of treatment. It is well known that the pattern of recurrence, in patients recurring after both types of local treatment tends to be in the pelvic lymph nodes. This study investigates whether prophylactic irradiation of pelvic lymph nodes result in fewer recurrences and ultimately result in an improvement in survival. Roach reported on early results of the trial.
Sue Yom, MD, PhD, FASTRO, the Irwin Mark and Joan Klein Jacobs Distinguished Professor and vice chair of strategic advisory in the UCSF Department of Radiation Oncology, was a presenter for “Meet the Expert” session “ASTRO Journal Editors-in-Chief: Ask Them Anything!” Yom is the editor-in-chief of the International Journal of Radiation Oncology, Biology, Physics (the Red Journal), the flagship journal of ASTRO’s three journals. Yom discussed what the Red Journal is looking for in terms of cutting-edge research in the radiation sciences, how they are recognizing and incentivizing reviewers, and what is being done to protect against human and AI-generated fraud.
Marianna Elia, MS, BS, a PhD student in UCSF-UC Berkeley Joint Program in Computational Precision Health, presented “Multi-Institutional Validation of the Shield-Rt Machine Learning Model to Prevent Acute Care Events During Radiotherapy” during the scientific session “DHI 1: The Digital Revolution in Radiation Oncology: AI Models for Enhanced Patient Care.” Approximately 10-20% of patients undergoing radiation therapy (RT) will require acute care in the form of emergency visits or hospitalization during the course of treatment. The researchers previously reported the results of SHIELD-RT, where machine learning was applied to electronic health record (EHR) data to identify patients at high risk for acute care events and direct increased clinical evaluations – reducing acute care by 45% and overall costs by 48%. In this study, the researchers externally validated the model retrospectively at multiple institutions with distinct patient populations, clinical practices, and different EHR systems. The early phase validation results showed that the model is robust to changes in the patient population and shows real promise for directing care and reducing acute care event rates in diverse healthcare settings.
Ke Sheng, PhD, FAAPM, DABR, vice chair of Medical Physics and the endowed chair of Physics and Engineering in the UCSF Department of Radiation Oncology, served as moderator and a presenter during the scientific session “Radiation and Cancer Physics 7: Ai-Driven Imaging and Predictive Modeling.” The session focused on the application of AI in cancer therapy. This session featured seven talks that explore radiobiological modeling and image-based prediction of tumor response and toxicity. The presentations emphasized how advanced data science is being applied to enhance precision medicine for cancer patients.
Wan-Jin Yeo, PhD, USCF postdoctoral scholar in the UCSF Department of Radiation Oncology, presented “Characterization of Glioblastoma Infiltration and Survival by Brain Regions” during the quick pitch session “CNS 4: “Trials, Toxicity, and Translational Updates in CNS.” Yeo and his collaborators investigated the spatial infiltration patterns of gliomas (Grades 2, 3, and 4) based on anatomical and functional brain regions, as well as the risk for mortality when gliomas infiltrated each of these regions. Isocitrate dehydrogenase (IDH) mutation status was also used to further stratify the gliomas, since IDH mutation (as opposed to IDH wildtype) is known to be associated with improved prognosis. The researchers found that gliomas were consistently the most prevalent within the cerebral white matter and lateral ventricles across all subgroups. By detailing specific infiltration behaviors of gliomas, the researchers hope treatment plans may be improved in the future by taking into account glioma infiltration regions.
Steve Braunstein, MD, PhD, associate professor and vice chair of the UCSF Department of Radiation Oncology, presented “SRS for Trigeminal Neuralgia” during the ASTRO/ISRS (International Stereotactic Radiosurgery Society) joint session “Rediscovering Indications for Non-tumor Stereotactic Radiosurgery.” Radiotherapy is a major component of interdisciplinary cancer care, benefiting the lives of many patients, across a variety of cancer types. However, radiotherapy has utility beyond cancer treatment and includes a growing number of indications to manage several benign diseases including osteoarthritis, vascular and pain disorders. This talk highlighted the well-established role of stereotactic radiosurgery (SRS) as an effective treatment for trigeminal neuralgia, a cranial nerve disorder that can cause devastating daily facial pain and is often not durably managed by other medical therapy. Braunstein shared his UCSF experience and best practices to optimally manage patients with trigeminal neuralgia.
Braunstein also presented “Disparities in Utilization of Proton Therapy for Pediatric Cancers: an NCDB Analysis” during a poster Q&A session. The pediatric cancer community increasingly recognizes the potential benefit of proton-based radiotherapy over conventional photon-based radiotherapy techniques as proton treatment delivery affords more conformal treatment without compromising tumor control. This translates into reduced short-term and long-term toxicity for many patients who have an indication for radiotherapy as part of their cancer care. Unfortunately, there are only a few proton facilities throughout the United Status. This National Cancer Database Study conducted by UCSF and Emory Winship Cancer Centers examined proton utilization across different groups across the United States and revealed challenges in access for several groups, including those of lower socioeconomic status and residing at a distance from proton treatment centers.
Jo Chien, MD, professor and medical director of UCSF Breast Medical Oncology, is one of three presenters at the scientific session “Cancer Breakthroughs Session: A Collaborative Review of the Year's Most Impactful Studies.” Chien’s talk highlighted leading abstracts presented at ASCO 2025 that are of interest and relevant to radiation oncologists. These abstracts have the potential to impact or change practice, including whether to give immunotherapy with radiation in different tumor types.
Education Sessions
Christine Chung, MD, FASTRO, MPH, medical director of Radiation Oncology Services at the UCSF-John Muir Health Cancer Center, was the moderator and a presenter for the education session “Challenges in Breast Cancer Management: Recurrent Disease, Reconstruction and Hypofractionation.” This session examined the options for treating patients with recurrent breast cancer, the challenges of reconstructive surgery in patients with recurrent breast cancer and assess the role of post-mastectomy hypofractionation in practice, with an analysis of the RT CHARM and FABREC trials.
Ana Velazquez Mañana, MD, MS, FASCO, assistant professor of Medicine in the UCSF Division of Hematology/Oncology, presented “New Advances in the Systemic Therapy for Treatment of Lung Cancer” during the international session “Bridging the Gap: Translating the Latest Research into Clinical Practice in Latin America.” The session reviewed and updated clinical management of common cancers, treatment controversies and evaluate guidelines of treatment.
Alexandra Hotca-Cho, MD, a radiation oncologist and assistant professor in the UCSF Department of Radiation Oncology, presented “Navigating the Challenges: Re-Irradiation Strategies for Esophageal and GEJ Cancers” during the education session “Re-Irradiation in Gastrointestinal Malignancies: Finding the Goldilocks Zone Of ‘Just Right’ Personalized Treatment.” With increasing systemic therapy options for gastrointestinal cancer patients, re-irradiation in gastrointestinal cancers is an increasingly important treatment strategy. Re-irradiation offers the possibility of improved tumor control, alleviating pain or obstruction, and may potentially improve survival. This session gave a clinical overview of commonly encountered clinical scenarios in gastrointestinal cancer patients where re-irradiation may help improve patient outcomes.
Jennie Taylor, MD, MPH, a neuro-oncologist and UCSF associate professor of Clinical Neurology, presented “Updates in Systemic Therapies for IDH Mutated Grade 2 - 3 Gliomas” during the “ASTRO/SNO Joint Session: Current Multidisciplinary Management of Molecularly Defined IDH Mutant Grade 2 - 3 Glioma - Who, What, When, Why and How?” Although representing a minority of primary brain tumors, mIDH-mutant gliomas constitute a significant proportion of long-term glioma survivors. Taylor’s presentation reviewed current treatment considerations for systematic therapy, including traditional cytotoxic treatments. She also reviewed emerging data of mIDH inhibitors marking a major therapeutic shift, and where their data is still lacking.
Please visit ASTRO 2025 for complete meeting abstract and session information.