Specific requirements for translation of biological research into clinical radiation oncology

Radiotherapy has been optimized over the last decades not only through technological advances, but also through the translation of biological knowledge into clinical treatment schedules. Optimization of fractionation schedules and/or the introduction of simultaneous combined systemic treatment have significantly improved tumour cure rates in several cancer types. With modern techniques, we are currently able to measure factors of radiation resistance or radiation sensitivity in patient tumours; the definition of new biomarkers is expected to further enable personalized treatments. In this Review article, we overview important translation paths and summarize the quality requirements for preclinical and translational studies that will help to avoid bias in trial results. Translation of preclinical radiobiological research into clinical radiotherapy has largely improved treatment outcomes. Indicatively, based on the results of current biological research, fractionation schedules have been optimized, and combined treatments have been developed. In this Review, we discuss translation paths that have substantially improved radiotherapy and summarize what quality requirements within preclinical and translational studies will ensure the development of unbiased clinical trials.