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  1. Article ; Online: Towards Data Driven RT Prescription: Integrating Genomics into RT Clinical Practice.

    Torres-Roca, Javier F / Grass, G Daniel / Scott, Jacob G / Eschrich, Steven A

    Seminars in radiation oncology

    2023  Volume 33, Issue 3, Page(s) 221–231

    Abstract: The genomic era has significantly changed the practice of clinical oncology. The use of genomic-based molecular diagnostics including prognostic genomic signatures and new-generation sequencing has become routine for clinical decisions regarding ... ...

    Abstract The genomic era has significantly changed the practice of clinical oncology. The use of genomic-based molecular diagnostics including prognostic genomic signatures and new-generation sequencing has become routine for clinical decisions regarding cytotoxic chemotherapy, targeted agents and immunotherapy. In contrast, clinical decisions regarding radiation therapy (RT) remain uninformed about the genomic heterogeneity of tumors. In this review, we discuss the clinical opportunity to utilize genomics to optimize RT dose. Although from the technical perspective, RT has been moving towards a data-driven approach, RT prescription dose is still based on a one-size-fits all approach, with most RT dose based on cancer diagnosis and stage. This approach is in direct conflict with the realization that tumors are biologically heterogeneous, and that cancer is not a single disease. Here, we discuss how genomics can be integrated into RT prescription dose, the clinical potential for this approach and how genomic-optimization of RT dose could lead to new understanding of the clinical benefit of RT.
    MeSH term(s) Humans ; Neoplasms/genetics ; Neoplasms/radiotherapy ; Neoplasms/pathology ; Medical Oncology ; Antineoplastic Agents ; Prognosis ; Genomics
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2023-06-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1146999-7
    ISSN 1532-9461 ; 1053-4296
    ISSN (online) 1532-9461
    ISSN 1053-4296
    DOI 10.1016/j.semradonc.2023.03.007
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    Zs.A 3654: Show issues Location:
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  2. Article ; Online: Letter Response.

    Sedor, Geoffrey / Scott, Jacob G / Kattan, Michael W / Torres-Roca, Javier F

    Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

    2021  Volume 16, Issue 5, Page(s) e28–e29

    MeSH term(s) Genomics ; Humans ; Lung Neoplasms ; Prescriptions ; Radiation Tolerance
    Language English
    Publishing date 2021-03-31
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2432037-7
    ISSN 1556-1380 ; 1556-0864
    ISSN (online) 1556-1380
    ISSN 1556-0864
    DOI 10.1016/j.jtho.2021.02.027
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  3. Article ; Online: Response to: Noncancer Cells in Tumor Samples May Bias the Predictive Genomically Adjusted Radiation Dose.

    Grass, G Daniel / Scott, Jacob G / Sedor, Geoffrey / Kattan, Michael W / Torres-Roca, Javier F

    Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

    2021  Volume 16, Issue 6, Page(s) e48–e49

    MeSH term(s) Dose-Response Relationship, Radiation ; Humans ; Lung Neoplasms
    Language English
    Publishing date 2021-05-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2432037-7
    ISSN 1556-1380 ; 1556-0864
    ISSN (online) 1556-1380
    ISSN 1556-0864
    DOI 10.1016/j.jtho.2021.03.020
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  4. Article ; Online: Radiotherapy with genomic-adjusted radiation dose - Authors' reply.

    Scott, Jacob G / Sedor, Geoffrey / Scarborough, Jessica A / Kattan, Michael W / Torres-Roca, Javier F

    The Lancet. Oncology

    2021  Volume 22, Issue 11, Page(s) e470–e471

    MeSH term(s) Dose Fractionation, Radiation ; Genomics ; Humans ; Radiation Dosage ; Radiation Oncology
    Language English
    Publishing date 2021-10-08
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(21)00601-X
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  5. Article ; Online: Changing Radiotherapy Paradigms in Penile Cancer.

    Johnstone, Peter A S / Spiess, Philippe E / Sedor, Geoff / Grass, G Daniel / Yamoah, Kosj / Scott, Jacob G / Torres-Roca, Javier F

    European urology open science

    2022  Volume 36, Page(s) 47–48

    Abstract: Radiation therapy (RT) has not been prominent in the treatment of penile cancer because of poorly reproducible results when used in the adjuvant setting. A genomic signature has recently been described that assays radiosensitivity of tumors and informs ... ...

    Abstract Radiation therapy (RT) has not been prominent in the treatment of penile cancer because of poorly reproducible results when used in the adjuvant setting. A genomic signature has recently been described that assays radiosensitivity of tumors and informs radiotherapy doses in these cases. Clinical validation in more than 1600 patients demonstrated associations with both overall survival and time to first recurrence. In addition, the signature predicted and quantified the therapeutic benefit of RT for each individual patient. Since penile cancer patients were not part of this analysis, we applied the model to patients with primary and nodal penile cancer tissue and clinical outcomes.
    Language English
    Publishing date 2022-01-04
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-1683
    ISSN (online) 2666-1683
    DOI 10.1016/j.euros.2021.12.005
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  6. Article: A molecular assay of tumor radiosensitivity: a roadmap towards biology-based personalized radiation therapy.

    Torres-Roca, Javier F

    Personalized medicine

    2012  Volume 9, Issue 5, Page(s) 547–557

    Abstract: The last two decades have seen technological developments that have led to more accurate delivery of radiation therapy (RT), which has resulted in clinical gains in many solid tumors. However, a fundamental question and perhaps the next major hurdle is ... ...

    Abstract The last two decades have seen technological developments that have led to more accurate delivery of radiation therapy (RT), which has resulted in clinical gains in many solid tumors. However, a fundamental question and perhaps the next major hurdle is whether biological strategies can be developed to further enhance the effectiveness and efficiency of RT. This article addresses the development of a novel genomics-based molecular assay to predict tumor radiosensitivity, and proposes that this assay may prove pivotal in the development of biologically guided RT.
    Language English
    Publishing date 2012-08-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2299146-3
    ISSN 1744-828X ; 1741-0541
    ISSN (online) 1744-828X
    ISSN 1741-0541
    DOI 10.2217/pme.12.55
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  7. Article ; Online: Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease.

    Ahmed, Kamran A / Torres-Roca, Javier F

    Cancer control : journal of the Moffitt Cancer Center

    2016  Volume 23, Issue 1, Page(s) 21–29

    Abstract: Background: The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is ...

    Abstract Background: The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is now a primary management option for patients with oligometastatic disease.
    Methods: The properties of SBRT are summarized and the results of retrospective and prospective studies of SBRT use in the management of oligometastases are reviewed. Future directions of SBRT, including optimizing dose and fractionation schedules, are also discussed.
    Results: SBRT can deliver highly conformal, dosed radiation treatments for ablative tumors in a few treatment sessions. Phase 1/2 trials and retrospective institutional results support use of SBRT as a treatment option for oligometastatic disease metastasized to the lung, liver, and spine, and SBRT offers adequate toxicity profiles with good rates of local control. Future directions will involve optimizing dose and fractionation schedules for select histologies to improve rates of local control while limiting toxicity to normal structures.
    Conclusions: SBRT offers an excellent management option for patients with oligometastases. However, additional research is still needed to optimize dose and fractionation schedules.
    MeSH term(s) Disease Management ; Dose Fractionation ; Humans ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Prospective Studies ; Radiation Tolerance ; Radiosurgery ; Retrospective Studies ; Spinal Neoplasms/secondary ; Spinal Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2016-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1328503-8
    ISSN 1526-2359 ; 1073-2748
    ISSN (online) 1526-2359
    ISSN 1073-2748
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    Zs.A 4467: Show issues Location:
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  8. Article ; Online: Using the genomic adjusted radiation dose (GARD) to personalize the radiation dose in nasopharyngeal cancer.

    Leung Chiang, Chi / Sik Kwan Chan, Kenneth / Li, Huaping / Tong Ng, Wai / Chung Hang Chow, James / Cheuk Wai Choi, Horace / On Lam, Ka / Ho Fun Lee, Victor / Kai Cheong Ngan, Roger / Wing Mui Lee, Anne / Eschrich, Steven A / Torres-Roca, Javier F / Wing Hon Wong, Jason

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2024  , Page(s) 110287

    Abstract: Background: Locally advanced nasopharyngeal cancer (NPC) patients undergoing radiotherapy are at risk of treatment failure, particularly locoregional recurrence. To optimize the individual radiation dose, we hypothesize that the genomic adjusted ... ...

    Abstract Background: Locally advanced nasopharyngeal cancer (NPC) patients undergoing radiotherapy are at risk of treatment failure, particularly locoregional recurrence. To optimize the individual radiation dose, we hypothesize that the genomic adjusted radiation dose (GARD) can be used to correlate with locoregional control.
    Methods: A total of 92 patients with American Joint Committee on Cancer / International Union Against Cancer stage III to stage IVB recruited in a randomized phase III trial were assessed (NPC-0501) (NCT00379262). Patients were treated with concurrent chemo-radiotherapy plus (neo) adjuvant chemotherapy. The primary endpoint is locoregional failure free rate (LRFFR).
    Results: Despite the homogenous physical radiation dose prescribed (Median: 70 Gy, range 66-76 Gy), there was a wide range of GARD values (median: 50.7, range 31.1-67.8) in this cohort. In multivariable analysis, a GARD threshold (GARD
    Conclusion: GARD is independently associated with locoregional control in radiotherapy-treated NPC patients from a Phase 3 clinical trial. GARD may be a potential framework to personalize radiotherapy dose for NPC patients.
    Language English
    Publishing date 2024-04-16
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2024.110287
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  9. Article: Trimodal Therapy Using an MR-guided Radiation Therapy Partial Bladder Tumor Boost in Muscle Invasive Bladder Cancer.

    Liveringhouse, Casey / Netzley, Alexander / Bryant, John M / Linkowski, Lauren C / Weygand, Joseph / Sandoval, Maria L / Dohm, Ammoren / Dookhoo, Marsha / Kelley, Stacey / Rosenberg, Stephen A / Latifi, Kujtim / Torres-Roca, Javier F / Johnstone, Peter A S / Yamoah, Kosj / Grass, G Daniel

    Advances in radiation oncology

    2023  Volume 8, Issue 6, Page(s) 101268

    Abstract: Purpose: Bladder preservation with trimodal therapy (TMT; maximal tumor resection followed by chemoradiation) is an effective paradigm for select patients with muscle invasive bladder cancer. We report our institutional experience of a TMT protocol ... ...

    Abstract Purpose: Bladder preservation with trimodal therapy (TMT; maximal tumor resection followed by chemoradiation) is an effective paradigm for select patients with muscle invasive bladder cancer. We report our institutional experience of a TMT protocol using nonadaptive magnetic resonance imaging-guided radiation therapy (MRgRT) for partial bladder boost (PBB).
    Methods and materials: A retrospective analysis was performed on consecutive patients with nonmetastatic muscle invasive bladder cancer who were treated with TMT using MRgRT between 2019 and 2022. Patients underwent intensity modulated RT-based nonadaptive MRgRT PBB contoured on True fast imaging with steady state precession (FISP) images (full bladder) followed sequentially by computed tomography-based RT to the whole empty bladder and pelvic lymph nodes with concurrent chemotherapy. MRgRT treatment time, table shifts, and dosimetric parameters of target coverage and normal tissue exposure were described. Prospectively assessed acute and late genitourinary and gastrointestinal (GI) toxicity were reported. Two-year local control was assessed with Kaplan-Meier methods.
    Results: Seventeen patients were identified for analysis. PBB planning target volume margins were ≤8 mm in 94% (n = 16) of cases. Dosimetric target coverage parameters were favorable and all normal tissue dose constraints were met. For MRgRT PBB fractions, median table shifts were 0.4 cm (range, 0-3.15), 0.45 cm (0-2.65), and 0.75 cm (0-4.8) in the X, Y, and Z planes, respectively. Median treatment time for MRgRT PBB fractions was 9 minutes (range, 6.9-17.4). We identified 32 out of 100 total MRgRT fractions that may have benefitted from online adaptation based on changes in organ position relative to planning target volume, predominantly because of small bowel (13/32, 41%) or rectum (8/32, 25%). Two patients discontinued RT prematurely. The incidence of highest-grade acute genitourinary toxicity was 1 to 2 (69%) and 3 (6%), whereas the incidence of acute GI toxicity was 1 to 2 (81%) and 3 (6%). There were no late grade 3 events; 17.6% had late grade 2 cystitis and none had late GI toxicity. With median follow-up of 18.2 months (95% CI, 12.4-22.5), the local control rate was 92%, and no patient has required salvage cystectomy.
    Conclusions: Nonadaptive MRgRT PBB is feasible with favorable dosimetry and low resource utilization. Larger studies are needed to evaluate for potential benefits in toxicity and local control associated with this approach in comparison to standard treatment techniques.
    Language English
    Publishing date 2023-05-18
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2023.101268
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  10. Article ; Online: Genomic-adjusted radiation dose - Authors' reply.

    Scott, Jacob G / Harrison, Louis B / Torres-Roca, Javier F

    The Lancet. Oncology

    2017  Volume 18, Issue 3, Page(s) e129

    MeSH term(s) Genomics ; Radiation Dosage
    Language English
    Publishing date 2017-03-02
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(17)30119-5
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