Using GARD to Personalize Adjuvant Radiotherapy
Dr. Javier F. Torres-Roca is a radiation oncologist at Moffitt Cancer Center who specializes in providing radiation therapy to treat cancer. You may know that radiation therapy – or radiotherapy - is a common cancer treatment established over 120 years ago! For the last 100 years, scientists like Dr. Torres-Roca have been trying to learn how to use this type of treatment more effectively mostly by designing new technologies, while still treating everyone the same.
Dr. Torres-Roca wanted to challenge this. “Imagine a T-shirt company that only sells large T-shirts because they do not know that their customers come in different sizes. Sure, a large T-shirt will fit some, but some may need more coverage while others may not need as much coverage,” he said.
Dr. Torres-Roca has dedicated his career to understanding how patients can benefit from more personalized approaches to their radiation treatment since no two cancer patients are the same.
His research has been divided into three phases, each building from the last to better understand how radiation therapy can be tailored.
First, his team looked at how tumor cells responded to radiation after one dose. This was done using cells grown in their lab and exposing them to radiation. The work created a scoring system that Dr. Torres-Roca and team call the Radio Sensitivity Index (RSI), which measures if a cell is sensitive or resistant to radiation. Second, the RSI score was validated using data from tumors donated as part of the TCC protocol and other independent data from outside of Moffitt. Third, his team used Total Cancer Care patients’ medical record data to relate tumor response to standard of care radiotherapy to their findings in the lab.
This “bench to bedside” research collaboration created the very first Genomic Adjustment Radiation Dose, or GARD, a tool that radiation oncologists can use when treating patients. GARD is a metric that allows providers to adjust the dose of radiotherapy based on the RSI score of the tumor. Now Dr. Torres-Roca is ready to start using GARD to find a dose that will benefit each patient individually. Dr. Torres-Roca’s team is now planning a clinical trial to test treatment doses adjusted by GARD.
As Dr. Torres-Roca and his team prepared to revolutionize the way radiotherapy is prescribed, he recognized the invaluable contribution the Total Cancer Care study had on his research.
“TCC has made this all possible because this is difficult and very novel research for radiation oncology, which makes it difficult to fund. We don’t think we could have completed this research without the TCC study and the patients who agreed to participate,” he said.
Dr. Torres-Roca collaborated with other Moffitt faculty members, including Dr. Bill Dalton, Dr. Steven Eschrich, Dr. Jacob Scott and Dr. Louis Harrison.