RadOnc on the Run

During National Colorectal Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Krishan R. Jethwa, MD, MPH, about key themes that have emerged with the use of radiotherapy in the field. Among several topics discussed in this episode of RadOnc on the Run, the experts highlighted how the treatment paradigm has evolved to encompass more individualized treatment decision-making, particularly for patients with rectal cancer.More than a decade ago, the standard of care for patients with locally advanced rectal cancer entailed a “cookie cutter” treatment pathway consisting of long-course chemoradiotherapy, surgery, and adjuvant systemic therapy, according to Jethwa. Over time, the field began to adopt more personalized treatment algorithms depending on patient goals, wishes, and values to optimize cancer control while protecting long-term quality of life and function. Jethwa also touched upon strategies for mitigating acute and long-term toxicities, which range from fatigue and diarrhea in the short term to incontinence and bowel-related issues later down the line. Other topics of conversation included the evolution of imaging, genomics, and genetics in the field, as well as the potential next steps for researching risk stratification. “Rectal cancer is a highly heterogeneous disease [with] a broad spectrum of local risk and a broad spectrum of risk for distant metastasis. Having the optimal treatment approach does require multidisciplinary care,” Jethwa said. “In 2026 and beyond, the care of patients is no longer one-size-fits-all. It's very much tailored to the individual. Contemporary practice utilizes all sorts of tools from a genomics imaging perspective, as well as multidisciplinary treatment approaches. It’s important for us to work together as colleagues and teammates to best care for our patients.”Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Jethwa is an assistant professor of Radiation Oncology at Mayo Clinic Rochester.

At the 2026 ASCO Genitourinary Cancers Symposium, RadOnc on the Run host Brandon Mancini, MD, MBA, FACRO, reviewed several key presentations on the growing roles that radiotherapeutic modalities could play in the management of genitourinary malignancies. He spoke in San Francisco, CA, to highlight oral abstracts and poster sessions exploring the intersection between radiation oncology and prostate cancer, kidney cancer, and other patient populations.Among numerous abstracts, Mancini, director at Bold Advanced Medical Future Health, clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®, highlighted the following:How Do Pre-Visit Educational Videos Impact Prostate Cancer Radiation Consultations?One presentation explored whether provider-developed educational videos could minimize the amount of time that radiation oncology clinicians, residents, and nurses dedicate to patients for prostate cancer consults, thereby boosting clinical efficiency. Data showed that administering videos alone without changing provider approaches may not be sufficient to improve clinical efficiency, although educational videos may give patients more resources to develop questions before a clinical visit. Findings from this study, Mancini said, may prompt clinicians to reconsider how to prepare patients more effectively for their consults.How Safe is Immunotherapy Plus Radiation in High-Risk Prostate Cancer?As part of another presentation, investigators of a phase 2 trial (NCT05568550) evaluated the safety of pembrolizumab (Keytruda) plus radiotherapy and androgen deprivation therapy (ADT) with or without olaparib (Lynparza) among those with high-risk localized prostate cancer. The investigators noted that pembrolizumab plus radiation/ADT was feasible and typically tolerable, and that adding olaparib to this regimen did not increase the incidence of high-grade adverse effects, although low-grade urinary toxicities were more common. Mancini said that these results may warrant further investigation of pembrolizumab-based treatment to determine whether patient outcomes can improve in the long term.Can LLMs Help Grade Radiation-Related Toxicities?In another study presented at the meeting, investigators evaluated the ability of large language models (LLMs) to extract and grade toxicities from clinical notes and patient-reported outcomes among those who underwent radiotherapy for prostate cancer in a phase 2 trial (NCT02874014). Overall, the investigator’s ensemble model achieved strong performance metrics, supporting the conclusion that LLMs could feasibly extract and grade toxicity in this population. Besides supporting LLMs as potential assistants in one’s workflow, Mancini described how this study reflects the need to capture “every last ounce” of data from patients in radiation oncology practice.References Martin SA, Amin SA, Strudthoff E, Baine M. Impact of pre-visit educational videos on clinic efficiency for prostate cancer radiation oncology consultations. J Clin Oncol. 2026;44(suppl 7):332. doi:10.1200/JCO.2026.44.7_suppl.332 Myint ZW, Yan D, Strup S, et al. Interim safety analysis of a randomized phase II trial comparing pembrolizumab with radiation versus pembrolizumab, olaparib, and radiation in localized high risk prostate cancer. J Clin Oncol. 2026;44(suppl 7):362. doi:10.1200/JCO.2026.44.7_suppl.362 Wilson R, Mastroleo F, Osorio MB, et al. Using large language models for grading CTCAE toxicity after radiation therapy for prostate cancer. J Clin Oncol. 2026;44(suppl 7):357. doi:10.1200/JCO.2026.44.7_suppl.357

At the 2026 American College of Radiation Oncologists (ACRO) Summit, host Brandon Mancini, MD, MBA, FACRO, sat down with Brian Lally, MD, FACRO, to chat about the latest happenings at the meeting. Throughout their discussion, they emphasized advocating for the radiation oncology field and networking with others to spread the potential impact of radiotherapy.Lally began with an overview of his involvement with ACRO, describing his participation in the planning committee for the annual summits as well as his previous work in finance and operations. He and Mancini stressed the intimate nature of meetings like the ACRO Summit, where radiation oncologists can network and form long-lasting professional relationships and personal connections with one another.Regarding other notable initiatives in the field, Lally brought attention to the efforts of Jessica Schuster, MD, FACRO, who serves as the editor-in-chief of Contemporary Updates: Radiotherapy Innovation & Evidence (CURiE), an ACRO-based publication highlighting new advancements in radiation oncology. He also discussed a new accreditation program that serves as a joint venture between ACRO, the American College of Radiology (ACR), and the Radiosurgery Society (RSS), which may contribute to further growth in the field.“Advocacy is such a critical component of ACRO. It is critical that we advocate for the field and represent the college and our members in DC so that we can stay in our clinics and treat our patients,” Lally stated. “You’re not going to see a direct return on the investment you put into those programs—ACR, ACRO, and the American Society for Radiation Oncology [ASTRO]—but it’s critical that you be part of them. It’s critical that you participate.”Mancini is director at Bold Advanced Medical Future Health, clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and editor at large for the RadOncReview, a supplement of the journal ONCOLOGY®. Lally is president-elect of ACRO and an associate professor and vice-chair for Operations in the Department of Radiation Oncology and Hollings Cancer Center Medical University of South Carolina.

As part of ushering in a new podcast series on CancerNetwork®, Brandon Mancini, MD, MBA, FACRO, introduced himself as the host of RadOnc on the Run, a program dedicated to discussing critical advances and considerations in radiation oncology care and research. He outlined the podcast’s objective of serving as an educational resource among radiation oncologists in the field, describing aims such as reviewing the latest data to emerge from key oncology conferences and meetings, as well as strategies for collaborating with members of a multidisciplinary team. Additionally, the program looks to share ideas for safely and efficiently administering radiation to patients by touching upon topics like billing, policy, and mitigating potential adverse effects during treatment.Mancini first discussed how his background and prior work led to his current roles in the field. He is currently the director at BAMF Health, clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and editor-at-large for The RadOnc Review, a supplement of the journal ONCOLOGY®. On top of the new podcast, Mancini emphasized the RadOnc Review as a new resource that may fill an informational gap in the radiation oncology space. The supplement, which will be PubMed-indexed under the journal ONCOLOGY and published on a quarterly basis, is currently accepting all major manuscript types.As part of RadOnc on the Run, Mancini detailed the goal of keeping listeners up to date with techniques, challenges, and other developments regarding the radiotherapeutic management of cancer. Emphasizing expert-led, high-level insights, the podcast will feature perspectives from specialists in surgical oncology, gynecologic oncology, patient advocacy, and other disciplines to explore how widely applicable radiation therapy can be. From covering benign conditions like osteoarthritis to discussing novel modalities such as MRI-guided radiation therapy, RadOnc on the Run will deliver comprehensive conversations on the most salient topics in radiation oncology.