Trial will test MRI-guided radiation for advanced pancreatic cancer

Researchers are testing the use of a procedure that uses stereotactic MRI imaging to guide treatment of advanced pancreatic cancer.

Researchers are testing the use of a procedure that uses stereotactic MRI imaging to guide treatment of advanced pancreatic cancer.

The initiative was announced by ViewRay, a Cleveland-based vendor that manufacturers the radiation therapy system used to deliver the system that enables precise treatment of cancer patients through the use of advanced imaging technology.

The company says the first patient has been enrolled for the test, to be conducted by researchers from the Henry Ford Cancer Institute and the University of California Los Angeles.

The treatment trial is called Stereotactic MRI-guided On-table Adaptive Radiation Therapy (SMART), and it is intended to explore the clinical benefits of precise, high-dose radiation therapy enabled by MRI-guidance combined with daily on-table adaptation in the treatment of pancreatic cancer.

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The trial is designed to enroll 133 participants with borderline resectable or inoperable locally advanced pancreatic cancer. Patients must be 18 years and older and have documented non-metastatic disease after three months of systemic therapy. Radiation therapy will be delivered using ViewRay's MRIdian system.

Each participant will be aligned in the treatment system with MRI image guidance; on-table adaptive re-planning will be used when clinically indicated. In all patients, real-time MRI imaging will be used throughout treatment delivery to monitor the target location and control the radiation beam as necessary.

Researchers say the trial will further investigate the potential for the treatment. Retrospective analysis of precise, high-dose MR-guided radiation therapy using adaptive dose planning has shown promising results with locally advanced pancreatic cancer, suggesting the potential for improving overall survival when compared with patients receiving lower radiation doses, without increasing the rate of serious gastrointestinal toxicity.

"High-definition MR and daily treatment plan adaptation allow us to deliver ablative radiation doses safely to pancreatic cancer patients for the first time ever," says Parag Parikh, MD, co-PI of the study and Director of GI Radiation Oncology and MR-Guided Radiation Therapy at the Henry Ford Cancer Institute in Detroit.

"Through the SMART trial, we will build upon the promising experience from UCLA, Washington University, Amsterdam UMC, University of Miami and University of Wisconsin by further exploring MRIdian's impact on associated toxicity, local control and patient outcomes in pancreatic cancer at multiple institutions around the world," he adds.

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