U1355 - Molecular Radiotherapy and Therapeutic Innovations (RAMO-IT)

The U1355/RAMO-IT unit is developing an integrated program aimed at transforming radiation therapy in oncology, moving from a standardized approach to precision radiation therapy that is personalized, biologically informed, and harmonizable across centers. Its work focuses on several complementary areas: immuno-radiotherapy, to understand and harness the immunomodulatory effects of radiation; new radiation strategies, including the modulation of doses, volumes, timing, and dose rates, notably FLASH radiotherapy; the reduction of radiation-induced toxicity through mechanistic and interventional approaches; and the ultra-personalization of treatments using AI, radiomics, imaging, dosimetry, and omics data. The goal is to better tailor treatment to the specific characteristics of each tumor, each patient, and each clinical context, while improving the efficacy, safety, and reproducibility of treatment practices.

The unit’s research has led to a better characterization of the interactions between radiation therapy, the tumor microenvironment, and systemic immunity, particularly the role of radiation-induced lymphopenia and immunosuppressive pathways activated by irradiation. This research paves the way for treatment planning strategies aimed at preserving the immune system, optimizing radiation-immunotherapy combinations, and minimizing toxicities affecting healthy tissues—including those of the lungs, skin, mucous membranes, intestines, and the neurocognitive system. Emerging approaches, such as FLASH, heterogeneous irradiation, photobiomodulation, MRI-guided therapy, and AI tools for treatment delineation, planning, and adaptation, represent major opportunities for clinical translation. Radiation therapy is used to treat 50–60% of cancer patients, and Unit U1355 is working to make it more effective, safer, more equitable, and more standardized.