Asal Rahimi M.D., M.S.

Grateful to see our Phase I Ablative Preop Single Fraction Radiation Breast Cancer Trial, published in JAMA Network Open. jamanetwork.com/journals/jaman… Main Outcome: 30-38Gy ONE fraction pre-op RT led to 72% pCR Rate/ 92% npCR+pCR 🚀 🧵1/4

Our Ethos Adaptive Radiation Therapy Training Course was a huge success! Attendees learned to personalize cancer treatment in real time, practiced planning workflows, and simulated treatment with expert guidance to bring advanced care back to their clinics.

@StephenChunMD @UChicagoRadonc @NRGonc @ASTRO_org @UTMDAnderson @PrajnanDasMD @ACKoongMDPhD @PSchlembachMD @rweichselbaum @IBCradiation Congratulations!!

Congratulations to @UChicagoRadonc/@NRGonc/@ASTRO_org Steven Chmura on being named Chair of @UTMDAnderson Breast Radiation Oncology effective 9/1/2026. The future of breast cancer at MDACC is bright!!! @PrajnanDasMD @ACKoongMDPhD @PSchlembachMD @rweichselbaum

@jfcdrr @DavidSherMD @UTSW_RadOnc @DaveParsonsPhD Soon!

@DavidSherMD @UTSW_RadOnc @AsalRahimiMD @DaveParsonsPhD Some paper/abstract describing the SO-FAST technique?. Thanks.

SO proud of our breast adaptive team at @UTSW_RadOnc, led by @AsalRahimiMD and @DaveParsonsPhD. After months of preparation, they delivered the first fully Sim-Omitted/direct-to-unit Fast-Forward breast treatment (SO-FAST). After consult, the patients show up on Day 1 for online simulation and fraction 1. Fewer hospital encounters for the patient (and less time and financial toxicity), better use of resources for the clinic, and a faster time to start. Their work complements our other SO initiatives, including heterotopic hip (SO-HO), opposed beam palliative, including WBRT (SO-Pal and SO-Whole), stereotactic prostate (SO-PRO, on MRL) and hypofractionated glioma (SO-GLO, on MRL). I love a good acronym, but even better is a treatment paradigm that makes treatment easier and faster for patients.

The manuscript under preparation. authors includes: Shanshan Tang, Justin Visak, Tingliang Zhuang, Chang-Shiun Lin, Chien-Yi Liao, Mona Arbab, Sean Domal, Narine Wandrey, Cynthia Tye, Prasanna Alluri, David Sher, Shahed Badiyan, Asal Rahimi, Mu-Han Lin, and David Parsons.

This study explores a faster way to deliver RT for breast cancer, where planning and treatment are completed in real time within about an hour by skipping traditional pre-treatment steps and using advanced imaging and artificial intelligence instead.

Our team delivered the first simulation-omitted (So-Fast) breast treatment on the Ethos today. Kudos to our physics team led by Dr David Parsons for doing the heavy lifting to reduce time commitments for our patients.

Congrats to all that matched into radonc! We are so excited to work with Tessa, @BMGodinich and Hamza! Welcome to @UTSW_RadOnc family!

@mleitc @utswcancer @UTSW_Surgery @nt_acs Congratulations!!

Congratulations to Margaret Gallagher, Breast Surgical Oncology Fellow on winning Best Surgical Oncology Presentation at N. Tx American College of Surgeons Annual Mtg - surgical outcomes after PREOP single fraction partial breast XRT @utswcancer @UTSW_Surgery @nt_acs

In Collaboration with BrachyAcademy we are excited to announce our hands-on Gyn Brachytherapy Training Program email precious.king@utsw.edu bit.ly/4sZicM2

@pnbarry Congrats!

Excited!

@ssuuvvaamm @ChandrakanthMv @K_Yadavir @DrHolmesLA @SpringerNature @JAMAOnc @dr_yakupergun @BapnaAjay @SuyogCancer @DrRishabhOnco Definitely on the horizon!

@ChandrakanthMv @K_Yadavir @DrHolmesLA @SpringerNature @AsalRahimiMD @JAMAOnc @dr_yakupergun @BapnaAjay @SuyogCancer @DrRishabhOnco RT preop seems quiet intresting modality.

What if lumpectomy becomes optional? ❄️ FROST- freeze it ☢️ Rahimi- zap it once 90% near-pCR with a single radiation dose (Rahimi) ~1% 1-yr recurrence with cryoablation (FROST) De-escalation ≠ compromise. HR+ early BC is being redefined. #ebc #MedTwitter #Oncology

@KhashiFattah You are an incredible physician and UTSW is lucky to have you in the residency program. Looking forward to seeing all your accomplishments over the years. Thankyou for the kind words!

Ending the year & my breast rotation with my favorite attending Dr. @AsalRahimiMD, deeply grateful for the privilege of learning from an incredible mentor who made me to think why we treat patients beyond all CALGBs & NSABPs. One photo that will always stay in my office proudly.

@aguilera_md @utswcancer Thankyou @aguilera_md . The next generation of breast trials and other subsites look very bright for rad onc!

Congrats @AsalRahimiMD! Huge step forward. RT—short-course or SBRT—as part of neoadjuvant care. Maybe there is a future non-op pathway in breast cancer? ENT, prostate, lung, GI… it’s happening across diseases. What an evolution— amazing collab @utswcancer to make this a reality!

@DrRishabhOnco Thank you for the excellent synopsis and review @DrRishabhOnco @OncoAlert @myESMO @ASCO @ESMO_Open @JAMANetworkOpen

💥 Ablative Radiation… and Delayed Surgery in Ca Breast? The Rahimi Trial | JAMA Network Open 2025 🔥 💡 Single-fraction preoperative stereotactic partial breast irradiation (sPBI) in early HR+ breast cancer. 30 vs 34 vs 38 Gy - all in ONE shot ⚡️ Endocrine therapy ➜ ⏳ wait ➜ ✂️ delayed surgery. And the results are wild. 🤯 🎯 Trial Essentials • 🧪 Phase 1 | n = 44 • 🎀 HR+, HER2-neg, cN0 • 🎯 sPBI: 30 / 34 / 38 Gy (1 fraction) • 💊 Endocrine therapy after RT • 🗓️ Surgery allowed up to 12 months later 📈 Key Results 1. Safety • 🚫 MTD not reached up to 38 Gy • 😊 Mostly grade 1 • ⚠️ 1 late G3 wound issue (diabetes) 2. Response Rates 30 Gy → pCR 36% | pCR+near pCR 64% 34 Gy → pCR 47% | pCR+near pCR 93% 38 Gy → pCR 67% | pCR+near pCR 93% 💥 If surgery delayed >9 months: • pCR 72% • pCR+near pCR 92% 🧬 Biology Behind It • 📉 Ki-67 dropped 11% → 2% • 🟩 95% had Ki-67 <3% in residual disease • 🧲 Radiation + endocrine therapy = slow, sustained tumor kill • ⏳ Time > Dose 🧭 What Mattered Most? Time to surgery • 📈 Strongest predictor of pCR • ➕ Each extra day improved odds • 🎚️ Dose beyond 30 Gy gave minimal extra benefit • 🕘 Surgery >9 months = best response ✨ Takeaway A single 30–38 Gy shot ⚡️ + endocrine therapy + delayed surgery might be the first step toward no-surgery management for select early HR+ breast cancers. 🚀 Opens the door for true “radiation-only” curative trials.” 💡 Future paradigm: Ablate 🔥 • Wait ⏳ • Omit Surgery ✂️ …for carefully selected luminal A disease. 📓Full paper in comment below ⬇️ #BreastCancer #RadiationOncology #MedTwitter #OncoTwitter @JAMANetworkOpen @myesmo @esmo_open @ASCO @OncoAlert

Stereotactic partial breast irradiation could be a nonsurgical treatment option for some early-stage hormone receptor-positive (HR+) breast cancers #radiology @UTSWMedCenter @AsalRahimiMD buff.ly/D0FHrMo

@ndesai2005 @NiuSanford @BobTimmermanMD @UTSW_RadOnc @MonaArbabMD @PrasannaAlluri @DaveParsonsPhD @chikarebeccaN @DrBasakDogan @hmcarthur Thankyou @ndesai2005 ! I feel the same about all your work and efforts

@AsalRahimiMD @NiuSanford @BobTimmermanMD @UTSW_RadOnc @MonaArbabMD @PrasannaAlluri @DaveParsonsPhD @chikarebeccaN @DrBasakDogan @hmcarthur Awesome work - been great to learn from your experience putting this and other follow on trials together.

Grateful to see our Phase I Ablative Preop Single Fraction Radiation Breast Cancer Trial, published in JAMA Network Open. jamanetwork.com/journals/jaman… Main Outcome: 30-38Gy ONE fraction pre-op RT led to 72% pCR Rate/ 92% npCR+pCR 🚀 🧵1/4

@pipcosper @PrasannaAlluri @DrBasakDogan @MonaArbabMD @BobTimmermanMD @UTSW_RadOnc @chikarebeccaN @DaveParsonsPhD @hmcarthur Shoot me an email @pipcosper ! Asal.rahimi@utsouthwestern.edu

@AsalRahimiMD @PrasannaAlluri @DrBasakDogan @MonaArbabMD @BobTimmermanMD @UTSW_RadOnc @chikarebeccaN @DaveParsonsPhD @hmcarthur Awesome! I’d love to look at those residual tumors under the microscope 👀🔬

@jesusfuel I’m up for the challenge @jesusfuel!!!

Esto estaremos debatiendo en 10 años.