ESTRO 2025 - Abstract Book

S161

Invited Speaker

ESTRO 2025

Natural disasters such as wildfires, hurricanes, and heat waves are increasingly disrupting cancer treatment centers worldwide. This segment will outline: • Wildfires: Poor air quality and facility closures impacting radiotherapy schedules and patient adherence. • Hurricanes & Flooding: Infrastructure damage leading to power outages, supply chain disruptions, and forced relocations of patients and providers. • Heat Waves: Increased energy demands straining hospital cooling systems and power supplies. 4. Consequences for Patients: Disruptions in Treatment and Outcomes Delayed or interrupted treatment has significant consequences for patient outcomes. This presentation will discuss: • The link between treatment delays and increased cancer mortality. • The disproportionate burden on vulnerable populations, including those in rural or underserved areas. • Strategies to build climate resilience in oncology, including decentralized care models, telemedicine, and adaptive treatment pathways. 5. Toward a Sustainable and Resilient Future for Cancer Care The talk will conclude with a discussion of solutions and strategies to mitigate the effects of climate change on oncology, including: • Integrating environmental metrics into healthcare policy and accreditation standards. • Enhancing hospital disaster preparedness and energy resilience. • Promoting sustainability in radiation oncology through innovation and research. This presentation will provide a global perspective on the intersection of climate change and cancer care, emphasizing the need for immediate action to ensure equitable, high-quality oncology services in the face of growing environmental challenges.

5026

Speaker Abstracts Ania Wrona Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland

Abstract:

The combination of radiotherapy with targeted agents in NSCLC is expected to improve the therapeutic ratiotumor control and overall treatment results.

Randomized clinical trials showed that advanced NSCLC with EML4-ALK rearrangement ALK tyrosine kinase inhibitors (TKIs) provide superior response rate,PFS and OS,and lower toxicity compared to chemotherapy.

Conflicting data exist on the nature of ALK TKIs and ionizing radiation cooperation.Results from one panelof NSCLC cell lines with varying expression levels of c-MET and EML4-ALK showed that crizotinib,first generation ALK TKI,did not affect cellular radiosensitivity.In another model crizotinib in combination with RT was shown to inhibit ALK autophosphorylation and phosphorylationof its downstream effectors,leading AKT, STAT3andERK1/2 to radiosensitization of cells harboring the EML4 - ALK rearrangement. Inmany preclinical models it was proved that the ALKinhibition elicits anti-proliferative,pro-apoptotic and antiangiogenic effects in ALK -positive NSCLCcell lines,enhanced by the exposure to RT. To datewe lack evidence from clinical trials of RT-ALK TKIs superiority over standard chemoradiation (CRT) in locally advanced NSCLC.The sole trialdedicated to molecularlyselected patients-the NRG/RTOG1306 trial-evaluated erlotinib and crizotinib as a 3-month induction preceding standard CRT in stage III EGFR -positive or ALK -positive NSCLC.The underpowered trialrevealed disappointing results.The median loco-regional PFS was 14.7months in ALK -