Navigating the Critical Translational Questions for Implementing FLASH in the Clinic

IF 2.6 3区医学 Q3 ONCOLOGY Seminars in Radiation Oncology Pub Date : 2024-06-14 DOI:10.1016/j.semradonc.2024.04.008

Billy W. Loo Jr , Ioannis I. Verginadis , Brita Singers Sørensen , Anthony E. Mascia , John P. Perentesis , Albert C. Koong , Emil Schüler , Erinn B. Rankin , Peter G. Maxim , Charles L. Limoli , Marie-Catherine Vozenin

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Abstract

The “FLASH effect” is an increased therapeutic index, that is, reduced normal tissue toxicity for a given degree of anti-cancer efficacy, produced by ultra-rapid irradiation delivered on time scales orders of magnitude shorter than currently conventional in the clinic for the same doses. This phenomenon has been observed in numerous preclinical in vivo tumor and normal tissue models. While the underlying biological mechanism(s) remain to be elucidated, a path to clinical implementation of FLASH can be paved by addressing several critical translational questions. Technological questions pertinent to each beam type (eg, electron, proton, photon) also dictate the logical progression of experimentation required to move forward in safe and decisive clinical trials. Here we review the available preclinical data pertaining to these questions and how they may inform strategies for FLASH cancer therapy clinical trials.

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在临床中实施 FLASH 的关键转化问题导航

FLASH效应 "是指通过超快速辐照，在时间尺度上比目前临床上相同剂量的常规辐照短几个数量级，从而提高治疗指数，即在一定程度的抗癌疗效下降低正常组织的毒性。这种现象已在许多临床前体内肿瘤和正常组织模型中观察到。虽然潜在的生物机制仍有待阐明，但通过解决几个关键的转化问题，可以为 FLASH 的临床应用铺平道路。与每种射束类型（如电子、质子、光子）相关的技术问题也决定了推进安全和决定性临床试验所需的实验逻辑进展。在此，我们回顾了与这些问题相关的现有临床前数据，以及这些数据如何为 FLASH 癌症治疗临床试验提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Radiation Oncology 医学-核医学

CiteScore

5.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Each issue of Seminars in Radiation Oncology is compiled by a guest editor to address a specific topic in the specialty, presenting definitive information on areas of rapid change and development. A significant number of articles report new scientific information. Topics covered include tumor biology, diagnosis, medical and surgical management of the patient, and new technologies.