Clinical Trials

ViewRay believes in the value of clinical studies and supports sponsored and investigator-initiated research studies.

Clinical Success

Stereotactic MRI-Guided On-Table Adaptive Radiation Therapy (SMART) for Locally Advanced Pancreatic Cancer

Ongoing Clinical Study
ViewRay has a sponsored study titled “Prospective phase II Study of Stereotactic MR-guided on-table Adaptive Radiation Therapy (SMART) for Patients with Borderline or Inoperable Locally Advanced Pancreatic Cancer.”

High-dose magnetic resonance imaging (MRI) guided hypofractionated radiation therapy delivered using daily adaptive dose planning has been shown in a retrospective study to result in improved overall survival, relative to patients receiving lower radiation doses, in patients with locally advanced pancreatic cancer, without increasing the rate of serious gastrointestinal toxicity.

The goal of the proposed trial is to investigative in a controlled, prospective manner the robustness of this outcome, and to track quality of life over a 5-year trial period.

Eligible Participants
Patients with borderline resectable or inoperable locally advanced pancreatic cancer who are 18 years and older and meet the inclusion and exclusion criteria noted within the study description.

Trial Design
In this single-arm study, participants will receive radiation therapy using integrated magnetic resonance imaging (ViewRay’s MRIdian MR-Guided Radiation Therapy System) at a dose of 50 Gray in 5 fractions (treatment sessions). Fractions will be delivered at least twice per week and with at least 18 hours between treatments. Each participant will be aligned in the treatment system with MRI-guidance. On-table adaptive replanning will be used when clinically indicated. In all patients, real-time MR-imaging will be used throughout treatment delivery to monitor the target location and control the radiation beam, as necessary.

Outcome Measures
The primary outcome measure of the study is grade 3 or higher gastrointestinal toxicity in the first 90 days after treatment. Secondary measures include overall survival at two years, distant progression-free survival at six months, and changes in patient-reported quality of life (pre-treatment to 12 months post-treatment and for longer periods up to five years).

To find more information regarding the SMART study, our multi-center, prospective, single-arm clinical trial for inoperable, locally advanced or borderline resectable pancreatic cancer, please provide your contact information via the form below or follow the link to the listing [ENROLLMENT COMPLETE]

Investigator-Initiated Research

In addition to our sponsored study, ViewRay has a robust investigator-initiated research program supporting clinical and technical projects. For more information, please visit our IIR page.  Additionally, please see the list of publicly referenced clinical, prospective, phase I, II, or III studies below. 



Stereotactic Body Radiotherapy and Focal Adhesion Kinase Inhibitor in Advanced Pancreas Adenocarcinoma, Hyun Kim, MD, Washington University School of Medicine, Saint Louis, Missouri, United States,

Patients with advanced pancreas adenocarcinoma will be treated with standard of care chemotherapy followed by stereotactic body radiotherapy (SBRT) concurrent with the focal adhesion kinase (FAK) inhibitor and assessed for clinical outcomes such as progression free survival (PFS), local control, distant control, and toxicity in this study. 

Nivolumab, Ipilimumab and Chemoradiation in Treating Patients With Locally Advanced Pancreatic Cancer (LAPTOP), Inna Chen, MD, Herlev & Gentofte University Hospital, Denmark, Herlev, Denmark,

This study is to explore the safety and synergy of the proposed combinatorial approach, participants with locally advanced PC will receive nivolumab and ipilimumab administered in combination with gemcitabine and nab-paclitaxel followed by immune-chemoradiation.


Preoperative MR-Guided Radiation Therapy in Gastric Cancer, Hyun Kim, MD, Washington University School of Medicine, Saint Louis, MO, United States | Seoul National University College of Medicine, Seoul, Republic of Korea,

Patients with locoregional gastric adenocarcinoma will receive hypofractionated magnetic resonance guided radiotherapy followed by chemotherapy followed by surgery and pathologic complete response (pCR) rate will be quantified in this study.


Adaptative MR-Guided Stereotactic Body Radiotherapy of Liver Tumors (RASTAF), Magali Rouffiac Thouant, MD, & Emlie Rederstorff, PhD, Centre Georges François Leclerc, Dijon, France,

This is a phase II adaptative magnetic resonance-guided stereotactic body radiotherapy (SBRT) study for treatment of primary or secondary progressive liver tumors.

OAR-Based, Dose Escalated SBRT with Real Time Adaptive MRI Guidance for Liver Metastases, Michael Bassetti, MD, PhD, University of Wisconsin, Madison, Wisconsin,

This trial is to identify a safe maximum tolerated dose level for magnetic resonance image (MRI)-guided stereotactic body radiotherapy (SBRT) treatment of bowel and liver metastases, respectively.



Extremely Hypofractionated Intensity Modulated Stereotactic Body Radiotherapy for the Treatment of Prostate Cancer With Rising PSA After Radical Prostatectomy (EXCALIBUR), Amar Kishan, MD, UCLA / Jonsson Comprehensive Cancer Center, Los Angeles, California, United States,

This phase II trial investigates the effect of extremely hypofractionated intensity-modulated stereotactic body radiotherapy in treating patients with prostate cancer that has rising prostate-specific antigen (PSA) after radical prostatectomy.

CT-guided Stereotactic Body Radiation Therapy and MRI-guided Stereotactic Body Radiation Therapy for Prostate Cancer, MIRAGE Study, Amar Kishan, MD, UCLA / Jonsson Comprehensive Cancer Center, Los Angeles, California, United States, [ENROLLMENT COMPLETE]

This is a randomized trial designed to evaluate the superiority of magnetic resonance imaging (MRI)-guided stereotactic body radiotherapy (SBRT) over standard computed tomography (CT)-guided SBRT for prostate cancer (PCa) with respect to acute physician-scored genitourinary (GU) toxicity. 

Study of PSMA PET/MR Guided Stereotactic Body Radiation Therapy With Simultaneous Integrated Boost (SBRT-SIB) for High-Intermediate and High Risk Prostate Cancer, Josephine Kang M.D., Ph.D. Weill Cornell Medicine, New York, New York, United States,

Patients will undergo prostate-specific membrane antigen (PSMA) Positron Emission Tomography (PET)/Magnetic Resonance (MR) prior to start of the radiation treatment planning process and will be evaluated for recurrence free survival in this study.

Randomized Phase II Trial of Salvage Radiotherapy for Prostate Cancer in 4 Weeks v. 2 Weeks (SHORTER) Himanshu Nagar, MD, Weill Cornell Medicine, New York, New York, United States

This study will compare urinary and bowel side effects of hypofractionated radiotherapy in 20 treatments (4 weeks) to ultra-hypofractionated radiotherapy in 5 treatments (2 weeks) for prostate cancer that has returned after prostatectomy and evaluate time to progression and the quality of life.

Stereotactic Intensity Modulated Radiotherapy After Radical Prostatectomy (SCIMITAR), Amar Kishan, MD, UCLA / Jonsson Comprehensive Cancer Center, Los Angeles, California, United States, [ENROLLMENT COMPLETE]

This phase II trial is studying how well stereotactic body radiation therapy works in treating patients with prostate cancer that has not spread to other parts of the body and have undergone surgery. 



Magnetic Resonance-Guided Hypofractionated Adaptive Radiation Therapy With Concurrent Chemotherapy and Consolidation Durvalumab for Inoperable State IIB and IIIA Non-small Cell Lung Cancer, Gregory Vlacich, MD, PhD, Washington University School of Medicine, St. Louis, Missouri, United States,

This prospective, single-arm, phase II clinical trial with safety lead-in will test the feasibility and outcomes of magnetic resonance (MR)-guided radiation therapy system and apply principles of hypofractionation toward the current treatment paradigm of concurrent chemoradiation and consolidation immunotherapy for locally advanced non-small-cell lung cancer (NSCLC).


Real-Time MRI-Guided 3-Fraction Accelerated Partial Breast Irradiation in Early Breast Cancer, Bethany Anderson, MD, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, United States,

This trial will investigate a novel 3-fraction radiation regimen for participants undergoing breast-conserving therapy (BCT) for early breast cancer. 

Three Fraction Accelerated Partial Breast Irradiation as the Sole Method of Radiation Therapy for Low-risk Stage 0 and I Breast Carcinoma, Imran Zoberi, MD, & William Kennedy, MD, Washington University School of Medicine, Saint Louis, Missouri, United States,

This single institution, phase I/II study is designed primarily to evaluate three fractions accelerated partial breast irradiation as the sole method of radiation therapy for low-risk stage 0 and I breast carcinoma.


Pilot Study of Same-session MR-only Simulation and Treatment With Stereotactic MRI-guided Adaptive Radiotherapy (SMART) for Oligometastases of the Spine, Lauren Henke, MD, M.S.C.I., Washington University School of Medicine, Saint Louis, Missouri, United States,

This study will evaluate short-term goals of workflow feasibility and safety of same-session magnetic resonance (MR)-only simulation and treatment planning, on-table, using stereotactic magnetic resonance image (MRI)-guided adaptive radiotherapy (SMART). 

MARTHA-trial: MRI – Guided Adaptive RadioTHerapy for Reducing XerostomiA in Head and Neck Cancer Including Longitudinal Evaluation of the Patient’s Immune Profile Under Radiotherapy, Panagiotis Balermpas, MD, Zurich University Hospital, Zurich, Switzerland,

This prospective, phase II trial is to evaluate xerostomia after magnetic resonance image (MRI)-guided adaptive radiotherapy of head and neck cancer.


Immune Checkpoint Inhibitor and MR-guided SBRT for Limited Progressive Metastatic Carcinoma, Michael Chuong, MD, Miami Cancer Institute, Miami, FL, United States,

This is an open-label, single arm, phase II clinical trial in patients with metastatic solid malignancy of any histology who have previously experienced limited progression in at least 1 and up to 5 lesions while on immune checkpoint inhibitors monotherapy.


SMART Master Protocol, Stereotactic Magnetic Resonance Guided Radiation Therapy, Brigham & Women’s Hospital, Boston, Massachusetts, United States,

This is a master prospective Phase I-II trial evaluating the feasibility and efficacy of stereotactic magnetic resonance (MR) guided adaptive radiation therapy (SMART) in patients with cancer.

CONFIRM: Magnetic Resonance Guided Radiation Therapy, Brigham & Women’s Hospital, Boston, Massachusetts, United States | Dana Farber Cancer Institute, Boston, Massachusetts, United States,

This is a master clinical protocol evaluating magnetic resonance (MR) image-guided radiation in patients with gastric and breast cancer.

Medical Services

The MRIdian Linac System, with magnetic resonance imaging capabilities, is intended to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors, and conditions anywhere in the body where radiation treatment is indicated. Medical information services provides support for medical, scientific, and technical information in response to inquiries regarding the use of ViewRay products. Contact our Medical Affairs team at for more information.

1Chuong MD, Bryant J, Mittauer KE, Hall M, Kotecha R, Alvarez D, Romaguera T, Rubens M, Adamson S, Godley A, Mishra V, Luciani G, Gutierrez AN, Ablative 5-fraction stereotactic magnetic resonance-guided radiation therapy (MRgRT) with on-table adaptive replanning and elective nodal irradiation for inoperable pancreas cancer, Practical Radiation Oncology (2020)
2Finazzi T, Haasbeek CJA, Spoelstra FOB, Palacios MA, Admiraal MA, Bruynzeel AME, Slotman BJ, Lagerwaard FJ, Senan S, Clinical outcomes of stereotactic MR-guided adaptive radiation therapy for high-risk lung tumors International Journal of Radiation Oncology • Biology• Physics (2020); Rosenberg S. A. et al. (2018). A multi-institutional experience of MR-guided liver stereotactic body radiation therapy. Advances in Radiation Oncology, 4(1), 142-149; Rudra S. et al. (2019). Using adaptive magnetic resonance image-guided radiation therapy for treatment of inoperable pancreatic cancer. Cancer Medicine, 8(5), 2123-2132; Henke, L., et al. (2018). Phase I trial of stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of oligometastatic or unresectable primary malignancies of the abdomen. Radiotherapy and Oncology, 126(3), 519-526. Henke LE, et al. Stereotactic mr-guided online adaptive radiation therapy (smart) for ultracentral thorax malignancies: Results of a phase 1 trial. Adv Radiat Oncol 2019;4:201-209; Rosenberg SA, et al. A multi-institutional experience of mr-guided liver stereotactic body radiation therapy. Adv Radiat Oncol 2019;4:142-149; Kennedy WR, Thomas MA, Stanley JA, Luo J, Ochoa LL, Clifton KK, Cyr AE, Margenthaler JA, DeWees TA, Price A, Kashani R, Green O, Zoberi I, Single Institution Phase I/II Prospective Clinical Trial of Single Fraction High Gradient Adjuvant Partial Breast Irradiation for Hormone Sensitive Stage 0-I Breast Cancer, International Journal of Radiation Oncology • Biology • Physics (2020); Bruynzeel AME, Tetar SU, Oei SS, Senan S, Haasbeek CJA, Spoelstra FOB, Piet AHM, Meijnen P, Bakker van der Jagt MAB, Fraikin T, Slotman BJ, van Moorselaar RJA, Lagerwaard FJ, A prospective single-arm phase II study of stereotactic magnetic-resonance-guided adaptive radiotherapy for prostate cancer: Early toxicity results, International Journal of Radiation Oncology • Biology • Physics (2019)

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