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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Biomarkers in Stereotactic Ablative Radiotherapy: Current Evidence and Future Directions.

Mohamed Metawe1, Christos Mikropoulos1, Hasan Al-Sattar2

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International Journal of Molecular Sciences
|November 13, 2025
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Stereotactic ablative radiotherapy (SABR) offers precise cancer treatment. Biomarkers like ctDNA and EVs are crucial for predicting patient outcomes and personalizing SABR strategies.

Keywords:
PSMA+ extracellular vesiclesSABRbiomarkersctDNAimmunotherapyliquid biopsyoligometastatic cancerradiomicstranslational oncology

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Area of Science:

  • Oncology
  • Radiotherapy
  • Biomarker Discovery

Background:

  • Stereotactic ablative radiotherapy (SABR) has transformed cancer management for oligometastatic and primary tumors.
  • High-dose, conformal radiation in few fractions minimizes toxicity but shows variable patient outcomes.
  • Biological heterogeneity necessitates predictive and prognostic biomarkers for SABR.

Purpose of the Study:

  • To review the current landscape of biomarker development for SABR.
  • To discuss the role of biomarkers in refining SABR therapeutic approaches.
  • To explore future directions for personalized SABR treatment paradigms.

Main Methods:

  • Narrative review of existing literature on SABR biomarkers.
  • Categorization of key biomarker classes: ctDNA, EVs, radiomics, and immunological markers.
  • Analysis of biomarker integration into clinical trials and workflows.

Main Results:

  • Circulating tumor DNA (ctDNA) and extracellular vesicles (EVs) show promise as liquid biopsy markers.
  • Radiomic features extracted from imaging can offer prognostic insights.
  • Immunological markers are being investigated for their role in SABR response.
  • These biomarkers are being integrated into ongoing clinical trials for SABR.

Conclusions:

  • Biomarkers are essential for personalizing SABR and improving patient selection.
  • Further standardization, validation, and regulatory alignment are needed for clinical implementation.
  • Future SABR paradigms will likely involve multi-modal biomarker strategies for precision oncology.