About LINACS

LINACS: Living systematic review and meta-analysis of adverse events following combined modality treatment of cancer patients with novel systemic therapy and stereotactic radiotherapy.

Both stereotactic radiotherapy (SRT) and novel systemic therapies, including targeted therapy and immunotherapy, play an increasingly important role in cancer treatment. Their concurrent use may improve outcomes such as overall survival (OS), progression-free survival (PFS), and local control.^1,2

However, combined modality treatment may also be associated with increased rates of adverse events. A systematic review by Kroeze et al. and consensus recommendations from the EORTC-ESTRO OligoCare consortium indicate that concurrent treatment is generally well tolerated, although the risk of increased adverse events depends on the specific treatment combination. These findings highlight the need for timely generation of high-quality evidence in this rapidly evolving field.^3,4

Due to the rapid development of novel systemic therapies, combined with the fact that drug registration studies often do not allow simultaneous radiotherapy, there is often no or only limited available evidence on safety for the combination of SRT with new systemic therapies. This challenge will further increase in the future due to the rapid and continuous approval of new systemic therapies and increasing heterogeneity of tumour types regarding molecular and genetic subclassification.

A delay exists between performed systematic reviews and the published consensus statements that follow, resulting in multiple published articles including safety data in the interval between literature search and publication that were not taken into consideration. Therefore, regular updates on the current available evidence are essential to guide clinical decision-making. This living systematic review aims to provide a comprehensive and continuously updated overview of published data on adverse events following concurrent SRT and novel systemic therapy in cancer patients. The database will be updated every six months to maintain an up-to-date analysis of the available literature.

¹ Petrelli F et al. Crit Rev Oncol Hematol. 2019.  ² Geng Y et al. Cancer Med. 2021.  ³ Kroeze SG et al. Cancer Treat Rev. 2017.  ⁴ Kroeze SGC et al. Lancet Oncol. 2023.  Full references available on the Methods page.

Team

The LINACS website does not provide medical advice, diagnosis, or treatment. It is intended to support healthcare professionals and not to replace clinical judgment.

The platform aims to inform researchers and clinicians about the toxicity of combining novel anticancer agents with stereotactic radiotherapy. While it may support clinical decision-making, it does not provide definitive guidance on treatment combinations for individual patients. The authors and platform are not liable for any clinical decisions based on the presented data.