The National Association for Proton Therapy (NAPT) is getting ready for its annual National Proton Conference, taking place April 26 through 28 in Philadelphia.

In preparation for the event, HealthCare Business News sat down with Jennifer Maggiore, the organization’s executive director, to learn more about the state of proton therapy and what attendees can expect at this year’s conference.

HCB News: How has the landscape of proton therapy evolved since you first became involved in the field?
Jennifer Maggiore: The landscape of proton therapy has changed dramatically since its early days. Initially, proton therapy was primarily offered at a handful of large, stand-alone centers treating a limited range of tumors. Today, there is a greater emphasis on research-driven advancements, with more academic medical centers not only providing proton therapy but actively contributing to clinical trials and multi-institutional studies.

Another major shift is in the types of tumors being treated. Today, proton therapy is increasingly used for complex cases, including head and neck cancers, reirradiation, and certain breast, lung, and gastrointestinal malignancies. This evolution is driven by emerging clinical data, improved technology, and growing recognition of proton therapy’s ability to reduce toxicity compared to conventional radiation.
Additionally, the expansion of proton therapy has taken a new direction. Rather than exclusively building large, stand-alone centers, the trend has shifted toward smaller, single-room systems that are integrated into existing health systems. These facilities often form collaborative models between academic institutions and outpatient providers, improving accessibility and sustainability.

This transformation is reflected in the growth of NAPT, which has expanded from 30 to 49 member institutions in the past five years, underscoring the field’s progress and increasing adoption of proton therapy as an essential component of modern cancer care.

HCB News: There’s been a lot of discussion about expanding access to proton therapy—what steps are being taken to make treatment more widely available?
JM: There is a strong commitment within the proton therapy community to expand access and ensure that more patients can benefit from this technology. Over the past few years, we’ve seen new centers strategically opening in regions that previously lacked access, helping to close geographic gaps. For example, Penn Medicine has played a leadership role by leveraging its expertise to establish regional proton therapy centers, such as those in Lancaster, Pennsylvania, and at Virtua in South New Jersey.

Additionally, leaders in the field are actively guiding the next generation of providers to ensure sustainability and growth. NAPT plays a key role by hosting educational webinars, facilitating peer-to-peer knowledge sharing, and providing resources for both new and existing centers. Advocacy remains a major priority, particularly in securing appropriate reimbursement and establishing clear, evidence-based coverage guidelines that enable more patients to receive proton therapy without unnecessary barriers.

HCB News: Reimbursement remains a key issue in the field. Have you seen any recent shifts in how payers approach proton therapy coverage?
JM: Yes, we have seen meaningful progress in this area. In 2023, ASTRO updated its Model Policy for proton therapy, incorporating key recommendations from NAPT and reflecting the latest clinical evidence. Many insurance providers have since aligned their coverage policies with these professional guidelines, leading to broader and more consistent access to proton therapy for patients.

Beyond private insurers, we’ve also seen positive steps at the federal level. NAPT has actively supported policy changes that improve access, including reforms by CMS to streamline the prior authorization process for Medicare beneficiaries enrolled in Medicare Advantage plans. These efforts help reduce delays and administrative burdens for patients who qualify for proton therapy. While challenges remain, these developments indicate a growing recognition of proton therapy’s value in cancer treatment.

HCB News: What role does research play in advancing proton therapy, and how are collaborative efforts shaping future studies and clinical trials?
JM: Research is fundamental to the continued advancement of proton therapy, helping to refine its applications and identify the patient populations that stand to benefit the most. Given the specialized nature of proton therapy, high-quality evidence is essential to guide clinical decision-making and demonstrate both its therapeutic and economic value.

The proton therapy community has shown a strong commitment to generating robust evidence, with over 1,000 peer-reviewed studies supporting its clinical benefits and impact on patients’ quality of life. A significant step forward was the publication of the PARTIQoL trial, the first randomized phase III clinical trial comparing proton therapy to IMRT for prostate cancer. While not all studies can be randomized, this trial provided important data on patient-reported outcomes and reinforced the need for continued research in this space.

Recognizing the importance of collaboration, NAPT recently hosted its first Proton Therapy Research Symposium in partnership with key stakeholders, including the Proton Collaborative Group (PCG) and PTCOG-NA. This initiative underscores the commitment to advancing proton therapy through cooperative research efforts. One highly anticipated study is the randomized phase III trial led by Dr. Steven Frank at MD Anderson, comparing proton therapy versus IMRT for oropharyngeal head and neck cancer (OPC). The findings from this study will provide valuable insights into the role of proton therapy in reducing treatment toxicity while maintaining efficacy.

HCB News: The NAPT annual meeting brings together experts from across the industry. What unique opportunities does this year’s event offer for collaboration and learning?
JM: This year’s NAPT Annual Meeting promises to be an unparalleled opportunity for collaboration, education, and networking. Under the leadership of our Program Chair, Dr. Jeff Bradley, we’ve crafted an agenda that addresses both current challenges and future innovations in proton therapy.

One of the highlights is an exclusive tour of the Roberts Proton Therapy Center at Penn’s Abramson Cancer Center, a premier institution known for its excellence in clinical care, research, and patient support.

Other key sessions include: A keynote address by Dr. Arif Kamal, Chief Medical Officer of the American Cancer Society; The NAPT Excellence Awards Breakfast, recognizing leaders in the field; A PTCOG-NA session focused on defining the next generation of proton therapy research; Roundtable discussions tailored for administrators and their team fostering peer-to-peer learning; Sessions on optimizing workflow, navigating insurance and the appeals processes, the transformative role of AI in proton therapy, sustainable development and the latest advancements in clinical research.

HCB News: For hospitals or oncology practices considering adding proton therapy, what factors should they take into account before making that investment?
JM: Investing in proton therapy is a long-term commitment, and institutions must plan strategically to ensure sustainability and growth. A few key considerations include:

• Long-Term Vision: With more indications being treated with proton therapy, it’s crucial to plan for the future. This includes designing facilities that allow for technology upgrades and innovations.
• Clinical Expertise: Engaging experienced proton therapy professionals early in the process—both on the clinical and operational side—can significantly impact a center’s success. Learning from established programs can help avoid common pitfalls.
• Financial Planning: Proton therapy requires significant upfront investment, but financial sustainability depends on assessments of patient volume, establishing sustainable reimbursement and securing institutional or community partnerships.
• Workflow Integration: Many centers find success when proton therapy is seamlessly integrated into the broader oncology care continuum, ensuring efficient patient referrals and coordination with other treatment modalities.

Hospitals and practices considering proton therapy can benefit from speaking with experienced providers in the field, many of whom will be at our NAPT Annual Meeting, where they can share best practices and lessons learned.

HCB News: What excites you most about the future of proton therapy, and where do you see the field heading in the next five to ten years?
JM: The future of proton therapy is incredibly promising. The field is growing, making treatment more accessible to patients across the country. Currently about 70% of NCCN designated centers are treating with or are planning to treat patients with proton therapy. As new regional centers open and existing centers continue to refine their expertise, more people will have access to this highly precise treatment.

Additionally, the integration of artificial intelligence (AI) and adaptive treatment planning is poised to revolutionize cancer care. AI-driven advancements will enable even greater precision in radiation delivery, minimizing damage to healthy tissue and enhancing patient outcomes. FLASH therapy, which delivers radiation in ultra-high doses within fractions of a second, holds the potential to dramatically reduce treatment times and further spare surrounding healthy tissue.

Overall, the combination of increased access, ongoing research, and emerging technologies will ensure that proton therapy continues to play a pivotal role in the future of oncology care.