title: Combination of stereotactic ablative body radiation with targeted therapies.
abstract: Recent advances allow safe and effective delivery of ablative doses of radiation with stereotactic precision to tumours, resulting in very high levels of tumour control. Parallel advances in the understanding of tumour biology enable delivery of systemic drugs that selectively antagonise biological pathways in the tumour and surrounding microenvironment. Data is emerging that these treatments have synergistic effects that might further increase therapeutic efficacy, and they are therefore being increasingly used in combination, primarily in metastatic or recurrent disease. In this Review we summarise the biological rationale and clinical data for both sterotactic ablative radiotherapy (SABR) and targeted therapies, and the emerging experience with combination of these treatments. We describe potential pathways of cooperation in both tumour and normal tissue between SABR and targeted drugs, and, because fatal toxicities have been reported, we outline clinical precautions.
authors.affiliation: Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Zeng
authors.affiliation: Department of Medicine (Medical Oncology Division), University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Baik
authors.affiliation: Department of Medicine (Medical Oncology Division), University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Shailender
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Mayr
authors.affiliation: Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: rengan@uw.edu.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Rengan
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008297:Male; D058990:Molecular Targeted Therapy / Q000379:methods*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D016634:Radiosurgery / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D011505:Protein-Tyrosine Kinases