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ASTRO 2026

68th ASTRO Annual Meeting — Boston Convention and Exhibition Center (BCEC), Boston, MA · Sep 26 – 30, 2026. ~11,000 attendees, the largest radiation-oncology meeting in the world. 2026 theme: "Data to Dialogue: Communicating Radiotherapy's Value to Advance Care."

Status: Scaffold — meeting is ~4.5 months out as of today (May 11, 2026). Abstract acceptance notifications are scheduled to land May 14, 2026 (per ASTRO 2026 Abstract Guidelines); regular-abstract embargoes lift in stages between then and the meeting, with late-breaking abstracts released on the day of presentation. This vault stands up the per-trial template and program-notes prep page now so the live-coverage scaffold is ready when the program grid and Plenary slate (3–5 top-rated abstracts) are released later in the summer.

Why this is in the vault

ASTRO is the radiation-oncology counterpart to ASCO 2026. Same disease groups (prostate, lung, breast, GI, brain mets, head-and-neck), one modality over: where ASCO carries the systemic-therapy randomized phase 3, ASTRO carries the locoregional control + technology readout — SBRT fractionation, proton-vs-photon, hypofractionation, oligometastatic ablation, MR-linac adaptive workflows, FLASH-RT first-in-human, brain-mets SRS, and the AI in treatment planning / contouring secondary track that bridges to RSNA 2026 and MICCAI 2026.

ASCO 2026's Plenary trials (PROTEUS prostate, LIBRETTO-432 adjuvant lung, KEYNOTE-B15 perioperative bladder) all have ASTRO-side counterparts where the radiation arm or radiation-modality question is the contested variable. Cross-link discipline matters here — many "ASTRO trials" are NRG / RTOG-Foundation / EORTC / Canadian cooperative-group studies that ASCO discussants reference but never present in full.

Format note (and the design decision behind this vault): ASTRO is primarily clinical, secondarily tools — closer in shape to the ASCO vault than to AACR or RSNA, but with a meaningful AI / treatment-planning secondary track that warrants flagging. The per-trial template is the primary artifact. The AI-tools layer (auto-contouring, dose-prediction, synthetic-CT, MR-linac online adaptive AI, FLASH-dosimetry models) is captured inside the relevant trial pages when the model is named, with a cross-link table in program-notes.md pointing at the matching RSNA / MICCAI tool dossiers — no standalone tools/ directory at scaffold stage. If post-meeting coverage warrants it, a separate tools/ directory gets carved out.

What we have / will have to work with

Source Coverage Notes
ASTRO Meeting Library / amportal.astro.org abstract full-text post-embargo; presentation slides for many sessions amportal.astro.org — primary source for the per-trial pages
ASTRO 2026 Scientific Program page session grid, Plenary slate (3–5 abstracts), Clinical Trials sessions, LBAs, Science Highlights, Cancer Breakthroughs astro.org/.../scientific-program
ASTRO Daily News per-day session recaps written by ASTRO editorial astro.org/.../daily-news (2025 example; 2026 microsite lights up at meeting time)
International Journal of Radiation Oncology • Biology • Physics (Red Journal) abstract supplement + companion full-paper publications timed to the meeting redjournal.org — practice-changing trials often co-publish on day of presentation
ASTROnews + Practical Radiation Oncology post-meeting editorial framing astro.org/news-and-publications
Press Kit embargoed media briefings, "Predict the Plenary" preview astro.org/.../press-kits (2025 archive; 2026 kit drops late August)
Trade press / analyst OncLive radiation channel, Targeted Oncology, ASCO Post (covers ASTRO secondarily), Radiation Economics Substack, Cancer Letter radiationeconomics.substack.com runs a "Predict the Plenary" preview annually
Company press releases Elekta (Unity MR-linac), ViewRay (MRIdian), Varian / Siemens Healthineers (Ethos, ProBeam), IBA, RaySearch, Mevion, Hyper Sight; FLASH-RT vendor toplines (IntraOp, Avo) wire-service syndication
Plenary livestream + replay full talk video + discussant ASTRO Virtual Meeting (separate registration; on-demand replay ~12 months)
Social #ASTRO26 on X / Bluesky useful for real-time room reactions; the radonc Twitter community is dense and discipline-specific

The Red Journal abstract supplement is the load-bearing primary source — every accepted abstract gets a print-citable abstract, and many headline trials co-publish full papers on day of presentation. Per-trial pages should cite the abstract permalink (amportal) + Red Journal DOI when available, not company press releases.

Program shape

ASTRO 2026 runs Saturday Sep 26 (pre-meeting) through Wednesday Sep 30, five days, BCEC. The structure (per the 2025 template + 2026 scientific-program page):

  • Saturday Sep 26 — pre-meeting refresher courses, workshops, residents' day; exhibit hall load-in.
  • Sunday Sep 27 — opening day. Presidential Address + named lectures. First scientific sessions. Exhibit Hall opens.
  • Sunday – Tuesday (Sep 27–29) — full program days. Scientific sessions, oral abstract sessions, panels, Clinical Trials sessions, Science Highlights, Cancer Breakthroughs. Plenary Session (3–5 top-rated abstracts, unopposed) — typically Tuesday morning. Late-Breaking Abstract (LBA) session — typically Monday or Tuesday.
  • Wednesday Sep 30 — closing day, lighter program. Final oral sessions; residents' track wrap-up.
  • Exhibit Hall — open Sun Sep 27 through Tue Sep 29 (closed Wed). Vendor demo programming concentrated here: Elekta Unity, Varian Ethos / ProBeam, ViewRay MRIdian, Siemens Healthineers, RaySearch, MIM Software, Limbus AI, AI-Rad Companion, plus auto-contouring / synthetic-CT startups.
  • ~2,500+ abstracts (proffered papers, posters, digital posters) — same scale as 2025.
  • Tracks dominating the corpus:
  • GU (prostate) — SBRT fractionation (5-fx SOC consolidation post-NRG-GU005); proton-vs-photon; oligo-met / oligo-progression strategies; PSMA-directed re-irradiation.
  • Lung — SBRT for early-stage NSCLC; SABR-COMET-type oligo-met platforms; chemo-RT + IO sequencing (PACIFIC successor designs); proton thoracic (RADCOMP/PROTECT NSCLC arm).
  • Breast — partial-breast accelerated; hypofractionation regional nodal; proton-vs-photon (RADCOMP cardiac follow-up); skip-RT post-neoadjuvant.
  • CNS / brain mets — SRS fractionation, hippocampal-sparing WBRT, post-op cavity SRS, leptomeningeal.
  • GI — pancreatic SBRT, anal canal de-escalation, esophageal proton, rectal cancer non-operative / TNT.
  • Head & neck — proton (TORPEdO follow-up), de-escalation HPV+, re-irradiation.
  • Heme — Hodgkin / MALT / orbital RT, BCL/CD19 CAR-T bridging-RT.
  • Technology / Physics — MR-linac (Unity, MRIdian) adaptive workflows; FLASH-RT (FAST-01/02 follow-up, first-in-human in solid-tumor sites); AI in treatment planning, auto-contouring, dose-prediction; proton arc therapy; carbon-ion; synthetic-CT for MR-only workflows.
  • Immuno-RT — RT + IO mechanism + early-phase (NRG-LU007 / FORCE / WITH-RT type designs); abscopal-effect biomarker work.

Organization

conferences/astro-2026/
├── index.md             # this page
├── program-notes.md     # pre-meeting prep: tracks, expected Plenary slate, key trial watch list,
│                        # AI-tools secondary track, NRG/RTOG cooperative-group calendar, key dates
└── trials/              # PRIMARY artifact — one entry per trial / readout
    └── index.md         # template + master trial index table (incl. AI-tool flag column)

The trials/ directory is load-bearing. Each trial gets one Markdown file. Template at trials/index.md — extended from the ASCO 2026 template with radiation-specific fields (modality, dose / fractionation, target volume, plan-evaluation method, AI-tool involvement). Expected ~30–50 entries spanning the Plenary slate, top-polled LBAs, and major track headliners (NRG, RTOG-Foundation, EORTC, cooperative-group readouts).

What's different from ASCO 2026

  • The locoregional question is the question. Most ASTRO trials test a modality, fractionation, or volume variable on top of a (usually unchanged) systemic-therapy backbone. The reading-template lens shifts from "drug vs comparator" to "dose / volume / modality vs comparator."
  • Cooperative groups dominate the LBA slate. Unlike ASCO (industry-sponsored Plenary), ASTRO Plenary trials are mostly NRG Oncology, RTOG Foundation, EORTC, Canadian cooperative groups, NRG-led NCI-CTEP trials. Sponsor cross-links go through cooperative-group identity, not just industry sponsor.
  • Technology vendors anchor the secondary narrative. Elekta (Unity MR-linac), Varian (Ethos / ProBeam / Hyper Sight), ViewRay (MRIdian), Siemens (carbon-ion, proton), IBA, RaySearch — these are the JPM-equivalent commercial players for ASTRO. Track product-cycle announcements like JPM tracks pharma pipelines.
  • AI-in-planning is real but secondary. The treatment-planning AI track (auto-contouring, dose-prediction, synthetic-CT, MR-only workflows, adaptive-replanning AI) is meaningful — typically 50–150 abstracts per year — but it sits underneath the trial corpus, not next to it. Cross-link aggressively to RSNA 2026 tools and MICCAI 2026 tools, don't duplicate.
  • Drug names are not the index. Modality + trial-acronym is the index. (PROTECT, RADCOMP, NRG-GU005, TORPEdO, FAST-02, SABR-COMET-10, PACIFIC-9, EMPOWER.)
  • ASCO 2026 — clinical-translation sibling. Many ASCO 2026 Plenary trials (PROTEUS prostate perioperative, LIBRETTO-432 adjuvant RET+ NSCLC, KEYNOTE-B15 perioperative bladder, ALCHEMIST adjuvant lung) test systemic-therapy arms on the disease where ASTRO is testing the radiation arm. Cross-link by disease group and by trial number / cooperative-group identity.
  • ESMO 2026 — European counterpart; some EORTC radiation trials present at both ASTRO and ESMO.
  • SABCS 2026 — breast counterpart. RADCOMP cardiac follow-up + partial-breast / regional-nodal RT trials often dual-present.
  • RSNA 2026 — medical-imaging sibling. Cross-modality AI for treatment planning (auto-contouring, synthetic-CT, dose-prediction) overlaps directly with RSNA's diagnostic-AI track. Imaging foundation models surfaced at RSNA frequently get re-purposed for contouring at ASTRO.
  • MICCAI 2026 — methods-side counterpart for the segmentation / dose-prediction / adaptive-RT-AI literature. MedSAM, SegVol, TotalSegmentator-RT, and the auto-contouring lineage all originate at MICCAI and surface clinically at ASTRO.
  • AACR 2026 — radiation-biology side. NRG-led radiogenomics, immuno-RT mechanism, RT-DNA-damage-response biomarker work all surfaces at AACR before reaching ASTRO trials.
  • JPM 2026 — financing / commercial layer for the radiation-oncology vendors (Elekta, Varian / Siemens Healthineers, ViewRay, RaySearch, FLASH-RT players).
  • Conferences timeline — ASTRO's position in the year's oncology cycle (AACR Apr → ASCO May/Jun → ASTRO late Sep → ESMO Oct → SABCS Dec → ASH Dec → JPM Jan).

Next step

  • Now (May 2026, T-4.5 months): stand up per-trial template and program-notes prep file (this commit). Identify candidate trial shortlist from public toplines + cooperative-group calendars (NRG quarterly call, RTOG-Foundation pipeline page, EORTC trial list). Acceptance notifications May 14 — pull program data shortly after.
  • Summer 2026 (T-2 to T-4 months): full program goes live; Plenary slate (3–5 abstracts) announced. Pre-build stub pages for Plenary + top 10 LBA candidates.
  • Late summer / Sep (T-1 month): ASTRO Press Kit drops; "Predict the Plenary" Substack post lands; press-program embargoed previews. Pull highlighted trials and pre-build pages.
  • Live meeting (Sep 26 – 30): Daily News + Red Journal companion publications feed the trial pages. Plenary day (typically Tue Sep 29) is the high-priority slot.
  • Post-meeting (Oct 2026): finalize trial corpus. Cross-check against ASCO 2026 / ESMO 2026 sibling trials for the systemic-arm + radiation-arm matched-pair audit. Decide whether AI-tools secondary track warrants standalone tools/ directory.

Sources