2020 ROI Publication Award Winner
The ROI is honoring Robert T. Dess, MD, assistant professor at the University of Michigan, with this year’s Publication Award as the lead author of the article, “Association of Presalvage Radiotherapy PSA Levels After Prostatectomy with Outcomes of Long-term Antiandrogen Therapy in Men with Prostate Cancer.” The manuscript was published in JAMA Oncology in March 2020 following initial presentation of the results during the Plenary Session at the 2019 ASTRO Annual Meeting.
Dr. Dess led the large study team that conducted a secondary analysis of the Radiation Therapy Oncology Group (RTOG) 9601 randomized clinical trial, and the results of the analysis show for the first time that prostate-specific antigen (PSA) level can be used as a predictive biomarker to personalize treatment and optimize outcomes for men with recurrent prostate cancer. The original RTOG 9601 study showed that adding antiandrogen therapy to radiation therapy improved the overall survival rate among men whose prostate cancer recurred after surgery to remove the prostate, becoming a recommended standard of care. “Given that practice has changed to begin delivering salvage radiation therapy at much lower PSA levels than when the RTOG 9601 study began in 1998, we wanted to investigate what impact PSA level prior to radiation and long-term antiandrogen therapy would have on overall survival and other outcomes,” says Dr. Dess.
The research team initially split the data from the RTOG study into two groups based on the pre-salvage radiation therapy PSA level stratification variable. For patients with a PSA level higher than 1.5 ng/mL, there was an overall survival benefit associated with the long-term antiandrogen therapy. However, patients with a PSA level of 1.5 ng/mL or lower showed no significant improvement in overall survival with antiandrogen therapy compared to placebo. In subsequent post hoc analyses, patients with a PSA level of 0.6 ng/mL or lower who received long-term antiandrogen therapy were more likely to experience cardiac and neurological side effects as well as an increase in other causes of death.
The ROI selected Dr. Dess as the recipient of the 2020 Publication Award because when to use hormone therapy with salvage radiation in prostate cancer is an important clinical question and the results of the study are potentially practice changing. If the findings in this secondary analysis are confirmed through randomized clinical trials, it could have a significant impact on the treatment of and outcomes for patients who require salvage radiation therapy. Groups such as the National Comprehensive Cancer Network (NCCN) and NRG Oncology are already taking the results of the analysis into account.
Dr. Dess will use the $5,000 grant that accompanies the ROI Publication Award to continue developing improved prognostic and predictive biomarkers and models in localized and recurrent prostate cancer. He will also be recognized in-person at the 2021 ASTRO Annual Meeting.
Many excellent nominations were received for the 2020 Publication Award, and the ROI selected two early career researchers to recognize with Honorable Mentions:
- Rachel B. Jimenez, MD, of the Massachusetts General Hospital and lead author of, “Phase II Study of Proton Beam Radiation Therapy for Patients with Breast Cancer Requiring Regional Nodal Irradiation,” which was published in the Journal of Clinical Oncology. In this prospective trial, Dr. Jimenez and her team provided evidence of the safety and efficacy of proton therapy for breast cancer as well as a favorable side effect profile, potentially improving long-term outcomes for patients. The study also provided data to support the ongoing phase III trials of proton therapy for patients with breast cancer.
- Jacob Miller, MD, of Stanford University School of Medicine and lead author of, “Cost-Effectiveness and Quality-Adjusted Survival of Watch and Wait After Complete Response to Chemoradiotherapy for Rectal Cancer,” which was published in the Journal of the National Cancer Institute. Dr. Miller and his team developed a decision-analytic model to compare quality-adjusted survival and costs for three treatment approaches for locally-advanced rectal cancer. They demonstrated that a watch-and-wait strategy following clinical complete response to neoadjuvant chemoradiotherapy offers comparable cancer-specific survival, superior quality-adjusted survival, and decreased costs relative to surgery.
Through the Publication Award, the ROI highlights outstanding research in the ROI’s priority research areas being led by early career investigators. The ROI is pleased to see so many engaged in research on communication, safety and quality, toxicity management, comparative effectiveness and the value of radiation therapy. Join the ROI in celebrating Dr. Dess, Dr. Jimenez, and Dr. Miller for their important contributions to advancing radiation oncology and improving outcomes for patients with cancer!