Michael Pennock, MD, MBiot

Pioneering a New FLASH Proton Therapy Delivery Method
 

Michael Pennock, MD, MBiot, and his team at the Montefiore Einstein Cancer Center are exploring the potential of proton pencil-beam scanning Bragg peak FLASH (PBS-BPF), a new method to deliver proton therapy that they developed. With this novel modality, they aim to minimize radiation dose to healthy tissues surrounding the tumor and reduce toxicity. In their ROI-funded research, Dr. Pennock’s team is focusing on treatment for head and neck cancer, which can result in side effects that jeopardize eating and speaking for patients.
 
FLASH proton therapy delivers a very high dose of radiation at an extremely fast rate, and much more research is needed to ensure this relatively new treatment option is safe and effective for patients. Most studies to date have used transmission proton FLASH, in which the beams must enter one side of the body, pass through the tumor target and exit through the opposite side in order to generate FLASH dose rates. In prior research, Dr. Pennock’s team has shown that PBS-BPF can eliminate the exit dose beyond the tumor target, maintain FLASH dose rates and potentially reduce side effects caused by damage to healthy tissues. "Investigating the radiobiological effects of this new technology will allow us to leverage novel treatment modalities, reduce normal-tissue toxicity, increase safety, and create more effective treatments for difficult scenarios such as head and neck reirradiation," says Dr. Pennock.
 
With support from ROI, Dr. Pennock and his team are conducting preclinical and translational research to compare PBS-BPF, transmission proton FLASH therapy, and conventional proton therapy. The research includes:

• Examining the impact of each treatment method on two of the most common side effects of radiation for head and neck cancer: oral mucositis, the inflammation of mucus membranes in the mouth, and xerostomia, dry mouth caused by reduced saliva production.  
• Analyzing tissue damage, bio-molecular markers, and clinical outcomes for each treatment method to determine which has the best normal tissue preservation.
• Assessing radiation-induced damage to stem cells caused by each treatment method and investigating the effects of reirradiation.

Dr. Pennock and his team are laying the necessary groundwork for their new proton FLASH therapy, PBS-BPF, to eventually be studied in human clinical trials. They are hopeful that patients with head and neck cancer can experience fewer side effects and shorter treatment times in the future through this new treatment delivery paradigm.