Precision (Personalized) Radiation for Cancer Treatment
In oncology, precision medicine is well along on its path towards becoming clinical reality. Our goal is to understand how to further personalize radiation therapy so that treatment can be based on individual characteristics of patients to maximize benefits and minimize side effects.
What are clinical and biological markers?
Traditional Clinical-Pathologic Features
- Patient age, performance status, co-morbidities
- Tumor stage, histology, anatomical site
- Validated ImmunoHistoChemistry (IHC), blood markers
Tumor Imaging Features
- Tumor size, invasion, distribution
- PET avidity before/during/after radiation
- Radiomics feature
Tumor Imaging Features
- Mutation status (oncogenes, DNA repair, TMB)
- Copy number alterations, gene expression
- Pathway alteration
Tumor Functional Profile
- Proteomics, metabolomics
- Ex vivo assays (immune response, DNA repair)
- Patient-derived models
How are biological markers used to individualize Radiation Therapy?
Biomarkers can be used to determine who receives radiation and who can avoid it. If radiation is required, it can be individualized to the appropriate radiation target and field size. Similarly, the radiation dose and fraction can also be assigned. Biomarkers can also help establish the optimal sequence of therapies, if radiation therapy needs to be combined with other agents.
Sequencing Pipeline
Through our extensive collaborations with various groups both within and outside of MGH, we have created a pipeline to allow us to deeply sequence tumors from radiation patients for biomarker discovery and validation.
