Recent advancements in lung cancer imaging and treatment are transforming patient care, shifting towards precision medicine, multidisciplinary collaboration and cutting-edge technologies. Experts at the European Congress of Radiology highlighted key developments from the perspectives of oncologists, thoracic surgeons and radiologists, underscoring the role of personalised therapies, innovative surgical techniques and AI-driven diagnostics.
The Thoracic Oncologist's Perspective
Dr. Maximilian Johannes Hochmair presented an insightful analysis of recent advancements in lung cancer treatment, highlighting the shift toward personalised medicine through biomarker identification. Lung cancer is now classified into over 100 subtypes, requiring tailored therapies.
Modern treatment emphasises multidisciplinary collaboration among oncologists, radiologists, and surgeons, along with comprehensive testing to determine the best therapy. This approach has improved survival rates through immunotherapy, targeted therapies, and innovative drug combinations like bispecific monoclonal antibodies.
Hochmair presented clinical cases demonstrating significant treatment responses, including complete tumour remission following chemo-immunotherapy. He shared a particularly moving case: "I had tears in my eyes when I saw this report," describing a patient with a complete pathological response post-surgery. However, he also discussed challenges, such as misinterpretation of imaging and treatment-related side effects, putting an accent on the need for careful patient monitoring.
In conclusion, he reflected on past errors in managing immune-related adverse events and stressed the importance of timely interventions, showcasing how emerging therapies are enhancing lung cancer prognosis and patient quality of life.
The thoracic surgeon's perspective
Alireza Hoda discussed advancements in lung cancer treatment as of 2025, marking a shift from traditional surgeries and chemotherapy to targeted, minimally invasive approaches. While he stated surgical options are still vital for stage 4 oligometastatic disease, he emphasised the rising importance of stereotactic body radiotherapy (SBRT) and interventional oncology.
Hoda highlighted the impact of lung cancer screening, particularly referencing the Nelson trial for earlier lesion detection, and pointed to innovations in diagnostics like cone-beam CT, electromagnetic navigation, and robotic bronchoscopy. “I think this is going to be the game changer for the future,” Hoda stated regarding robotic bronchoscopy, though he acknowledged cost considerations.
He also described the benefits of minimally invasive techniques like segmentectomy and wedge resection, which lead to lower mortality rates, reduced pain, and faster recovery. Studies from Japan, the U.S., and Europe support the effectiveness of these approaches, with a focus on precision surgery using radiologic mapping and dye marking. In conclusion, Hoda asserted that improved screening will enable earlier interventions and that ongoing innovations will continue to enhance lung cancer treatment protocols.
The radiologist's perspective
Lucian Beer’s session focused on advancements in lung cancer diagnosis and treatment, accentuating the need for lung cancer screening in Austria, where no systemic programme exists. He noted that AI could enhance diagnostic speed and accuracy to address workforce shortages.
Beer discussed the updated TNM classification, refining N2 lymph node involvement and metastasis, which aids in tailored treatment decisions, especially in distinguishing between patients with single and multiple metastases. He highlighted the importance of tumour heterogeneity in treatment selection and how imaging techniques like FDG and anti-PDL1 scans can guide immunotherapy decisions. “We can assess tumour heterogeneity using this method and also tell the oncologist that this patient might benefit from PDL1 inhibitor therapy.”
Additionally, Beer emphasised local ablative therapies (microwave, radiofrequency, and cryoablation) as alternatives to surgery or systemic treatments for oligometastatic lung cancer. He referenced a study showing that local treatment of progressive lesions can improve progression-free survival compared to a wait-and-watch approach.
With ongoing innovations in screening, imaging and targeted treatments, lung cancer management is becoming increasingly precise and effective. Multidisciplinary strategies, AI integration and minimally invasive techniques are enhancing early detection and patient outcomes, shaping the future of lung cancer care.
Source & Image Credit: ECR 2025
