Integrating Radiotherapy With Systemic Therapy in Cancer

Radiotherapy is increasingly delivered alongside systemic cancer therapy rather than in isolation. Across disease sites and stages, combinations with chemotherapy, immunotherapy, endocrine therapy, and molecularly targeted agents are reshaping treatment intent, sequencing, toxicity management, and expectations for local and systemic control. At the same time, the biological effects of these combinations are becoming more complex, with growing interest in radiosensitization, immune modulation, resistance mechanisms, and biomarker-guided treatment selection. Despite rapid progress, important questions remain about which combinations work best, for whom, at what time point, and with what balance of efficacy and safety.This Research Topic aims to bring together translational, clinical, and practice-oriented work on how radiotherapy can be most effectively integrated with systemic therapy in modern oncology. Rather than focusing on a single disease site or drug class, the collection is intended to highlight cross-cutting lessons that matter to the wider radiation oncology community. We are particularly interested in studies that clarify treatment sequencing, define patient selection strategies, improve safety, or identify mechanisms that explain synergy or resistance (as well as hazards of combined therapy approaches). Submissions may address prospective trials, retrospective series, translational models, biomarker studies, or implementation experience, provided the radiotherapy component is central and the findings are relevant to combined-modality care.To capture the breadth and depth of current research, we welcome articles including but not limited to the following topics:• Biological mechanisms underlying synergy, radiosensitization, immune priming, and resistance.• Sequencing and scheduling of radiotherapy with chemotherapy, immunotherapy, endocrine therapy, or targeted agents.• Clinical outcomes of combined-modality treatment across tumor sites and treatment settings.• Acute and late toxicity, normal tissue effects, and strategies to optimize safety.• Biomarkers, imaging, and molecular features that support patient selection or response prediction.• Real-world implementation, multidisciplinary workflows, and treatment decision-making in combined care pathways.By bringing these perspectives together, this collection aims to support more precise, evidence-based integration of radiotherapy and systemic therapy across oncology practice. We invite original research, reviews, systematic reviews, meta-analyses, clinical trial reports, brief research reports, and perspective articles that advance combined-modality cancer care.Please note: manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal. Topic editors: Dirk Böhmer, Rachit Kumar, Michael Dean Story Source: https://www.frontiersin.org/research-topics/84646/integrating-radiotherapy-with-systemic-therapy-in-cancer