Radiotherapy with genomic-adjusted radiation dose

We read the Article by Jacob G Scott and colleagues 1 Scott JG Sedor G Ellsworth P et al. Pan-cancer prediction of radiotherapy benefit using genomic-adjusted radiation dose (GARD): a cohort-based pooled analysis. Lancet Oncol. 2021; 22: 1221-1229 Summary Full Text Full Text PDF PubMed Scopus (24) Google Scholar with great interest. The biological effect of radiotherapy quantified by the genomic-adjusted radiation dose (GARD) is significantly associated with time to first recurrence and overall survival for patients with cancer treated with radiotherapy. We present three discussion points regarding this study. Pan-cancer prediction of radiotherapy benefit using genomic-adjusted radiation dose (GARD): a cohort-based pooled analysisThe biological effect of radiotherapy, as quantified by GARD, is significantly associated with time to first recurrence and overall survival for patients with cancer treated with radiation. It is predictive of radiotherapy benefit, and physical dose of radiation is not. We propose integration of genomics into radiation dosing decisions, using a GARD-based framework, as the new paradigm for personalising radiotherapy prescription dose. Full-Text PDF Radiotherapy with genomic-adjusted radiation doseWe read with great interest the cohort-based pooled analysis of the pan-cancer prediction of radiotherapy benefit using genomic-adjusted radiation dose (GARD) by Jacob G Scott and colleagues.1 It is impressive that the biological effect of radiotherapy could be predicted using GARD, with correlation to overall survival and recurrence-free survival. However, several clinical details of the study could affect its overall generalisability. Full-Text PDF Radiotherapy with genomic-adjusted radiation dose – Authors' replyIn our study,1 our goal was to test whether the biological effect of radiation, quantified by the genomic-adjusted radiation dose (GARD),2 associates with clinical outcomes in a continuous analysis, using clinical data from 1615 patients from 11 cohorts spanning seven cancer types. We show a strong statistical association between GARD and both overall survival and time to first recurrence. We chose time to first recurrence by necessity, as the available cohorts did not report the same metrics of recurrence. Full-Text PDF