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Updated: Nov 26, 2025
Author Spotlight: Radiotherapy and Clonogenic Assays for Advancing Cancer Research and Personalized Medicine
Published on: April 5, 2024
Personalizing Radiotherapy Prescription Dose Using Genomic Markers of Radiosensitivity and Normal Tissue Toxicity in
Jacob G Scott1, Geoff Sedor2, Jessica A Scarborough1
1Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio; Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio.
Radiation therapy (RT) dosing is often one-size-fits-all, leading to suboptimal outcomes. Personalized RT using genomic data can improve tumor control and reduce toxicity for cancer patients.
Area of Science:
- Oncology
- Genomics
- Radiation Biology
Background:
- Cancer is a complex, heterogeneous disease.
- Current radiation therapy (RT) dosing is empirical and not personalized.
- This leads to over- and under-dosing, impacting treatment efficacy and toxicity.
Purpose of the Study:
- To address the limitations of uniform RT dosing.
- To introduce a personalized approach using genomic data.
- To improve tumor control and minimize normal tissue complications.
Main Methods:
- Developed the genomic-adjusted radiation dose (GARD) method.
- Created a patient-specific competing hazards mathematical model.
- Incorporated tumor control probability and normal tissue complication probability equations.
Main Results:
- Validated the competing hazards model using NSCLC patient data.
- Explained the failure of RTOG 0617 trial results.
- Demonstrated that 80% of patients experienced toxicity without tumor control benefit due to uniform dosing.
Conclusions:
- Cancer exhibits significant radiosensitivity heterogeneity.
- Empirical RT dose escalation fails due to biological imprecision.
- Incorporating genomics into RT can improve clinical outcomes in lung cancer.
