New trial to test approach to improve large tumor treatment

A new clinical trial at the University of Cincinnati Cancer Center will test the safety and effectiveness of a more targeted radiation dose for patients with large tumors.

Andrew Frankart, MD, is leading the trial, supported by a five-year, $729,000 American Cancer Society (ACS)/American Society for Radiation Oncology (ASTRO) Clinician Scientist Development Grant.

Trial details

The research focuses on a method of delivering radiation called lattice therapy, where certain parts of tumors are preferentially targeted with higher doses of radiation compared to other areas.

"That allows you to achieve higher doses within a tumor, hopefully get better tumor control and also avoid some of the side effects that come with escalated doses of radiation to normal tissue," said Frankart, a Cancer Center physician researcher and assistant professor of radiation oncology in UC's College of Medicine.

Frankart recently presented research at the ASTRO annual meeting that found complex lattice therapy plans can be developed quickly enough to be used clinically to treat tumors at various challenging sites in the body.

"We were able to demonstrate successfully that it is not something that takes a lot of extra time despite it being a much more complex planning approach," he said. "We've gotten the information that we need, so we will be focusing more on the clinical outcomes now."

The grant will support the translation of Frankart's findings into clinical practice through the trial, which is expected to enroll 37 adult patients and analyze the underlying biology of tumor and immune responses to lattice therapy radiation.

"We're focusing on patients who have large or bulky tumors. The approach is more based upon where it's located and how large it is, and those are things that have previously prevented radiation from being as effective," Frankart said. "Using this new approach to overcome some of those barriers hopefully means it can benefit more patients because we're broadly including multiple disease sites."

Frankart has a clinical focus on pediatric cancer, seeing patients at the Cincinnati Children's/University of Cincinnati Medical Center Proton Therapy Center. He said he hopes the findings from this trial for adult patients will also later translate to pediatric cancer.

Career development

Vinita Takiar, MD, Ph.D., Frankart's mentor on the project, said the goal is for this research to lay the foundation for a career trajectory for Frankart focused on the use and study of lattice therapy more broadly.

"We look forward to learning how to use it best and which patients will benefit from it the most," said Takiar, a Cancer Center physician researcher, professor and vice chair of research in UC's Department of Radiation Oncology. "We also hope to optimize the delivery so that it can be used more broadly in the community."

Frankart completed his undergraduate degree, medical school and residency all at UC, becoming a faculty member in August. The ACS/ASTRO grant is awarded to an early-career physician interested in having research be a significant part of their practice.

"The grant is certainly a reflection of the excellent mentorship I've received through residency and the support of the department more broadly," he said. "Since my time as an undergrad, I've always felt like UC is a special place to be part of within the medical community. Throughout the Cancer Center, at UC and Cincinnati Children's, you can tell that everyone cares about what they're doing and they care about the patients as individuals. They also care about each other within the medical team, and I think that leads to outstanding care for our patients."

Frankart is the first UC researcher to receive the grant, and only one researcher nationwide is awarded this grant every year. Mentor Takiar said Frankart embodies many characteristics essential to being a successful physician researcher, including "attention to detail, learning from every opportunity and putting in the hard work."

"Career development awards are essential in allowing sufficient research time for early-career investigators to really focus on the research project," Takiar said. "Dedicated time for both career and project development sets the foundation for physician-scientists for the early years as well as those to come."

Provided by University of Cincinnati