Biomarkers for Radiation Oncology
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Hesham Elhalawani, MD, MSc, is developing a decision-making tool to help diagnose radiation necrosis (RN) earlier in patients being treated with immunotherapy and stereotactic radiosurgery (SRS) for brain metastases. Dr. Elhalawani and mentor Ayal Aizer, MD, MHS, are using artificial intelligence to conduct an analysis of MRIs performed before and after SRS to identify imaging biomarkers to predict which patients are most likely to develop RN.
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David Miyamoto, MD, PhD, is developing a new blood test to detect and analyze circulating tumor cells in patients with muscle-invasive bladder cancer with an ROI Biomarkers for Radiation Oncology Award. This non-invasive liquid biopsy test will help identify patients who can be effectively treated with bladder-preserving trimodality therapy, a combination of radiation therapy, chemotherapy, and limited surgery that avoids removing the entire bladder.
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Sonal Noticewala, MD, MAS
, is exploring the role of the microbiome in how patients with pancreatic cancer respond to chemoradiation. With mentor Cullen Taniguchi, MD, PhD, Dr. Noticewala is examining bacterial profiles in paired tissue samples of pancreatic tumors and peri-tumoral regions to define a signature microbiome associated with patient response to chemoradiation, which could lead to studies that target the microbiome to optimize treatments.
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Nina Sanford, MD, and Wen Jiang, MD, PhD, are Co-Principal Investigators on a project to develop a novel microscale biochip device to monitor disease progression and treatment response in anal cancer. Their innovative technology will be used to capture circulating exosomes and to detect a microRNA specific to anal cancer in patient blood samples before, during and after chemoradiation that would allow for greater personalization of treatment.
Improving Diversity and Inclusion in Radiation Oncology
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Dr. Seible and his team launched the
Alaska
Native
Internship in
Oncology (ANION) program to inspire and guide Alaska Native (AN) students toward careers in radiation oncology to increase their representation in the cancer care workforce, which could ultimately help address health disparities experienced by AN patients. The ANION program is the first oncology-based educational outreach program specifically serving AN students.
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G. Nic Rider, PhD, and Stephanie Terezakis, MD, of the University of Minnesota – Twin Cities are evaluating disparities in cancer care for patients who identify as lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+). Their qualitative study will provide rich information about the training needs of various health care providers to deliver more competent, quality care to LGBTQ+ patients with cancer.
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Sara Alcorn, MD, PhD, and Crystal Aguh, MD, are leading a multidisciplinary team to develop a web-based tool that will objectively assess acute skin toxicity in patients with a wide range of skin tones who are receiving radiotherapy to treat breast cancer. This unique collaboration between the Department of Radiation Oncology and the Department of Dermatology aims to improve quality of life for patients across the range of skin tones.
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Malcolm Mattes, MD, and his team are working to develop a more diverse radiation oncology workforce by introducing students to the specialty earlier in medical school. Using a multifaceted approach, they are studying the perceived value of each of the initiatives as well as the impact of the program on radiation oncology residency applications and matches. Dr. Mattes' work is supported by an Improving Diversity and Inclusion in Radiation Oncology Award.
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Dr. Oladeru is researching to better understand disparities in cancer care in the Florida state prison system and to develop cancer education materials tailored for incarcerated individuals. Results from her study could improve patient outcomes by increasing awareness and understanding of cancer prevention and early detection among incarcerated people and ultimately decrease the current high incidence of late-stage diagnosis in this population.
Personalized Radiation Therapy
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Dr. Bergom, Dr. Ibrahim and their team are conducting a pilot study to determine whether advanced cardiac MRI can be used to detect early, non-symptomatic damage to the heart in lung cancer patients treated with radiation therapy. They are working to better understand how radiation therapy affects the heart so that treatment plans can be personalized to reduce damage to the heart and improve long-term outcomes among patients with lung cancer.
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Dr. Byun and his team are exploring whether using virtual and augmented reality platforms during consultation visits could increase patient knowledge about radiation therapy, reduce anxiety, and improve the quality of their overall treatment experience. Their CurieUx mixed reality patient education software includes a novel virtual reality 360° tour of simulation and treatment rooms and interactive virtual disease-specific anatomy models.
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Dr. Golden and his team are improving communication between patients with cancer and their physicians by developing a personalized clinical discussion guide that explains external beam radiotherapy using a graphic narrative format. With a grant from the ROI, the team has created six new guides in the “Communicating the External Beam Radiotherapy Experience” (CEBRE) series that are tailored for breast, central nervous system, digestive system, head and neck, lung and prostate cancers.
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Adam Wolfe, MD, PhD, and his team investigated new biomarkers to help personalize treatments for patients with pancreatic cancer. They identified and validated a novel molecular signature that is made up of microRNAs found in blood and tumor tissue samples that could be used to better predict which patients with pancreatic cancer could benefit the most from radiation therapy following surgery.
2018 Innovative Projects in Radiation Oncology
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Fumiko Chino, MD, Yvonne Mowery, MD, PhD, and their team conducted a prospective study of patient reported outcomes and financial toxicity for patients with head and neck cancer receiving radiation therapy. ROI supported the team's work as part of the 2018 Innovative Projects in Radiation Oncology awards, which focused on funding research to address some of the field’s most pressing challenges.
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Dr. Hoffman and her team prospectively surveyed patients with prostate cancer to study whether receiving counseling from a radiation oncologist in a multidisciplinary clinic increased patients’ awareness of radiation therapy as a treatment option with a favorable side effect profile. The team also assessed changes in treatment choice and explored why any changes were made. The results are being used to develop patient education materials.
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Dr. Nabavizadeh and his team are prospectively studying whether stereotactic body radiation therapy (SBRT) can be safely used to help patients with hepatocellular carcinoma (HCC) and advanced cirrhosis as they await a liver transplant. The ROI supported Dr. Nabavizadeh’s work as part of the 2018 Innovative Projects in Radiation Oncology awards, which sought to address some of radiation oncology’s highest priority topics, including SBRT.
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Dr. Tang and his team conducted an analysis to understand the barriers to access and costs associated with treatment options for patients with prostate cancer including, surgery, IMRT, SBRT, brachytherapy, proton therapy and active surveillance. The ROI supported Dr. Tang’s work as part of the 2018 Innovative Projects in Radiation Oncology awards, which focused on funding research to address some of the field’s most pressing challenges.
Leveraging Big Data to Optimize QA and Patient Care Improvement Initiatives
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Dr. McNutt and his team used big data and machine learning approaches to develop better predictive models for toxicities associated with head and neck cancer and to create a clinical decision support tool to help provide patients with more personalized care. The ROI supported Dr. McNutt’s groundbreaking work to stimulate this emerging field of research using big data to improve the safety and quality of radiation therapy.
2016 Innovative Projects in Radiation Oncology
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Dr. Martin and his team conducted a clinical trial using smartphone-connected technology to monitor lung cancer patients undergoing radiation therapy. ROI awarded Dr. Martin an Innovative Projects in Radiation Oncology grant to investigate the correlation between patient reported outcomes, the continuous biometric monitoring via smartphones and the side effects of radiation therapy.
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Nitin Ohri, MD, and his team conducted a randomized clinical trial to determine if giving patients daily customized step count goals as measured and guided through fitness trackers could improve patients’ ability to tolerate concurrent chemoradiotherapy. Dr. Ohri’s study explored whether this relatively simple intervention can reduce the number of missed treatments, decrease treatment-related toxicities and improve quality of life for cancer patients.
Examination of the Comparative Value of Radiation Therapy
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Dr. Shah and his team developed novel episode-based Medicare payment definitions for stereotactic body radiation therapy (SBRT) to treat patients with early stage non-small cell lung cancer (NSCLC). As part of ROI’s value of radiation therapy initiative, Dr. Shah’s study included an exploration of whether an academic versus nonacademic setting has an impact on the relative value of SBRT compared with surgery.
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Dr. Sher and his team conducted parallel comparative effectiveness and cost comparison studies for early-stage and locally advanced oropharyngeal cancer using two large databases, SEER-Medicare and the HealthCore Integrated Research Database (HIRD). The results from Dr. Sher’s ROI-funded study are providing important evidence about the value of radiation therapy in the treatment of oropharyngeal cancer.
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Dr. Slatore and his team conducted a comparative, mixed-method study to better understand the patient-centered outcomes associated with radiation therapy versus surgery for early stage non-small cell lung cancer (NSCLC.) Dr. Slatore's ROI-funded work on the value of radiation therapy for the treatment of lung cancer laid the groundwork for additional research now being supported by the National Cancer Institute.
Best Practices for Toxicity Management in Radiation Oncology
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Dr. Rajagopalan developed the RadOnc Toolbox app that features evidence-based interventions for managing and preventing eight of the most common radiation-related toxicities and a number of other clinical tools. The ROI supported the development of the RadOnc Toolbox to provide practitioners with an evidence-based resource for toxicity management in order to improve outcomes for cancer patients and survivors.
IMRT Treatment Delivery Accuracy
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Dr. Greer and his team are developing the WatchDog system that determines treatment delivery accuracy for radiation therapy patients in real-time and can prevent mistreatment. Dr. Greer received ROI’s inaugural research award to conduct the team’s first clinical demonstration of the WatchDog system as part of the ROI’s safety and quality initiative.