Genetic tests can detect patients with HPV-positive throat cancer who may benefit from lower doses of radiation, according to Cleveland Clinic Research. The study, published in Newspaper of clinical researchIt is based on an increasing set of evidence that radiation therapy can be personalized using a genomic tumor, possibly shifting the approaches of treatment from the rule, where the radiation is prescribed to a uniform dose, to a dose called Genomic (Gard).
The current standard radiation dose for HPV-positive neck cancer is 70 Grays (GY), which offers treatment rates between 80% and 95%, but can cause long-term side effects such as swallowing and breathing problems. So far, efforts to reduce radiation doses (for example, 60Gy) have failed in clinical trials. There have been no proven strategies for dose delicacies,
There was a feeling in the field we are stuck. All data tell us that the lower doses should work, but clinical trials have failed to prove it. We wanted to ask: Could the missing piece be genetic? ”
Jacob Scott, MD, DPPil, Study Guide, Oncologist Radiation in Cleveland Clinic
They returned to the model of the Radiation Dose (Gard), which Dr. Scott had developed in collaboration with the oncologist of the Moffitt Javier Torres-Roca Cancer Center, MD.
Gard uses a volume gene expression to calculate the minimum radiation dose required to control cancer. Unlike models based only on clinical characteristics such as tumor size or smoking history, Gard incorporates genomic data from ten radiophysis genes to predict the patient’s specialist response.
Dr. Scott and Dr. Torres-Roca were previously validated in many types of cancer. To see if Gard could be used in head and neck cancer, DRS. Scott and Torres-Roca worked with internationally renowned oncologist of the head and neck Lisa Licitra, MD, from the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy. Dr. Licitra and her team were the driving forces behind the big data to decide the project, the largest database of patients with cancer of the world.
Data analysis by 191 patients in the database confirmed that the highest Gard ratings were associated with improved survival results, even when patients received the same radiation dose. The researchers then applied Gard retrospectively to participants from an unsuccessful 2024 clinical trial that examined 60 GY instead of 70 GY. While the total survival was slightly lower at 60 GY (96-98% versus 99%), the Gard analysis revealed that about 22% of patients would probably maintain excellent results in a lower personalized dose.
“This is a crucial framework for planning the next wave of clinical trials,” says Dr. Licitra. “It shows that genetics can help us choose the right patients for reduced doses, which we could not do before.”
“This project is based directly on nearly two decades of research on radio sensitivity and genomics,” adds Dr. Torres-Roca. “We have shown that the incorporation of genomics into oncology of radiation is not only feasible, but necessary to pass through the dosage restrictions of a size.”
The team hopes that these findings will pave the way for new clinical trials that incorporate Gard to make decisions before treatment begins.
“We already have open tests using Gard in other cancers,” says Dr. Scott. “From our own knowledge, this is one of the only two approaches that have successfully reduced the radiation dose for patients.
Source:
Magazine report:
Ho, E., et al. (2025). Personalized treatment for HPV+ Orals using a dose of adapted genomic radiation. Newspaper of clinical research. Doi.org/10.1172/JCI194073
