December 14, 2020/News Releases

Combining Genomics and Mathematics Helps Personalize Radiation Therapy for Lung Cancer

Rather than a one-size-fits-all approach, new technology provides opportunity to choose personalized radiation dose to improve outcomes and reduce toxicity

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TAMPA, Fla., and CLEVELAND, Ohio — Clinical trials in lung cancer over the decades have determined an optimal “one size fits all” dosing scheme for patients treated with radiation therapy, but new research now shows this is not as biologically accurate as once believed. A new technology using tumor genomics to personalize radiation dosing demonstrates that the standard of care approach may be suboptimal for up to 75% of lung cancer patients.

A paper published in the Dec. 9 Journal of Thoracic Oncology, co-authored by Dr. Javier F. Torres-Roca, a senior member in the Radiation Oncology Program at Moffitt Cancer Center, and Dr. Jacob G. Scott, a radiation oncologist and physician researcher in the Department of Translational Hematology and Oncology Research at Cleveland Clinic, demonstrates an approach to combine individual tumor genomics and mathematics to personalize the dose of radiation therapy for lung cancer patients. By applying this personalized technology, their study shows an opportunity to increase the efficacy and decrease the toxicity of radiation therapy.

“It’s standard of care to give patients the same radiation dose based on the type of cancer and its stage,” Torres-Roca said. “The idea that this is optimal for every patient is in direct conflict with the fact that all cancers are different. In this study, we demonstrate that the standard dose results in the majority of patients getting either too much or too little radiation. So we developed a new technology that can personalize the dose required for a specific patient’s tumor biology and quantified the clinical opportunity this provides.”

In 2017, Torres-Roca and Scott developed the Genomic Adjusted Radiation Dose (GARD), a method of dosing that accounts for biological differences and can be utilized to predict the optimal radiation therapy dose for each individual patient. The results were published in Lancet Oncology and were used as a basis for this most recent advance.

“Here we extend our work with GARD to define a new paradigm for clinical radiotherapy dose decision-making,” Scott said. “By developing a patient-specific mathematical model that factors in individual tumor biology and healthy tissue complication probabilities, we optimize clinical outcome for each individual patient.”

While the study involved non-small cell lung cancer patients, Torres-Roca and Scott are confident the technology can be used in other cancers, as well.

Moffitt Cancer Center expects to start a clinical trial utilizing the new technology in early 2021.

Moffitt Cancer Center: Steve Blanchard, 813-745-1718,
Cleveland Clinic: Katrina Healy, 216-386-0955,

Changing to: Rather than a one-size-fits-all approach, new technology provides opportunity to choose personalized radiation dose to improves outcomes and reduce toxicity

About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 67,554 employees worldwide are more than 4,520 salaried physicians and researchers, and 17,000 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,026-bed health system that includes a 165-acre main campus near downtown Cleveland, 18 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2019, there were 9.8 million total outpatient visits, 309,000 hospital admissions and observations, and 255,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at Follow us at and News and resources available at

About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. The Tampa-based facility is one of only 51 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s scientific excellence, multidisciplinary research, and robust training and education. Moffitt is the No. 11 cancer hospital and has been nationally ranked by U.S. News & World Report since 1999. Moffitt’s expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet® status, its highest distinction. With more than 7,000 team members, Moffitt has an economic impact in the state of $2.4 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit, and follow the momentum on Facebook, Twitter, Instagram and YouTube.

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