WP10 – Personalised Radiotherapy for Glioblastoma

Impact/relevance

The research in this WP may ultimately lead to a new standard-of-care in radiotherapy (RT) for glioblastoma (GBM) patients. Establishing personalised RT for the GBM patient, has great potential to impact RT for all glioma patients.

Background

RT has a key role in the treatment of GBM patients as it doubles the median overall survival. While it is more and more recognised that GBM is a very heterogeneous disease, also reflected by large clinical differences, RT is still similar for the vast majority of patients. We thus hypothesize that personalising RT will improve patient outcomes, both in terms of reducing treatment toxicity and improving local control. 

Aim

This project aims to personalise the RT dosage, target, and modality.

Methods

Part 1. Danish cohort

We are currently establishing a retrospective Danish cohort containing clinical, RT and follow-up imaging data from 1574 GBM patients treated with RT between 2012 and 2019. We will develop an artificial intelligence prediction model for the location of disease progression within the brain, taking into account patient, disease and treatment heterogeneity. This will subsequently be used to develop a patient selection tool for radiation dose escalation and a personalised radiation target.

Part 2. Clinical trials

We are initiating a phase 1 radiation dose escalation trial using Proton therapy (PT) to find the maximum tolerable radiation dose (MTD) within the multimodality treatment of GBM patients. The study is derived from the DNOG RT board and supported by the Danish Center for Particle Therapy.

Expected outcome

The expected outcome of our research will be a patient selection tool for dose escalation, identifying those who may benefit most from high dose RT. Furthermore, a personalised target, which will be more precise thus leading to less tumour miss while sparing healthy brain better. And finally, the identification of the MTD when using innovative PT.