Jacob G. Scott, MD, DPhil, associate staff, Departments of Translational Hematology and Oncology Research and Radiation Oncology, Cleveland Clinic, clinical assistant professor, Department of Molecular Medicine, adjunct assistant professor, Department of Physics, Case Western Reserve University School of Medicine, member, Development Therapeutics Program, Case Comprehensive Cancer Center, Case Western Reserve University, discusses the incorporation of genomic-adjusted radiation dose (GARD)–based radiotherapy dosing in oncology.

Although it can be difficult to define levels of evidence in biomarker studies based on archival tissue specimens, GARD-based radiotherapy dosing is backed by level 1 evidence and is potentially ready for use in clinical practice, Scott says. However, incorporating a clinical decision support tool will require some relearning of practice standards, which have always been based on empirical evidence from dose-escalation trials, Scott explains. 

The tool, which is similar to an oncotype assay, supports the idea that quantifying the biological effect of radiotherapy with GARD is associated with time to first recurrence and overall survival for patients with cancer who undergo radiation treatment. Moreover, GARD-based dosing is predictive of benefit with radiation therapy, Scott concludes. 

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Jacob G. Scott, MD, DPhil, discusses the incorporation of genomic-adjusted radiation dose–based radiotherapy dosing in oncology.  



Dr. Scott on the Incorporation of GARD-Based Radiotherapy Dosing in Oncology 

Jacob G. Scott, MD, DPhil, associate staff, Departments of Translational Hematology and Oncology Research and Radiation Oncology, Cleveland Clinic, clinical assistant professor, Department of Molecular Medicine, adjunct assistant professor, Department of Physics, Case Western Reserve University School of Medicine, member, Developmental Therapeutics Program, Case Comprehensive Cancer Center, Case Western Reserve University, discusses the rationale to evaluate genomic-adjusted radiation dose (GARD)–based radiotherapy dosing in oncology.

Many patients with cancer who require radiation therapy receive a 5-to-6-week treatment schedule of radiation dosed at around 2 Gy per day, Scott says. However, patients have varied responses to this approach.

Notably, GARD-based radiotherapy dosing quantitatively predicts for how well a patient may benefit from radiation given at a particular dose, Scott explains.

Findings from a recent cohort-based pooled analysis that were published in 

 demonstrated that the biological effect of GARD-quantified radiotherapy is associated with time to first recurrence and overall survival in patients with cancer who received radiation therapy, Scott concludes. 

Jacob G. Scott, MD, DPhil, discusses the rationale to evaluate genomic-adjusted radiation dose–based radiotherapy dosing in oncology.  



Jacob G. Scott, MD, DPhil

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Dr. Scott on the Incorporation of GARD-Based Radiotherapy Dosing in Oncology

Dr. Scott on the Rationale to Evaluate GARD-Based Radiotherapy Dosing in Oncology