Focus on the Numbers of Radiation Oncology Trials or Clinical Relevance—Reply

In Reply We would like to thank Dr Chargari and colleagues for their insightful comments on our article. While we emphasized the limited number of radiotherapy trials and the lack of industry sponsorship for these studies, we did not imply that these issues should be the only areas for improvement. As Dr Chargari and colleagues point out, radiotherapy research is lagging behind that of medical oncology in terms of precision approaches. In recent years, targeted therapy, specifically therapy targeting activating mutations, has revolutionized systemic treatment for many cancers. However, none of these agents were approved to be combined with radiotherapy, except for cetuximab. Although the combination of immune checkpoint therapy with radiotherapy appears promising, validated biomarkers to select the appropriate patients for this combination of therapy are still lacking. Moreover, more preclinical and translational work are needed to better understand the interaction between immunotherapy and radiotherapy, the appropriate sequencing of the 2 treatments, and the optimal radiation regimen when combined with immunotherapy. With more knowledge, we will be able to design future trials that may change clinical practice, even with limited resources.

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