TAMPA, Fla., and CLEVELAND, Ohio — Clinical trials in lung cancer over the decades have determined an optimal “one size fits all” dosing scheme for patients treated with radiation therapy, but new research now shows this is not as biologically accurate as once believed. A new technology using tumor genomics to personalize radiation dosing demonstrates that the standard of care approach may be suboptimal for up to 75% of lung cancer patients.
A paper published in the Dec. 9 Journal of Thoracic Oncology, co-authored by Dr. Javier F. Torres-Roca, a senior member in the Radiation Oncology Program at Moffitt Cancer Center, and Dr. Jacob G. Scott, a radiation oncologist and physician researcher in the Department of Translational Hematology and Oncology Research at Cleveland Clinic, demonstrates an approach to combine individual tumor genomics and mathematics to personalize the dose of radiation therapy for lung cancer patients. By applying this personalized technology, their study shows an opportunity to increase the efficacy and decrease the toxicity of radiation therapy.
“It’s standard of care to give patients the same radiation dose based on the type of cancer and its stage,” Torres-Roca said. “The idea that this is optimal for every patient is in direct conflict with the fact that all cancers are different. In this study, we demonstrate that the standard dose results in the majority of patients getting either too much or too little radiation. So we developed a new technology that can personalize the dose required for a specific patient’s tumor biology and quantified the clinical opportunity this provides.”
In 2017, Torres-Roca and Scott developed the Genomic Adjusted Radiation Dose (GARD), a method of dosing that accounts for biological differences and can be utilized to predict the optimal radiation therapy dose for each individual patient. The results were published in Lancet Oncology and were used as a basis for this most recent advance.
“Here we extend our work with GARD to define a new paradigm for clinical radiotherapy dose decision-making,” Scott said. “By developing a patient-specific mathematical model that factors in individual tumor biology and healthy tissue complication probabilities, we optimize clinical outcome for each individual patient.”
While the study involved non-small cell lung cancer patients, Torres-Roca and Scott are confident the technology can be used in other cancers, as well.
Moffitt Cancer Center expects to start a clinical trial utilizing the new technology in early 2021.
This research was supported by the National Institutes of Health Loan Repayment Program, the Paul Calabresi Career Development Award for Clinical Oncology (K12 CA076917, R37 CA244613) and the DeBartolo Family Personalized Medicine Institute.
About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. The Tampa-based facility is one of only 51 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s scientific excellence, multidisciplinary research, and robust training and education. Moffitt is the No. 11 cancer hospital and has been nationally ranked by U.S. News & World Report since 1999. Moffitt’s expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet® status, its highest distinction. With more than 7,000 team members, Moffitt has an economic impact in the state of $2.4 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit MOFFITT.org, and follow the momentum on Facebook, Twitter, Instagram and YouTube.
About Cleveland Clinic
Cleveland Clinic is a nonprofit multi-specialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 67,554 employees worldwide that represent 140 medical specialties and subspecialties. Cleveland Clinic is a 6,026-bed health system that includes a 165-acre main campus near downtown Cleveland, 18 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2019, there were 9.8 million total outpatient visits, patients came for treatment from every state and 185 countries.