Predictive Biomarkers for Improving Radiation Therapy
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1 Predictive Biomarkers for Improving Radiation Therapy Pataje G. Prasanna, PH.D. Program Director Radiation Research Program National Cancer Institute Bethesda, MD, USA No financial conflict of interest Views expressed in this presentation are those of the authors; no endorsement by NCI, NIH or any other US Government Agency agencies has been given, implied, or inferred
2 Advise clinical trial work groups, SBIR Development Center, and Cancer Therapy Evaluation Program (CTEP) regarding scientific priorities and quality assurance in studies involving RT Advise potential applicants and grantees and direct research in radiation therapy Serve as NCI s liaison and advisor for radiation injury to normal tissue and development of radiation biomarkers to other institute centers and agencies Advise extramural investigators interested in the use of radiation biomarkers
3 Estimated Number of New Cancer Cases and Deaths, US 2015* Sites Estimated New Cases All sites 1,658,370 Oral Cavity and Pharynx 45,780 Estimated Deaths 589,430 8,650 Digestive System 291, ,300 Respiratory System 240, ,460 Brain and Nervous System 22,850 Breast 234,190 Prostate 220,800 15,320 40,730 27,540 Lymphoma 80,900 20,940 *American Cancer Society Data
4 Dose Delivery and Distribution Radiation- Effect Modulators Improved Efficacy of Radiotherapy and Quality of Life Biomarkers
5 Clinical Needs for Biomarkers Predict individual radiosensitivity Predict normal tissue tolerance/toxicity Assess/monitor tumor response
6 Important Adverse Effects after Conventional Radiotherapy of the Respiratory System : An Example Cancer Type Treatment Mortality Adverse Intermediate (Yr) Effects Larynx (Locally advanced) Lung, Non small cell (Locally advanced) Lung, Non Small Cell (Locally advanced) Lung, Small cell (Limited disease) Cisplatin 24% (2) Continuous hyperfractionated accelerated radiotherapy Chemo before radiation Chemotherapy Fibrosis 74% (5) Persistent dysphagia (7-15%) 71% (2) Gr 68% 3-5 (2) Late toxicity Prasanna et al. 2012
7 Hypersensitive Non responder Patient Selection is Critical to Improve Outcome
8 Radiation-Induced Brain Damage: Need for Predictive Biomarkers International Journal of Radiation Biology biomarkers of radiation-induced brain damage can be explored. Conclusions : Predictive biomarkers of radiation-induced brain injury may enable stratifying patients for customization of treat- ISSN: (Print) (Online) Journal homepage: ment and thus aid in improving the QOL and possibly prolonging survival. Here we discuss the challenges involved in leveraging recent Radiation-induced advances in radiation-specific brain damage, impact biomarker of research and translating Michael Robbins them to radiotherapy, work and the which need for for the predictive foreseeable future is likely biomarkers to remain a cornerstone of the treatment of brain tumors. Keywords: Pataje G. S. Prasanna, Radiotherapy Mansoor, M. radiation-induced Ahmed, Helen B. Stone, brain Bhadrasain damage, Vikram, Minesh P. Mehta & C. Norman Coleman mechanisms, radiation mitigator, predictive biomarkers To cite this article: Pataje G. S. Prasanna, Mansoor M. Ahmed, Helen B. Stone, Bhadrasain Vikram, Minesh P. Mehta & C. Norman Coleman (2014) Radiation-induced brain damage, impact of Michael Robbins work and the need for predictive biomarkers, International Journal of Radiation Biology, 90:9, Introduction To link to this article:
9 Acceleration of Clinical Translation: Radiation-Effect Modulators Model Prasanna et al., Radiat. Res. 2015
10 Summary Predicting individual radiation sensitivity, adverse effects of radiation therapy, and monitoring tumor response all will help improve treatment outcome. Current focus on radiation biomarkers is primarily on assessment of radiation doses after catastrophic accidental radiation exposures has advanced many technologies and platforms This recent progress may have cross utility to improve radiation therapy outcome among cancer patients and their quality of life. Discovery, development and validation of predictive biomarkers while provides an opportunity to improve radiation therapy outcome, it also presents several challenges
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