Gastrointestinal Cancer

Panel 22 - Real-Time Imaging-Based Biomarkers to Guide Personalized Radiotherapy for Gastrointestinal Malignancies

11:15 AM - 12:30 PM
Location: Room W196

Session Type: Panel
1.25 AMA PRA Category 1 Credits™
1.5 MDCB Credits

While the optimal treatment of GI malignancies frequently includes RT as neoadjuvant or definitive therapy, the advent of more effective systemic therapy regimens has prompted a re-evaluation of radiation therapy in many sites, including rectal and pancreas cancer (PROSPECT and LAP07, respectively). In this session we discuss the emerging role of imaging-based biomarkers to properly select patients for RT and guide optimal treatment - moving away from a "one-size-fits-all" approach to a more personalised approach based on the patient's own response.

In rectal cancer, we discuss the role of MRI for response assessment, moving beyond anatomical imaging to multiparametric imaging. Drawing on the experience for PROSPECT, where chemotherapy alone is used, and nonoperative management where chemoradiation serves as definitive management, we explore the link between imaging response and outcome, and how to evaluate imaging findings on MRI and functional imaging. Recognizing that systemic therapy and radiosensitizers play a synergistic role with RT, we discuss the use of PET to select the optimal treatment regimen, using CALGB 80803 as an example. Finally, we explore the role of machine learning in identifying novel imaging based biomarkers, using recent findings in the stratification of pancreas cancer patients as an example.

Logistics: The session will be organized in a case-based format with presentations by speakers spanning radiation oncology, medical oncology and radiology serving as moderators for each case that is discussed by all jointly and concluded by a summary slide. 15-20 minutes is allocated to each case (rectal, esophageal and pancreas) over 45-60 minutes.

Learning Objectives:


Mekhail Anwar, MD, PhD

University of California, San Francisco

University of California, San Francisco: Assistant Professor: Employee

I am a Physician-Scientist (MD, PhD) and Assitant Professor of Radiation Oncologist at the University of California, San Francisco specializing in the treatment of gastrointestinal mlaignancies. My research focuses on improving clinical outcomes for anal and pancreas cancer patients. As a co-leader of our clinical trials group in Radiation Oncology and a Core member of the Bioengineering Group spanning UC San Francisco and UC Berkeley, the primary focus of my research is to identify where gaps in diagnostic information and therapeutic tools compromise patient care, with an emphasis on imaging and biomarkers to both guide, and predict response to, radiotherapy. Key to these efforts is the introduction of new technologies based on integrated circuits (eg computer chip technology) for biosensing, enabling a new class of microfabricated molecular sensors to be placed directly inside the patient and tumor microenvironment, achieving an unprecedented level of sensitivity and rapid feedback times compared to conventional, external-based imaging. Specifically, I have led the development of new imaging strategies, sensors, interfacing electronics with cells and proteins, focusing on (1) optical detection of microscopic tumor cells in vivo essential to guiding personalized and more accurate surgery and radiotherapy, (2) using integrated circuits more broadly for high frequency cellular interrogation key to understanding the emerging field of tumor treating fields, (3) developing new approaches with modern clinical imagers for predicting response to radiotherapy and (4) developing new platform technologies to investigate fundamental biological phenomena.


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Panel 22 - Real-Time Imaging-Based Biomarkers to Guide Personalized Radiotherapy for Gastrointestinal Malignancies

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