Genetic Data May Inform Personalized Radiotherapy Strategies for Cancer Care

Just as it has become a guiding tool for chemotherapeutic strategies, the use of patient genetics may become more common in planning radiotherapy for patients with different types of cancer, according to Rachit Kumar, MD.

Kumar spoke with CancerNetwork® about where he hopes to see the radiation oncology field evolve with respect to the use of genetic information to inform radiotherapy decision-making. As part of achieving personalized cancer care, Kumar highlighted the prospect of using genetics to influence aspects of therapy, such as the length of radiation, while elucidating whether a patient has localized or metastatic disease burden.

Kumar is an assistant professor of radiation oncology and molecular radiation sciences at Johns Hopkins School of Medicine and a radiation oncologist specializing in genitourinary and gastrointestinal cancers at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center for Sibley Memorial Hospital and Suburban Hospital.

Transcript:

The idea of personalized medicine is obviously a buzzword in all cancer care, and that’s what every patient wants. That’s what providers want as well. We as physicians want to make sure that we’re giving patients the right option for them, not just a boilerplate option for their cancer and stage.

Where I think that we’re homing in now is [answering this question]: "How can we use the genetics of a patient’s cancer to make treatment decisions?" There are some diseases where that’s used quite widely in chemotherapy. For example, a lot of chemotherapy agents are specifically tailored to genetic alterations in patients. We’ve been doing that less so with radiation, but I think that there will be more and more trials that come out looking at the genetics of a patient’s cancer to say, based on this gene profile [or] protein expression profile, should [a patient] get a longer course of radiation? Should [they] get a shorter course of radiation? Is [their] disease more likely to be a local disease burden than a distant metastatic disease burden? If so, if it is a local disease burden, can we use local radiation more, and perhaps more than chemotherapy, to help attack that disease? Using genetics to guide our treatment, which has become much more common and much more mainstream in chemotherapy, will now become more common in radiation as well.