AN AMBITIOUS AGENDA
Research planned for the Proton Therapy Center will follow several tracks, including:
Basic biological research: How exactly do protons kill cancer cells? Scientists have long studied how ionizing radiation from photons disrupts DNA and causes cell death. But few have yet taken deep dives into the genetic and molecular pathways that protons can affect.
The scientific literature already reports, for example, that RNA responses differ when a cell is radiated with photons, protons or carbon ions. This has potential far-reaching implications for determining the most effective doses for specific types of cancer occurring in specific types of tissue.
One of several projects seeking to shed light along these lines will involve isolating cancer stem cells from the rest of a tumor, then testing that population’s reaction to proton vs. photon radiation.
Applied research and development: Currently, proton devices magnetically bend proton streams into pencil-like beams that can paint a tumor, layer by layer, with tiny bursts of radiation. The cell-killing damage can be confined to less than a millimeter of tissue.
Yet as impressive as that may be, even more precision is desired. When patients receive as many as 40 treatment sessions across several weeks, a variety of critical events can occur. Children grow. People lose or gain weight. The tumor itself can shift – and hopefully – shrink as treatment progresses, being replaced by healthy tissues.
The research gantry at Cincinnati Children’s will serve as a real-world test platform for evaluating imaging methods, computer targeting technologies, patient positioning techniques, and more. The goal: improve treatment plans created and updated at specific points in time into an even more flexible approach that keeps constant precise track of the size and location of a tumor.
Translational research: A major goal for proton research here is to develop and refine radio-sensitizing treatments that can augment proton therapy. These are drugs that can be given in conjunction with radiation treatments that increase the likelihood of cell death when hit by radiation. A number of such agents already exist, but their effects can vary with the types of cancer and radiation source, and few of these properties have been documented for children.
How proton therapy can work best in conjunction with evolving chemotherapy regimens and emerging immune therapy approaches remains to be explored. Engineering experts at UC are especially interested in exploring nanoparticles that could make it easier to target cancer cells or fortify healthy tissues near a tumor site.