Radiation Oncologist @MGHCancerCenter, EIC @Advances_ASTRO | #RadOnc | #BCSM | #protontherapy | #bioethics, views = my own
Boston, MA
Joined May 2020
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Honored to have joined my incredible breast surgery colleagues Drs. @okantotoku, @MontagnaGiacomo, Michelle Specht, and Andrea Abbott to discuss regional nodal irradiation in the neoadjuvant era! Please take a listen!
New on SurgOncToday🎙️
Drs. Abbott, Giacomo, Kantor, Specht, and Jimenez discuss regional nodal irradiation and how NSABP B-51 findings can inform treatment decisions. Patient cases highlight real-world application and multidisciplinary care.
Listen: ow.ly/rbTZ50ZgVAz
Rachel Jimenez, MD retweeted
New in Advances in Radiation Oncology:
Wallach et al. propose “curative oligometastatic radiotherapy” (CORT) as a distinct treatment-intent category for carefully selected patients with oligometastatic disease when cure, or exceptionally durable disease control, may be attainable.
The concept goes beyond metastasis-directed therapy alone: all known disease, including the primary when needed, is addressed with curative intent.
Proposed favorable features include limited metastatic burden, favorable disease biology or effective systemic options, controlled extracranial disease, good performance status, low tumor markers or favorable ctDNA, and a long disease-free interval.
The nuance: this is a terminology and clinical framework, not a validated prognostic model. CORT may improve communication, shared decision-making, trial design, and data collection, but selection must remain individualized and disease-specific.
A useful reminder that metastatic disease does not automatically make every course of radiotherapy palliative.
#radonc #OligometastaticDisease #OncTwitter
Rachel Jimenez, MD retweeted
🧬☢️ Can we safely give radiation with abemaciclib? Real-world data says: yes!
@WambuiDr, @KAhmedMD & team analyzed 174 pts with HR+/HER2- metastatic breast cancer receiving concurrent abemaciclib + radiation therapy and found 👇:
🔹 76% had no dose change during RT
🔹 <5% discontinued abemaciclib during concurrent RT
🔹 Median time to treatment discontinuation: 368 days (~1 year) ⏳
💊 Most common adverse events (consistent with known abemaciclib profile):
• Diarrhea: 73%
• Fatigue: 63%
• Rash: 28%
• Neutropenia: 23%
📝 Importantly, most AEs occurred before or after RT, not during
🏥 Majority treated in community practices, reflecting real-world oncology care
📌 Takeaway: Adding RT to abemaciclib appears feasible and well tolerated in HR+/HER2- metastatic breast cancer—supporting continued multidisciplinary care without automatically holding CDK4/6i
@ASTRO_org
advancesradonc.org/article/S…
Rachel Jimenez, MD retweeted
During WRAD, we polled our community and asked how often people miss out on radiotherapy because it is not considered and 76% of you said: Often, it's a global problem.
Thank you to everyone who shared their voice. Did you know, MOST PEOPLE WITH CANCER NEED RADIOTHERAPY?
Rachel Jimenez, MD retweeted
New guidelines for PMRT are a game-changer! They provide a clear roadmap for oncologists who need radiation therapy, with a preference for moderate hypofractionation and DIBH for tissue sparing.
Read the full article: brnw.ch/21wVRom
#BreastCancer #PMRT
Rachel Jimenez, MD retweeted
Happy Peer Review Week.
Thank you to all of our #radonc reviewers!!
Thank you to the thousands of journal peer reviewers who make the Red Journal, Practical Radiation Oncology and Advances in Radiation Oncology possible! Check back for celebratory content throughout the week, and see ASTRO’s list of reviewer incentives and rewards here: astro.org/news-and-publicati…
Rachel Jimenez, MD retweeted
Rachel Jimenez, MD, Editor-in-Chief of @Advances_ASTRO, shares her thoughts – and gratitude - about reviewing for Advances in Radiation Oncology. tinyurl.com/prwjimenez #radonc #PeerReviewWeek #advancesRO
Rachel Jimenez, MD retweeted
Step forward for patients and progress. Chance to grow, connect, and lead together.
#Oncology #LeadershipMatters
@ASCO @ASCOPres
If you’re considering applying for the 2026-2027 Leadership Development Program, it’s crunch time! Don’t miss this opportunity to advance your career & expand your network of friends, mentors, & peers.
Applications are due by September 22: brnw.ch/21wVO3t
Appreciate the at-a-glance visual @DrRishabhOnco! 🔥🔥
🩺 From blanket use ➡️ precision care
New 2025 ASTRO–ASCO–SSO PMRT guideline tailors radiation after mastectomy to risk, biology & therapy response 🎗️
📝 J Clin Oncol 2025 | Jimenez et al.
🔑 Key Recommendations
🔹 Upfront mastectomy
• Node+ (pN1–3) → PMRT recommended (EBCTCG meta-analysis)
• pT4 → PMRT recommended (Danish 82b/c)
• pT3N0 → PMRT conditional (EORTC 22922)
• pT1–2N0 → PMRT not recommended (except select high-risk)
🔹 After neoadjuvant systemic therapy (NAST)
• cT4 / cN2–3 → PMRT recommended (retrospective + meta-analyses)
• Residual nodes (ypN+) → PMRT recommended (NSABP B-51, Alliance A011202)
• cT1–3N1/ypN0 → PMRT conditional (SUPREMO, TAILOR-RT)
• cT1–2N0/ypN0 → PMRT not recommended
🔹 Treatment volumes
• Chest wall + regional nodes (axillary, SCV, IMN) 🌐
• IMN benefit shown in EORTC 22922 & MA.20
🔹 Dose & fractionation
• Moderate hypofractionation (15–16 fx) = preferred (UK START, Chinese PMRT RCT, RT CHARM)
• Conventional (25 fx) only in select cases
🔹 Techniques
• CT-based 3D-CRT / IMRT ✅
• Deep Inspiration Breath-Hold 💨 for heart/lung sparing
• Bolus 🎯 if skin involvement, LVI, or positive margins
💡 Takeaway:
PMRT is not “all-or-none” — decisions must be individualized by nodal status, tumor biology & systemic response.
🔖 Save this for your next MDT/tumor board!
📖 Jimenez RB et al. J Clin Oncol. 2025.
🔗DOI: doi.org/10.1200/JCO-25-01747
#OncoTwitter #MedTwitter #BreastCancer #RadiationOncology @OncoAlert @myesmo @ASCO @ASTRO_org
Grateful to have collaborated with an incredible group of multidisciplinary breast cancer experts on the new ASTRO-ASCO-SSO guideline on PMRT! @ASTRO_org @ASCO @SocSurgOnc @ZeidanMd @pnbarry @RRabinovitch @richzellars @YAbdouMD @KekoaMDPhD @theRADSofKHAN
ascopubs.org/doi/10.1200/JCO…
Rachel Jimenez, MD retweeted
What do we think about radiation (RT) in recurrent/metastatic esophageal cancer setting?
In this ⏪retrospective review, 178 propensity score matched pts were either in the
1⃣ chemoimmunotherapy (ICI) group (n=64)
2⃣ICI + RT group (n=64)
ICI 🟰paclitaxel + platinum + anti-PD-1
RT 🟰esophageal primary + nodes using IMRT +/- metastasis tx
Who benefited from the addition of RT to ICIs?
☑️the overall group that received RT (OS 24 vs 13 months)
☑️those with distant metastases (OS 18 vs 11 mos)
☑️OS and PFS benefit in ♂️male pts with stage IVB disease
advancesradonc.org/article/S…
Rachel Jimenez, MD retweeted
We are accepting articles for this special call now!
📢Hear ye, hear ye!👂We want to see what 🫵you've been up in the benign disease space!
Submit your latest work on Radiation Indications for Non-Malignant Conditions by November 3, 2025.
Questions❔DM us!
advancesradonc.org/pb-assets…
It's not too late! Please join us for the ASTRO Refresher Course via livestream today and tomorrow! astro.org/refresher
We are counting down! ⏰ Hear from Rachel Jimenez, MD, to learn more about the virtual Annual Refresher Course in just 2 days and why you should register now.
Register here ➡️astro.org/meetings-and-educa…
@RachelJimenezMD
Rachel Jimenez, MD retweeted
Real pleasure to have Dr Bergom @carmenbergom give @MGHCancerCenter #radonc Grand Rounds on
🔥Radiation & the heart: a cautionary tale or a new frontier?🔥
Radiation can actually be good for the ❤️‼️👀
#radbio #medphys #physicianscientist #cardiooncology
Rachel Jimenez, MD retweeted
📢Hear ye, hear ye!👂We want to see what 🫵you've been up in the benign disease space!
Submit your latest work on Radiation Indications for Non-Malignant Conditions by November 3, 2025.
Questions❔DM us!
advancesradonc.org/pb-assets…
Rachel Jimenez, MD retweeted
Integrated RT (IMRT/VMAT) led to worse RIL!
Should we be considering RIL more often in breast cancer and the treatment techniques we use?
advancesradonc.org/article/S…
Rachel Jimenez, MD retweeted
What risk factors were associated with worse RIL?
👧🏽younger age
⚖lower BMI
✨multi-target RT
☢integrated RT (IMRT/VMAT)
🏳low pre-RT PLCs
Rachel Jimenez, MD retweeted
What does radiation-induced lymphopenia (RIL) mean in 15 fx breast tx?
Here are the RIL analyses from a prospective cohort trial & the POTENTIAL trial (internal mammary node RT in the modern era) using
✅hybrid RT (3D + electrons)
✅integrated RT (IMRT/VMAT)
Rachel Jimenez, MD retweeted
👉The 14Genes radiosensitivity index showed the most promising predictive performance across different Gleason score groups.
Can we use this as a prognostic indicator to identify patients that can avoid RT❓
Stratify high-risk patients❓
