Modeling precision genomic-based radiation dose response in rectal cancer
Zhigang Yuan1, Marissa Frazer1, Kamran A Ahmed1
1Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Future Oncology (London, England)
|July 21, 2020
Summary
This study introduces a genomic approach to personalize rectal cancer radiation therapy. It suggests that tailoring radiation doses based on tumor radiosensitivity index (RSI) could improve treatment outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Genomics
Background:
- Personalized medicine is crucial for optimizing cancer treatment.
- Rectal cancer management requires precise radiation dosing.
- Genomic markers can predict treatment response.
Purpose of the Study:
- To develop a genomic-based strategy for personalizing radiation dose in rectal cancer.
- To evaluate the utility of the radiosensitivity index (RSI) and genomic-adjusted radiation dose (GARD) for dose stratification.
- To model potential improvements in pathologic complete response (pCR) rates.
Main Methods:
- Modeled genomic-based radiation dose response using the radiosensitivity index (RSI).
- Utilized the clinically actionable genomic-adjusted radiation dose (GARD) framework.
- Analyzed RSI distribution and its correlation with treatment outcomes.
Main Results:
- Rectal cancer RSI exhibited a bimodal distribution (0.19-0.81).
- A pathologic complete response (pCR) rate of 21% was observed in tumors with RSI <0.31 at a genomic-adjusted radiation dose of 29.76 Gy.
- Dose escalation to 55 Gy for tumors with RSI 0.31-0.34 could potentially increase pCR by 10%.
Conclusions:
- The study provides a theoretical framework for an RxRSI-based prospective trial in rectal cancer.
- Genomic-based risk stratification shows promise for personalized radiation therapy.
- Further clinical validation is warranted to confirm these findings.
Keywords:
chemoradiation therapygenomic-adjusted radiation dosepathologic responseradiosensitivityrectal cancer
