News | Radiation Therapy | August 26, 2019

Moffitt Researchers Develop Model to Personalize Breast Cancer Radiation Treatment

The genomically-adjusted radiation dose (GARD) can predict risk of local tumor recurrence and optimize radiation dose

Moffitt Researchers Develop Model to Personalize Breast Cancer Radiation Treatment

August 26, 2019 — A personalized approach to cancer treatment has become more common over the last several decades, with numerous targeted drugs approved to treat particular tumor types with specific mutations or patterns. However, this same personalized strategy has not translated to radiation therapy, and a one-size-fits-all approach for most patients is still common practice. Moffitt Cancer Center researchers hope to change this mindset for radiation treatment with the development of a genomically-based model that can optimize and personalize a radiation dose to match an individual patient’s needs.

Radiation therapy is part of the standard treatment approach for breast cancer, but the dose administered to most patients is largely the same. Currently, clinical studies are being conducted to determine the benefits and risks of omitting radiation treatment in certain patients with breast cancer who are at a low risk of local disease recurrence. However, according to Javier Torres-Roca, M.D., senior member of Moffitt’s Department of Radiation Oncology, “a true genomic approach to personalize radiotherapy dose has not yet been undertaken.”

Previously, Torres-Roca and his team developed and validated a radiation sensitivity index (RSI) to predict the radiation sensitivity of tumors based on the patterns of 10 genes. However, they wanted to further develop the use of the RSI to more accurately determine the appropriate radiation dose for individual patients. The research team combined the RSI with a model that is used to determine the effect of radiation dose on tumor and normal tissues to create a new radiation dose determining method called genomically-adjusted radiation dose (GARD).

“GARD is the first opportunity for a genomically-driven personalized approach in radiation oncology, and is a research priority for the field,” explained Torres-Roca. “Our research has found that GARD values are lower for those tumors that are resistant to radiation and higher for those tumors that are sensitive to radiation treatment.”

In a new study published this month in EBioMedicine, Moffitt researchers validated the use of the GARD model in two separate groups of triple-negative breast cancer patients treated with radiation therapy from Europe (N=58) and the Total Cancer Care program at Moffitt (N=55).1 They demonstrated that GARD values were associated with the risk of breast cancer recurring locally. The researchers also used GARD to calculate an individualized radiation dose for each breast cancer patient in the group of patients from Moffitt. They found that the range for biological optimal radiation dose in triple negative breast cancer ranged from 30 to 76 Gy, and that the current standard to deliver 60 Gy to all patients could be overdosing a significant number of patients.

The researchers are now planning a clinical trial to be initiated at Moffitt where the radiation dose for breast cancer patients will be selected based on this model. They hope that the continued study of the GARD model and its implementation into practice will benefit patients by allowing a personalized approach to radiation treatment and will minimize the risks of additional radiation exposure. 

“Our analyses provide the first proposed range for optimal radiotherapy dose at an individual patient level in triple-negative breast cancer and proposes a significant number of patients can be treated with lower doses of radiotherapy while still maintaining high levels of local control,” said Kamran Ahmed, M.D., assistant member of the Department of Radiation Oncology at Moffitt and lead author of the study.

The study was supported by funds from the Morton Plant Mease Foundation.

For more information: www.ebiomedicine.com

 

Related Content

VIDEO: Personalizing Radiotherapy Using Genomic Markers of Radiosensitivity

Researchers Develop First Genetic Test Predicting Tumor Sensitivity to Radiotherapy

Radiation Therapy Treatment Advances

 

Reference

1. Ahmed K.A., Liveringhouse C.L., Mills M.N., et al. Utilizing the genomically adjusted radiation dose (GARD) to personalize adjuvant radiotherapy in triple negative breast cancer management. EBioMedicine, published online Aug. 12, 2019. https://doi.org/10.1016/j.ebiom.2019.08.019

Related Content

World's largest radiation oncology meeting will offer full conference on interactive platform October 25-28, 2020
News | ASTRO | July 09, 2020
July 9, 2020 — Registration opens today for the American Society for Radiation Oncology's (...
Simulation finds starting at age 30 with MRI and mammography to be the preferred strategy; starting at 25 prevented marginally more deaths, but with more testing and emotional stress

Getty Images

News | Breast Imaging | July 09, 2020
July 9, 2020 — Chest radiation is used to treat children with Hodgkin and non-Hodgkin lymphoma as well as lung metast
At the American Association of Physicists in Medicine (AAPM) 2019 meeting, new artificial intelligence (AI) software to assist with radiotherapy treatment planning systems was highlighted. The goal of the AI-based systems is to save staff time, while still allowing clinicians to do the final patient review. 
Feature | Treatment Planning | July 08, 2020 | By Melinda Taschetta-Millane
At the American Association of Physicists in Medicine (AAPM) 201
 Many patients with severe coronavirus disease 2019 (COVID-19) remain unresponsive after surviving critical illness. Investigators led by a team at Massachusetts General Hospital (MGH) now describe a patient with severe COVID-19 who, despite prolonged unresponsiveness and structural brain abnormalities, demonstrated functionally intact brain connections and weeks later he recovered the ability to follow commands

Getty Images

News | Coronavirus (COVID-19) | July 08, 2020
July 8, 2020 — Many patients with severe coronavirus disease 2019 (...
Hologic, Inc. announced he U.S. launch of the SuperSonic MACH 40 ultrasound system, expanding the company’s suite of ultrasound technologies with its first premium, cart-based system.
News | Breast Imaging | July 08, 2020
July 8, 2020 — Hologic, Inc. announced he U.S.
Changes outlined in new draft U.S. Preventive Services Task Force (USPSTF) lung cancer screening recommendations will greatly increase the number of Americans eligible for screening and help medical providers save thousands more lives each year.

Image courtesy of Cerner

News | Lung Imaging | July 08, 2020
July 8, 2020 — Changes outlined in new draft U.S.
Radiotherapy has been used to treat cancers for more than a century and continues to be utilized in cancer treatment plans today. Since the introduction of radiotherapy, clinicians have been working tirelessly to further refine treatments to better target cancer.
Feature | Radiation Therapy | July 06, 2020 | By Yves Archambault
Everything has room for improvement, right? Right. When it comes to cancer care, it is no different.
Proton therapy has evolved, and future predictions include smaller systems, more sophisticated proton dosimetry and devices that manipulate the proton beam
Feature | Proton Therapy | July 06, 2020 | By Minesh Mehta, M.D.
The field of proton...