Importance of Central Imaging Review in a Pediatric Hodgkin Lymphoma Trial Using Positron Emission Tomography Response Adapted Radiation Therapy

Hoppe, B.S.; McCarten, Kathleen; Pei, Qinglin; Kessel, Sandy; Alazraki, Adina; Mhlanga, Joyce; Lai, Hollie; Eutsler, Eric P.; Hodgson, David C.; Roberts, Kenneth B.; Charpentier, Anne-Marie; Keller, Frank G.; Voss, Stephan D.; Wu, Yue; Cho, Steve Y.; Kelly, Kara M.; Castellino, Sharon M.

doi:10.1016/j.ijrobp.2023.02.020

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…The data are an extraordinary resource, and it remains our responsibility to provide the informatics infrastructure to move imaging and radiation oncology objects for study to a common platform in a public domain linked to pathology and genetic information as a DICOM object linked to the platform in a manner similar to an image. This has the potential of being a worldwide resource for all to learn [25][26][27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Modern Dosimetry in Radiation Oncology Clinical Trials

Smith,

Ding,

Bishop-Jodoin

et al. 2023

Advances in Dosimetry and New Trends in Radiopharmaceuticals

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Clinical trials in radiation oncology are the best vehicle to optimize our strengths in therapeutic technology, define progress in our field, and improve patient outcome. Trials advance our knowledge in each disease site and provide us information to improve the radiation dose-volume for both tumor control and therapeutic sequelae to normal tissue. An increasing number of systemic and targeted therapies have been developed and are currently in early phase clinical trial design. Ultimately, these new therapies will need to be tested with standard-of-care therapy including radiation oncology. Therefore, during a study, it is essential that radiation therapy is delivered in a uniform and consistent manner for the credibility of the study. If the radiation therapy component of the study does not have a structure or management for maintaining therapeutic compliance, including a real-time data management strategy, it becomes difficult to trust the study outcome and apply the outcome to daily clinical practice. In this chapter, we review the strategy and process involved in the management of dosimetry in radiation oncology clinical trials and how this can impact clinical trial management, primary study endpoints, and the overall success of the study.

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Section: Discussionmentioning

confidence: 99%

Modern Dosimetry in Radiation Oncology Clinical Trials

Smith,

Ding,

Bishop-Jodoin

et al. 2023

Advances in Dosimetry and New Trends in Radiopharmaceuticals

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“…55 Real-time central review of iPET response is essential in response-adapted designs, and impacted RT utilization in 10% of patients on AHOD1331. 56 Technological advances contributing to normal tissue volume reduction include increasing adoption of intensity-modulated radiation therapy (IMRT) and proton therapy (PT). In AHOD1331, 3D conformal radiotherapy, IMRT, and PT were applied in 29%, 45%, and 27% of patients, respectively.…”

Section: Refining the Use Of Radiation Therapy In Hlmentioning

confidence: 99%

“…A significant reduction in normal tissue dose to breast, heart, and thyroid has been demonstrated with these changes 55 . Real‐time central review of iPET response is essential in response‐adapted designs, and impacted RT utilization in 10% of patients on AHOD1331 56 . Technological advances contributing to normal tissue volume reduction include increasing adoption of intensity‐modulated radiation therapy (IMRT) and proton therapy (PT).…”

Section: Recent Findingsmentioning

confidence: 99%

Children's Oncology Group's 2023 blueprint for research: Hodgkin lymphoma

Castellino,

Giulino‐Roth,

Harker‐Murray

et al. 2023

Pediatric Blood & Cancer

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The goal of therapy in pediatric Hodgkin lymphoma (HL) is to maximize overall survival while minimizing the morbidity of curative therapy. Key findings from recent Children's Oncology Group (COG) trials include: (i) superior event‐free survival with the addition of brentuximab vedotin (Bv) in frontline regimens for high‐risk disease, (ii) successful reduction in myeloablative regimens with demonstrated safety and efficacy of Bv and checkpoint inhibitor therapy in relapsed disease, and (ii) the potential to select a population that can be salvaged after relapse without receiving a stem cell transplant. The COG HL committee will lead a National cancer Institute National Clinical Trials Network phase 3 trial to evaluate the combination of Bv/nivolumab in early‐stage disease. Ongoing advances in technology and blood biomarkers are increasing the ability to deliver biologically driven, personalized treatment for HL.

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“…Involved‐site radiotherapy (ISRT) was used for mediastinal bulky disease and slow early responding lesions based on interim PET response, a huge evolutionary step from involved‐field radiotherapy (IFRT) to all sites of initial involvement. This strategy has currently resulted in a reduction of RT use from 76% on AHOD0831 to 55% 22,24 . While overall RT use is declining (S1826 < 5% of pediatric patients and AHOD2131 expected < 20%), the RT doses will increase from 21 to 30 Gy, with options for higher boost doses based on final PET response to 36–40 Gy.…”

Section: Hodgkin Lymphomamentioning

confidence: 99%

“…This strategy has currently resulted in a reduction of RT use from 76% on AHOD0831 to 55%. 22,24 While overall RT use is declining (S1826 < 5% of pediatric patients and AHOD2131 expected < 20%), the RT doses will increase from 21 to 30 Gy, with options for higher boost doses based on final PET response to 36-40 Gy. Despite the higher RT doses, increased toxicity is not expected due to the use of highly conformal RT technology (IMRT, proton therapy), smaller RT fields (e.g., residual site RT) and careful evaluation of normal tissue exposure.…”

Section: Hodgkin Lymphomamentioning

confidence: 99%

Children's Oncology Group's 2023 blueprint for research: Radiation oncology

Kalapurakal

Wolden

Haas‐Kogan

et al. 2023

Pediatric Blood & Cancer

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Radiation oncology is an integral part of the multidisciplinary team caring for children with cancer. The primary goal of our committee is to enable the delivery of the safest dose of radiation therapy (RT) with the maximal potential for cure, and to minimize toxicity in children by delivering lower doses to normal tissues using advanced technologies like intensity‐modulated RT (IMRT) and proton therapy. We provide mentorship for y ators and are actively involved in educating the global radiation oncology community. We are leaders in the effort to discover novel radiosensitizers, radioprotectors, and advanced RT technologies that could help improve outcomes of children with cancer.

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Importance of Central Imaging Review in a Pediatric Hodgkin Lymphoma Trial Using Positron Emission Tomography Response Adapted Radiation Therapy

Cited by 4 publications

References 27 publications

Modern Dosimetry in Radiation Oncology Clinical Trials

Modern Dosimetry in Radiation Oncology Clinical Trials

Children's Oncology Group's 2023 blueprint for research: Hodgkin lymphoma

Children's Oncology Group's 2023 blueprint for research: Radiation oncology

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