| Radiation Medicine Program - Research Bites
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Your source for the latest in RMP research
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Welcome to our summer issue of Research Bites. Over the next few issues, we will highlight impactful clinical trials that are currently active and accruing within RMP. These studies draw on interdisciplinary collaborations across our program and beyond, testifying to the breadth and scope of our RMP Investigators and Clinical Research Program (CRP). In this issue, read about the Patient Reported Outcomes/Metrics Program Trial (PROMPT) led by Drs. Philip Wong and Aisling Barry (former staff radiation oncologist), and the Serial CXCL12α Immune Profiling and Expression during Radiotherapy (SCIPER) study led by Dr. Michael Milosevic and a radiation oncology resident, Dr. Badr Id Said.
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Philip Wong
MD
Radiation Oncologist, Princess Margaret
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Patient-Reported Outcomes/Metrics Program Trial (PROMPT)
The Patient Reported Outcomes/Metrics Program Trial (PROMPT) led by Radiation Oncologists Drs. Philip Wong and Aisling Barry aims to investigate augmented patient virtual monitoring in patients undergoing palliative radiotherapy (NCT04983199). Patients receiving palliative radiotherapy (RT) will wear a Hexoskin® Smart Shirt, an innovative Canadian technology that can obtain biometric data including heart and breathing rates, as well as monitor vital signs, sleep, and physical activity during and after treatment. Additionally, the remote patient monitoring system can potentially detect important side effects of RT in patients. “Radiotherapy, in a palliative context, represents a significant proportion of a Radiation Oncologist's practice,” says Dr. Wong. “Challenges exist in assessing patient response and side effects during and following RT. Objective biometric measures obtained from a Hexoskin® may complement patient-reported outcomes collected electronically to better evaluate the effects of palliative RT.”
Drs. Wong and Barry received a 2021 Princess Margaret Grand Challenges Award for Digital Intelligence for the PROMPT study. Dr. Wong believes that clinical studies such as PROMPT will improve outcomes for patients with cancer by leveraging innovative technologies to drive the delivery of personalized care. “The ultimate objective of palliative RT is to improve the quality of life of patients. By incorporating new technologies, we hope that they will assist clinicians with prognostication, patient selection, and evaluation of treatment response in an evolving personalized health care model.”
Read the full interview. |
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Badr Id Said
MD
Radiation Oncology Resident, Princess Margaret
Michael Milosevic
MD
Radiation Oncologist, Princess Margaret
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Serial CXCL12α Immune Profiling and Expression during Radiotherapy (SCIPER) Study
“Radiation therapy is an effective and important mainstay in the curative treatment of many cancers... Unfortunately, despite continued advances in RT planning and delivery, overall cure rates remain suboptimal. It is therefore critical to develop strategies that will improve the effectiveness of RT,” says Resident Dr. Badr Id Said, who is leading the Serial CXCL12α Immune Profiling and Expression during Radiotherapy (SCIPER) study together with Dr. Michael Milosevic (REB # 20-6002). The SCIPER study aims to investigate the effects of the immune protein CXCL12α on RT response, as some patients receiving RT may experience an increase in circulating blood plasma CXCL12α, which could in turn reduce the effectiveness of RT. The study involves several site groups across RMP, including the head/neck, lung, sarcoma, lower gastrointestinal, and genitourinary groups, who are all dedicated to discovering new RT strategies that will improve outcomes for patients.
Dr. Milosevic’s research lab has discovered that an inhibitor drug targeting the CXCL12/CXR4 protein pathway improved RT effectiveness in mice. The SCIPER study seeks to improve our understanding of CXCL12α’s effects on RT in human cancers, as well as identifying patients that could benefit from combinatorial RT treatment strategies using inhibitors of the protein’s pathway. Dr. Id Said looks forward to the insights that will be gleaned from this study, and how it will guide future research. “…The information we learn from this study will pave the way for future phase II/III randomized trials of RT and CXCL12/CXCR4 inhibitors as a way to enhance the primary RT response, while also reducing treatment-related complications in a wide range of potentially curable cancers that affect thousands of Canadians annually.”
Read the full interview. |
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Huang et al. compare clinical presentation and outcomes of HPV-positive nasopharyngeal cancer (NPC) vs. Epstein-Barr virus-positive NPC and HPV-positive oropharyngeal cancer.
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Stanescu et al. describe the clinical implementation of an MRI-guided radiation therapy workflow used to treat patients with upper GI cancers on the MR-Linac at the Princess Margaret.
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- Berlin A, Brierley J, Cornford P, Chung P, Giannopoulos E, Mason M, Mottet N, Gospodarowicz M. TNM staging of prostate cancer: challenges in securing a globally applicable classification. Eur Urol. 2022 Aug;82(2):e52-e53.
- Damyanovich AZ, Tadic T, Foltz WD, Jelveh S, Bissonnette JP. Time-course assessment of 3D-image distortion on the 1.5 T Marlin/Elekta Unity MR-LINAC. Phys Med. 2022 Jun 28;100:90-98.
- Gutierrez-Valencia E, Kalyvas A, Villafuerte CJ, Millar BA, Laperriere N, Conrad T, Berlin A, Weiss J, Zadeh G, Bernstein M, Kongkham P, Shultz DB. Factors correlating with survival following adjuvant or definitive radiosurgery for large brain metastases. Neuro Oncol. 2022 Apr 26:noac106.
- Hosni A, Kim J, Dawson L, Ringash J. Short and simple palliative radiation therapy. Int J Radiat Oncol Biol Phys. 2022 Mar 1;112(3):583-584.
- Id Said B, Ailles L, Karamboulas C, Meens J, Huang SH, Xu W, Keshavarzi S, Bratman SV, Cho BCJ, Giuliani M, Hahn E, Kim J, O'Sullivan B, Ringash J, Waldron J, Spreafico A, de Almeida JR, Chepeha DB, Irish JC, Goldstein DP, Hope A, Hosni A. Development and validation of an oral cavity cancer outcomes prediction score incorporating patient-derived xenograft engraftment. JAMA Otolaryngol Head Neck Surg. 2022 Apr 1;148(4):342-349.
- Javor J, Cashell A, Rosewall T, Feuz C, Taylor E, Barry A. Eliminating tattoos for short course palliative radiation therapy: set-up error, satisfaction and cost. J Med Imaging Radiat Sci. 2022 Jun;53(2 Suppl):S56-S62.
- Kamran H, Aleman DM, McIntosh C, Purdie TG. SuPART: Supervised Projective Adapted Resonance Theory for automatic quality assurance approval of radiotherapy treatment plans. Phys Med Biol. 2022 Mar 9;67(6).
- Kong VC, Dang J, Li W, Navarro I, Padayachee J, Malkov V, Winter J, Raman S, Berlin A, Catton C, Warde P, Chung P. Dosimetric comparison of MR-guided adaptive IMRT versus 3DOF-VMAT for prostate stereotactic radiotherapy. Tech Innov Patient Support Radiat Oncol. 2022 Mar 2;21:64-70.
- Li W, Hill C, Cashell A, Hindle D, Feuz C, Rosewall T. Could knowledge of patient demographics facilitate a personalized approach to radiation therapy patient education? J Med Imaging Radiat Sci. 2022 Mar;53(1):41-50.
- Lukovic J, Kim JJ, Liu ZA, Cummings BJ, Brierley JD, Wong RKS, Ringash JG, Dawson LA, Barry A, Krzyzanowska MK, Chen EX, Hedley DW, Quereshy FA, Swallow CJ, Gryfe RN, Kennedy ED, Easson AM, Hosni A. Anal adenocarcinoma: a rare entity in need of multidisciplinary management. Dis Colon Rectum. 2022 Feb 1;65(2):189-197.
- Taylor E, Hill RP, Létourneau D. Modeling the impact of spatial oxygen heterogeneity on radiolytic oxygen depletion during FLASH radiotherapy. Phys Med Biol. 2022 Jun 2;67(11).
- Tosoni S, Voruganti I, Lajkosz K, Mustafa S, Phillips A, Kim SJ, Wong RKS, Willison D, Virtanen C, Heesters A, Liu FF. Patient consent preferences on sharing personal health information during the COVID-19 pandemic: "The more informed we are, the more likely we are to help". BMC Med Ethics. 2022 May 20;23(1):53.
- Zabel WJ, Allam N, Foltz WD, Flueraru C, Taylor E, Vitkin IA. Bridging the macro to micro resolution gap with angiographic optical coherence tomography and dynamic contrast enhanced MRI. Sci Rep. 2022 Feb 24;12(1):3159.
* Select publications with RMP first and/or last author. See the full list.
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Awards and Distinctions
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| Jean-Pierre Bissonnette: Fellow of AAPM, American Association of Physicists in Medicine. |
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| Ali Hosni: OARO Clinician Scientist Award, Ontario Association of Radiation Oncologists.
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| Richard Tsang: Fellow of ASTRO, American Society for Radiation Oncology.
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Grants
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- Androgen Suppression Combined with Elective Nodal and a Dose Escalated boost. A non-inferiority, phase 3 randomized controlled trial of Stereotactic Body Radiation Therapy versus brachytherapy boost (ASCENDE-SBRT). Canadian Institutes of Health Research (CIHR). PI: Loblaw A. Co-I(s): Brundage M, Hotte S, Niazi M, Ding K, Kwan W, Parulekar W, Glicksman R, Lee J, Reaume M, Helou J, Morton G. $4,475,254.
- Automated AI‐based imaging pipeline for quantifying MRI data in RT. Princess Margaret Cancer Centre. PI: Stanescu T. Co-I(s): Brade A, Conrad T, King J, Leung E. $50,000.
- Building an online education and skills development program for informal caregivers of cancer patients: Caregiver Accessible Cross-Continuum Education & Skills System for cancer (Caregiver ACCESS). MSH-UHN AMO Innovation Fund, University of Toronto. PI(s): Giuliani M, Papadakos J. $141,348.60.
- Canadian Cancer Trials Group. Major Program Grant, Canadian Cancer Society Research Institute. PI: Dancey J. Co-I: Sun A. $6,890,285.21.
- Clinical deployment of an end-to-end Artificial Intelligence (AI)-only radiotherapy treatment planning and decision support workflow. Project Grant, CIHR. PI(s): Purdie T, Berlin A, McIntosh C. Co-PI(s): Chan T, Conroy L, Han K, Hosni Abdalaty A, McNiven A, Winter J. $711,450.
- Disparities in clinical trial participation for patients with hematologic malignancies. Equity in Access Research Program, Leukemia and Lymphoma Society. PI(s): Rosenthal M, Rodin D. Co-I: Conti R. $651,433.
- Next generation precision oncology for pediatric-type AYA gliomas. Project Grant, CIHR. PI: Hawkins C. Co-I(s): Das S, Lim-Fat MJ, Tabori U, Tsang D. $1,755,000.
- Redox homeostasis in pancreatic cancer - molecular mechanisms and combined modalities. Project Grant, CIHR. PI: Koritzinsky M. Co-I(s): Harding S, McGaha T. $860,625.
- Sarcoma Micro-Dissected Tumor (MDT) generation. PANOV2, Mount Sinai Foundation. PI: Wong P. Co-I: Tsoi K. $70,000.
- Stepped care to enhance quality of life in advanced cancer: an interprofessional approach to alleviating cancer-related cognitive impairment for adults with brain metastases. CIHR. PI(s): Mayo S, Bernstein LJ, Edelstein K. Co-I(s): Julius A, Kongkham P, Liu Z, Moody L, Nissim R, Schagen S, Shultz D, Zadeh G. $325,124.
- Towards a low-cost, optimized proton therapy accelerator. Project Grant, CIHR. PI(s): Seuntjens J. Co-PI(s): Parodi K, Hodgson D, Pechlivanoglou P. $1,367,820.
- Understanding and improving the breast cancer experience for Black women. CIHR Project Grant - Priority Announcement: Equity in Cancer Prevention and Control, CIHR. PI: Covelli A. Co-I(s): Cil T, Daniel J, Gagliardi A, Lofters A, Naganathan G, Rodin D, Wright F. $100,000.
- Unlocking our data: creation of a robust dataset for the real-world clinical and economic evaluation of lymphoma management. Data Transformation Grants, Canadian Cancer Society. PI(s): Rodin D, Prica A. Co-I(s): Hodgson D, Kuruvilla J, Crump M, Tsang R, WWL Wong, Chan K. $124,473.
* Select grants with RMP PI/co-PI/co-I |
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Grant Resources
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