Abstract: 100, 181, 185, 243, 298, 316
WASHINGTON – Research Highlights from The University of Texas MD Anderson Cancer Center showcases the latest breakthroughs in cancer treatment, research and prevention. These advances are made possible by seamless collaboration between MD Anderson’s world-leading clinicians and scientists, bringing discoveries from the lab to the clinic and back.
This special edition features advances in radiation treatment approaches presented by MD Anderson researchers at the 2024 American Society for Radiation Oncology (ASTRO) Annual Meeting. Information about all content from the MD Anderson ASTRO Annual Meeting can be found at MDAnderson.org/ASTRO.
Hypofractionation shows benefit on breast cancer toxicity in randomized phase III trial (Abstract 100)
Regional lymph node irradiation (RNI) is a radiotherapy treatment that targets the lymph nodes near the breast. Although RNI has improved breast cancer survival rates, it also increases the risk of lymphedema (swelling due to blockage of the lymphatic system) in the upper extremities. In the randomized Phase III SAPHIRe trial, researchers led by Karen Hoffman, MD, compared hypofractionated RNI, which delivers higher doses of radiation in fewer sessions, to conventional radiation plans in 324 patients with invasive breast cancer. compared. Although lymphedema was less common with hypofractionated plans compared with traditional plans, the difference was not statistically significant, as assessed by an infrared imaging technique called perometry. However, physician-rated lymphedema was significantly lower in the hypofractionated group compared with the conventional group, at 15% and 27%, respectively. Patients who received short-term hypofractionated radiation were also less likely to experience side effects (52% vs. 78%), suggesting that a hypofractionated approach may reduce side effects. Hoffman is scheduled to announce his findings on September 29th.
Adding combination therapy to radiation improves outcomes without reducing quality of life in patients undergoing prostatectomy (Abstract 181) Prostate-specific antigen (PSA) levels increase and will also receive salvage radiotherapy and 6 months of gonadotropin-releasing hormone (GnRH) agonist. Previously published data from the FORMULA-509 trial showed that the addition of abiraterone acetate plus prednisone (AAP) and apalutamide (Apa) improved outcomes compared to bicalutamide in patients with PSA > 0.5 ng/ml. has been proven. New data presented by Karen Hoffman, MD, describes health-related quality of life outcomes three years after treatment in 345 patients. Researchers used validated questionnaires to assess patient-reported hormonal function, cognitive function, and fatigue. This study found that the addition of AAP and Apa improved overall outcomes without compromising patient-reported survival eligibility, reinforcing the benefits of this combination approach. Hoffman is scheduled to announce his findings on September 30th.
Long-term data continue to support hypofractionation in localized prostate cancer (Abstract 185)
Patients with localized prostate cancer benefit from hypofractionated treatment, which delivers higher doses of radiation in fewer sessions, but the long-term effects of this approach are not well understood. In the final analysis of MD Anderson’s phase III randomized trial, Comron Hassanzadeh, MD, and colleagues examined long-term outcomes in 206 patients receiving hypofractionated or conventionally fractionated radiation therapy. The initial benefits of hypofractionation were maintained after 10 years, with no increase in late toxicity. The 10-year treatment failure rate in the hypofractionated group was almost half that of the conventionally fractionated group, at 11% and 21%, respectively. The difference in failure rates was more pronounced in patients who did not receive androgen deprivation therapy (ADT), at 13% and 26%, respectively. These findings suggest that hypofractionated radiation provides clinical benefit without additional long-term toxicity for patients with localized prostate cancer, especially those not receiving ADT. Hassanzadeh will present his findings in an oral presentation on September 30th.
Long-term outcomes in locally advanced lung cancer show no difference between passive scatter proton therapy and conventional photon radiation therapy (Abstract 243)
Data to date show that intensity-modulated photon therapy (IMRT) and passively scattered proton therapy (PSPT) achieve similar outcomes for patients with inoperable non-small cell lung cancer receiving concurrent chemotherapy. have been suggested, but the long-term differences remain unclear. A new 10-year follow-up study led by Dr. Tingshi Su and colleagues found that long-term outcomes were consistent with the original trial report, with no significant differences in local recurrence, overall survival, or distant metastases. – Free survival rate between the two treatment groups. Additionally, there were no statistically significant differences in toxicities such as radiation pneumonitis, high-grade esophageal adverse events, and cardiac adverse events. Although most outcomes were similar, there was a lower incidence of major cardiac adverse events in the proton therapy group, highlighting that proton therapy can achieve clinical outcomes similar to IMRT with a generally superior safety profile . Su is scheduled to announce the findings on September 30th.
HPV-specific immunotherapy combined with chemoradiotherapy shows promise in locally advanced cervical cancer (Abstract 298)
Human papillomavirus (HPV)-related cancers currently have no Food and Drug Administration (FDA)-approved immunotherapy. However, these cancers express unique HPV-associated proteins E6 and E7, representing viable therapeutic targets. In the Phase II IMMUNOCERV trial, Adam Gripin, MD, and colleagues studied a new HPV-specific vaccine, PDS0101, targeting E6/E7, in combination with standard-of-care chemoradiotherapy in 17 patients with locally advanced HPV. I did. and associated cervical cancer. Ten of the 17 patients (59%) had a complete radiographic response at 4 months follow-up, whereas 5 patients (29%) had a decrease in tumor volume at day 35. reduced by more than 90%. A grade 3 or higher adverse event occurred. There were 8 patients. All patients who received five doses of PDS0101 were asymptomatic at 36 months, supporting continued study of this vaccine. Gripin plans to announce his findings on October 1st.
Circulating HPV DNA serves as a predictive biomarker for treatment failure in oropharyngeal squamous cell carcinoma (Abstract 316) Patients undergoing radiotherapy for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). This highlights the critical need to identify biomarkers that predict treatment response. Masu. To evaluate potential biomarkers, Li Wang, M.D., and colleagues used 155 patients with HPV-related OPSCC enrolled in a randomized phase III study comparing conventional radiation therapy to proton therapy. A total of 1,352 plasma samples were analyzed. The researchers examined tumor-derived HPV DNA, known as tumor tissue-modifying virus (TTMV)-HPV DNA, as a circulating blood biomarker. Specifically, we evaluated whether the initial clearance and subsequent detection of this DNA, i.e., recovery positivity (RP) score, could predict treatment failure. In their analysis, RP scores were strongly correlated with treatment failure. Furthermore, the median time to reappearance of TTMV-HPV DNA was significantly shorter than the median time to identify treatment failure by imaging, suggesting that this biomarker may predict treatment response earlier. It suggests that there is. Wang is scheduled to announce the findings on October 1st.
honors and awards
Eileen Chen, MD, PhD (Associate Professor of Radiation Oncology), Lily Lin, MD, PhD (Professor of Radiation Oncology), and Quynh Nguyen, MD, PhD (Professor of Radiation Oncology) have been named 2024 ASTRO Fellows. The following researchers were selected by the ASTRO Annual Meeting Steering Committee based on their abstract peer review scores: Benjamin Schrank, MD, PhD, in “Microbially-inspired antibody-drug conjugates unleash macrophage function” Fundamentals of Biology/Translation Award 266) is research into first-in-class antibody-drug conjugates that stimulate cancer cells to produce an immune response, rather than directly targeting them. Dr. Schrank will present research results October 1st: Vincent Bernard Pagan, MD, PhD, will present his study, “Radiation-induced subclone dynamics in pancreatic ductal adenocarcinoma,” demonstrating selective pressure on tumor subclones after stereotactic body radiation. Abstract Award-winning “Characterization” (Abstract 212) Therapeutic Therapy (SBRT) enables the identification of molecular processes that may lead to the characterization of novel targets in pancreatic ductal carcinoma. Pagan plans to release its findings on September 30th.
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