The Radiation Oncology Institute is delighted to honor Julian Hong, MD, MS, an assistant professor at the University of California San Francisco (UCSF), as the winner of this year’s ROI Publication Award. Dr. Hong is the lead author of the manuscript “System for High-Intensity Evaluation During Radiation Therapy (SHIELD-RT): A Prospective Randomized Study of Machine Learning–Directed Clinical Evaluations During Radiation and Chemoradiation” that was published in the Journal of Clinical Oncology in September 2020. The prospective randomized study demonstrated that a machine learning (ML) approach based on electronic health record (EHR) data could successfully triage patients to reduce acute care and is one of the first of its kind in the emerging field of healthcare artificial intelligence.
Dr. Hong began his research on ML when he was a resident at Duke University, where the study was conducted. He led the team that developed an algorithm to aggregate a patient’s pretreatment EHR history and cancer treatment plan and predict the likelihood that a patient will require acute care (emergency visit or unplanned hospital admission) during treatment with radiation or chemoradiation. For this study, patients identified to be at high risk of acute care by the ML model were randomly assigned to receive either standard of care management with at least one clinical evaluation per week with the treating radiation oncologist or mandatory evaluations twice a week. For the ML high-risk patients, the additional visits with a clinician resulted in a decrease in the rate of acute care including visits to the emergency department or unplanned hospital admissions from 22.3% to 12.3%. ML-identified low-risk patients had a 2.7% rate of acute care.
The ROI selected Dr. Hong’s patient-centered research for this year’s Publication Award because it has the potential to transform practice by improving quality, managing toxicities, and reducing health care costs. Dr. Hong is continuing to work with a multidisciplinary team across UCSF and Duke University to deploy his ML approach into standard practice and to broaden its applications. He is also establishing infrastructure to generalize his ML approach for use at UCSF and other cancer centers. Dr. Hong will use the $5,000 grant that accompanies the Publication Award to support these ongoing research efforts.
The ROI is presenting Publication Award Honorable Mentions to Michael S. Binkley, MD, MS, of Stanford University School of Medicine and William A. Hall, MD, of the Medical College of Wisconsin. Dr. Binkley is the lead author of “KEAP1/NFE2L2 Mutations Predict Lung Cancer Radiation Resistance That Can Be Targeted by Glutaminase Inhibition” that was published in December 2020 in Cancer Discovery. The results of this retrospective study demonstrated that KEAP1/NFE2L2 mutations are predictive of local recurrence after radiotherapy but not surgery in patients with localized non-small cell lung cancer. Dr. Binkley’s findings suggest that these mutations are clinically relevant biomarkers of radioresistance and that glutaminase inhibition may allow personalized radiosensitization of KEAP1/NFE2L2-mutant tumors.
Dr. Hall is the lead author of “NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer” that was published in January 2021 in the International Journal of Radiation Oncology•Biology•Physics. Dr. Hall led a multidisciplinary team composed of radiation oncologists, radiologists, and urologists in developing this updated atlas that includes a new consensus recommendation for a contour volume that differs from the prior recommendation published in 2009, provides recommendations for clinically node-positive disease and addresses contouring in the post-operative setting. The updated atlas is already having an impact on day-to-day practice and is important for the standardization of national practice patterns.
Through the annual Publication Award, the ROI highlights outstanding research in the ROI’s priority research areas being led by early career investigators. Nominators submitted many excellent manuscripts for consideration for the 2021 Publication Award, and 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. Hong, Dr. Binkley, and Dr. Hall for their important contributions to advancing radiation oncology and improving outcomes for patients with cancer!