Thoracic Oncology Innovations: Dr. Daniel Przybysz on AI, Global Trials, and Targeted Radiotherapy
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- Global equity initiatives aim to expand trial access for lung cancer patients in lower-income regions.
- High equipment costs and unfavorable exchange rates complicate modern radiotherapy adoption in developing nations.
- Artificial intelligence tools streamline repetitive clinical tasks like tissue contouring and medical note drafting.
- Combining targeted therapies with stereotactic radiosurgery helps preserve cognitive function in advanced lung cancer.
- MRI-guided adaptive radiotherapy enables clinicians to modify treatment plans daily based on tumor changes.
Professional Journey into Thoracic Oncology
Specialized radiation oncology relies on rapid technological developments to deliver targeted treatments for thoracic malignancies. In this profile, we chat with Dr. Daniel Przybysz, MD, a radiation oncologist specializing in lung cancer and a member of the Journal of Breakthroughs in Medicine & Science Editorial Board (JBMS, LLC) to discuss clinical progress, global trial equity, and emerging technologies.
Daniel is a radiation oncologist at RadioSerra Radiation Therapy in Petrópolis, Rio de Janeiro, Brazil, where he leads clinical practice in modern radiotherapy techniques including IMRT, SBRT, and brachytherapy across thoracic, genitourinary, and gynecologic malignancies. He has served on the IASLC Advanced Radiation Technology (ART) Committee for ten years and is a member of the NRG Oncology Genitourinary Committee.
Dr. Przybysz is also a contributor to UpToDate and an active peer reviewer and editorial collaborator for the Journal of Thoracic Oncology. His academic interests include stage III NSCLC, combined-modality therapy, immunotherapy–radiotherapy integration, and quality improvement in regional radiotherapy services.
Professional Journey into Thoracic Oncology
Kevin Famuyiro: Before we get started, how long have you been in thoracic oncology, and what drew you to specialize in radiation oncology?
Dr. Daniel Przybysz: I have been in the field for almost 15 years now, counting graduation, medical school, residency, and fellowships. I am originally from Brazil, but I moved to the United States when I was 14 for high school. I went back and forth for medical school and fellowship, working in St. Louis, Boston, and London before returning to Brazil five years ago.
The decision to enter thoracic oncology came during my radiation oncology residency. There was a lot of technology involved, rapid development underway, and the potential for curing, controlling, and saving lung cancer patients was amazing. That combination, along with advances in medical oncology, chemotherapy, and immunotherapy, worked a magic on me.
Global Equity in Thoracic Oncology Trials
Kevin Famuyiro: The IASLC consensus initiative focused on representation in thoracic oncology clinical trials. What specific gaps in trial design led to this global effort right now, and what measures change did you expect once the manuscript publishes?
Dr. Daniel Przybysz: The IASLC stands for the International Association for the Study of Lung Cancer, a worldwide organization with representatives from nearly every country. I serve on their radiation oncology committee, the multidisciplinary science committee, and the committee for women in thoracic oncology.
The initiative for growing representation exists because 99% of lung cancer patients worldwide are treated in places very different from MD Anderson, Mount Sinai in Los Angeles, or Memorial Sloan Kettering in New York. We are talking about developing regions in Brazil, African countries, Asian nations, and lower-income areas.
This initiative aims to build better access to modern radiation therapy, advanced treatments, molecular testing, and immunotherapy. Lung cancer care has seen improvements recently that we have not seen in decades. We want to expand access for women, ensure diverse patient voices are heard, and broaden availability for rare condition trials and modern technologies.
Overcoming Resource Constraints in Regional Care
Kevin Famuyiro: When establishing SBRT, SRS, and IGRT programs in Brazil, you faced resource constraints distinct from major academic centers. What specific clinical and logistical obstacles did you encounter, and how did you resolve them on the ground?
Dr. Daniel Przybysz: Stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS), and image-guided radiation therapy (IGRT) are precise treatment modalities. Radiation itself has not changed much in 100 years, but technological developments have improved how we deliver it by sparing healthy tissues and minimizing toxicity.
In developing countries like Brazil, the primary issue is cost. Currency exchange rates are unfavorable. A linear accelerator costs approximately $2.5 million USD, plus $4 million USD for bunker construction, totaling roughly 20 million Reais. Consequently, linear accelerators across the country often become aged.
We encountered obstacles with facility structuring, insurance reimbursement, price adjustments, and training medical physicists. We overcome these by establishing strict internal protocols, detailed checklists, heavy investments in staff training, and building a quality-focused multidisciplinary team. SBRT, SRS, and IGRT allow us to deliver treatments in fewer sessions, shifting patients from 30 daily visits to three or five, which dramatically expands access for patients traveling long distances.
The Evolving Role of Artificial Intelligence
Kevin Famuyiro: At WCLC 2025, you chaired the workshop on AI and the future of radiation oncology. Over the next one to three years, which specific clinical tasks will AI automate or alter for radiation oncologists, particularly in regional centers?
Dr. Daniel Przybysz: AI will not replace physicians. It will not simply scan a body and make autonomous diagnoses. Instead, it will take over hours spent on repetitive tasks like paperwork, treatment planning, and calculations.
In the next one to three years, AI will automate normal tissue contouring. Delineating healthy organs to protect them takes time, and automating that process creates workflow consistency.
AI will also enable faster replanning, automated plan checks, quality assurance verifications, and consultation note drafting.
For regional centers, AI shrinks the gap between small clinics and major academic institutions. It provides expert-level consistency across mid-sized and small clinics. Physicians still make final judgment calls and sign off on plans, but AI supports clinical decision-making and multidisciplinary case discussions.
Ninety-nine percent of the patients that are treated for lung cancer around the world are in places very different than MD Anderson, Mount Sinai in LA, or Memorial Sloan Kettering in New York.
— Dr. Daniel Przybysz
Kevin Famuyiro: Your co-authored research evaluates combining osimertinib and stereotactic radiosurgery for EGFR-mutant lung cancer brain metastases. How does combining targeted systemic therapy with local stereotactic radiosurgery alter clinical outcomes compared to using either modality alone?
Dr. Daniel Przybysz: Combining targeted systemic therapy or immunotherapy with radiation is one of the most substantial improvements in radiation oncology in 100 years. Immunotherapy triggers the immune system to fight cancer, and it works better when the tumor is inflamed by targeted local radiation.
Osimertinib is a targeted therapy that blocks the epidermal growth factor receptor (EGFR), which prevents tissue growth. Only about 10% of lung cancer patients express this receptor. When lung cancer metastasizes to the brain, producing stage 4 disease, outcomes historically carried very short survival expectancies.
Combining osimertinib with local stereotactic radiosurgery allows us to achieve long-term disease control for five, seven, or more years. Crucially, this approach avoids whole-brain radiation therapy, protecting patient memory, thinking, and cognitive function.
Milestones in Thoracic Radiotherapy History
Kevin Famuyiro: Dr. Alex Adjei invited you to write the radiation oncology section for the Journal of Thoracic Oncology 20th anniversary issue in 2026. What specific clinical trial data or technological developments from the last decade earned a place in that history and why?
Dr. Daniel Przybysz: The Journal of Thoracic Oncology (JTO) is the official journal of the IASLC, led by Editor-in-Chief Alex Adjei. This invitation recognizes how integral radiation therapy has become in thoracic oncology.
SBRT has earned a major place in history by becoming the standard of care for early-stage lung cancer patients who are not candidates for surgery due to smoking-related health debilities. Delivering precise, high-dose radiation in three to five fractions achieves high local control rates.
Another historical milestone is the Pacific Study, which established that administering immunotherapy after chemo-radiation in stage 3 lung cancer significantly improves overall survival. Technological advancements in image guidance, CT scans, and MRI tools now allow clinicians to visualize tumors before, during, and after every session.
International Experience and Local Patient Impact
Kevin Famuyiro: You trained at Harvard Medical School, MD Anderson, and The Royal Marsden before returning to lead care in Petropolis, earning the 2026 Dr. Oswaldo Cruz Award. How did those international clinical experiences shape your approach to daily patient care at RadioSerra?
Dr. Daniel Przybysz: My training at Harvard, MD Anderson in Houston, and The Royal Marsden in London shaped my approach completely. Experiencing different healthcare structures, patient populations, and resource levels provided a broad perspective on oncology care.
Techniques can be found online or reviewed through AI, but international training instills rigorous clinical standards. Bringing those standards to Petropolis ensures local patients receive the exact same quality of clinical decision-making as patients in Boston, Houston, or London. Receiving the Dr. Oswaldo Cruz Award from the city council was an honor that recognized our team’s ongoing commitment to local healthcare delivery.
MR-Guided Adaptive Radiotherapy and Dose Delivery
Kevin Famuyiro: Your research on MR-guided adaptive radiotherapy supported by grants from Varian, ViewRay, ASTRO, and CNPq focuses on dose delivery. What clinical data are you gathering to demonstrate that MR-guided adaptation improves local control or reduces toxicity compared to standard image-guided radiotherapy?
Dr. Daniel Przybysz: Adaptive radiotherapy represents the future of radiation oncology. Rather than using one scan to deliver 30 daily fractions over a month, adaptive care modifies the treatment plan daily based on real-time anatomical changes.
MR-guided adaptation uses daily MRI scans taken while the patient is on the treatment table. Tumors shrink and normal organs shift between sessions. Scanning daily allows us to adapt the radiation dose continuously, delivering a precise dose to the target while sparing healthy tissues.
We are gathering imaging data, dose delivery metrics, and patient-reported toxicity outcomes, such as reductions in coughing and esophagitis. In lung cancer, adapting treatment around the sixth or seventh fraction often reveals that the tumor volume has diminished by roughly 50%. Being able to cut the targeted volume in half mid-treatment significantly reduces side effects while maximizing local tumor control.
Learn more about Dr. Daniel Przybysz on Linkedin.
