29 Radiation Oncology and Cancer Imaging

PROJECT SUMMARY/ABSTRACT
The Radiation Oncology and Cancer Imaging Program (ROCIP) has been created at the recommendation of the
CCSG External Advisory Board and merges the previous Radiation Oncology Physics and Biology Program with
Diagnostic Imaging. The ROCIP now has 74 members (56 primary, 18 associate) and is led by Drs. Albert
Koong and David Piwnica-Worms with Dr. Junjie Chen as co-leader. Dr. Koong is a physician-scientist with
expertise in hypoxia and the unfolded protein response who pioneered the use of stereotactic ablative
radiotherapy for pancreatic cancer. Dr. Piwnica-Worms is a thought-leader in molecular imaging. Dr. Chen is an
international authority in DNA repair. Radiation Oncology (RO) and Cancer Imaging (CI) constitute a
multidisciplinary effort, emphasizing diagnosis, staging, treatment, and assessing response to multimodality
therapy. The focus of CI is to develop novel imaging modalities to help optimize clinical decisions. The focus in
RO is to develop advanced radiation therapy techniques that maximize the opportunity for cure while limiting
treatment-related toxicity. The ROCIP is organized around four major themes: (1) DNA Repair; (2) Imaging
Biomarkers of Response and Toxicity, (3) Immuno-Radiation Therapy; and (4) Imaging and Radiation
Effectiveness. Each theme is addressed by a specific aim. Aim 1: To Identify tumor-specific vulnerabilities in
DNA repair pathways that can be exploited for image-guided radiation therapy; Aim 2: To develop novel imaging
techniques that predict response to radiotherapy and chemotherapy. Aim 3: To develop strategies in radiation
sciences that potentiate the effects of immunotherapy and to visualize those effects in real time; and Aim 4: To
develop advanced personalized imaging to enhance the effectiveness of photon and proton radiotherapy. The
ROCIP's annual direct peer-reviewed funding totals $10.9M, of which $6.9M (63%) is from NCI. The program
has published 1602 papers, of which 582 (36%) are intra-programmatic, 782 (49%) are inter-programmatic, and
978 (61%) have one or more external collaborators. Twenty-seven percent of articles were published in journals
with IF >5 and 7% in journals with IF >10, including Nature, N Engl J Med, JAMA, Proc Natl Acad Sci USA, and
Lancet Oncol. Program members have collectively used all 14 CCSG shared resources. Notable scientific
accomplishments include identification of key pathways influencing DNA double-strand breakage and affecting
PARP inhibition; discovery that fasting abrogates toxicity by enhancing DNA repair in intestinal crypt cells after
chemoradiation; discovery of convergence between WNT signaling and DNA repair pathways in oncogenesis;
identification of optimal combinations of radiotherapy and immunotherapy; novel proton therapy trials to define
the role of proton therapy in various cancers; expansion of metabolic imaging with the introduction of clinical
magnetic resonance hyperpolarization; and identification of radiation dose distributions to the heart and lungs
that affect survival and normal tissue complications in patients with lung cancer. The breadth of these discoveries
illustrates the importance of the Program's contributions to the scientific community.

Grant Number: 5P30CA016672-49
NIH Institute/Center: NIH
Principal Investigator: Kristy Brock