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@ARTICLE{vanAken:304998,
author = {E. S. M. van Aken and B. Devnani and A. Prelaj and L.
Castelo-Branco and C. A. M. Marijnen and D. Martins-Branco
and M. A. Gambacorta and A. Lamarca and K. Harrington and G.
Minniti and M. Hecht and D. Papamichael and M. Krause$^*$
and R. Cathomas and K. Lindberg and S. M. O'Cathail and U.
Nestle and J. Barriuso and S. Nowicki and C. Rödel$^*$ and
P. Boot and C. Belka and U. Ricardi and F. Lordick and D. De
Ruysscher and G. Pentheroudakis and M. C. de Jong and A. K.
Gandhi},
title = {{ESMO}-{ESTRO} consensus statements on the safety of
combining radiotherapy with immune checkpoint inhibitors,
{VEGF}({R}) inhibitors, or multitargeted tyrosine kinase
inhibitors.},
journal = {Annals of oncology},
volume = {37},
number = {1},
issn = {0923-7534},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2025-01989},
pages = {17-32},
year = {2026},
note = {Volume 37, Issue 1, January 2026, Pages 17-32},
abstract = {The combination of radiotherapy (RT) with targeted agents
or immunotherapy may result in improved outcomes, but it can
also increase toxicity. However, there is a paucity of
high-quality toxicity data, leading to an absence of
evidence-based guidelines.To address this, ESMO and ESTRO
initiated a series of systematic reviews followed by a
Delphi consensus process to develop multidisciplinary,
evidence-based consensus statements regarding the safety of
combining RT with such agents. The current publication
describes the combination of RT with immune checkpoint
inhibitors (ICIs), vascular endothelial growth factor
(receptor) (VEGF(R)) inhibitors, or multitargeted tyrosine
kinase inhibitors (TKIs). By systematically covering
different drug classes and irradiated areas, 76 clinical
scenarios were evaluated during two Delphi rounds with 20
international experts. Safety statements were developed for
each scenario, based on the systematic literature reviews.A
total of 5,921 records were screened during the systematic
literature review process for ICIs, VEGF(R) inhibitors and
multitargeted TKIs, and 159 reports were selected for
inclusion in the final literature reviews and the database.
During the two Delphi rounds, agreement was reached
regarding the safety statements for 74 clinical
scenarios.Generally, the expected toxicity of combining RT
with ICIs is low, particularly for PD-(L)1 inhibitors. For
most combinations with VEGF(R) inhibitors and multitargeted
TKIs, exercising caution is recommended. The evidence-based
safety statements developed during this comprehensive
project, provide practical guidance on combining RT with
targeted cancer therapies and immunotherapy.},
keywords = {Consensus statements (Other) / Immune checkpoint inhibitors
(Other) / Radiotherapy (Other) / Systematic review (Other) /
Toxicity (Other) / Tyrosine kinase inhibitors (Other)},
cin = {DD01 / FM01},
ddc = {610},
cid = {I:(DE-He78)DD01-20160331 / I:(DE-He78)FM01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41016600},
doi = {10.1016/j.annonc.2025.09.008},
url = {https://inrepo02.dkfz.de/record/304998},
}