September 17, 2021 by John Fernandez
New Promise for Patients with Inoperable Pancreas Cancer
Patients with inoperable pancreas cancer may benefit from an advanced form of radiation therapy now available at Miami Cancer Institute. The technology delivers an unprecedented high dose of radiation over just five consecutive days and is showing promise in extending overall survival and improving quality of life.
The ViewRayTM MRIdian MR-Linac technology is used in conjunction with continuous real-time MRI scans, allowing for millimeter accuracy and adapting to daily changes in a patient’s internal anatomy. It is painless, non-invasive and requires no anesthesia or needles. Miami Cancer Institute was the second cancer center in the U.S. to begin treating patients with this technology in April 2018.
Known as MR-guided stereotactic ablative radiation therapy (SABR), the technology delivers nearly twice the radiation dose that is safely deliverable on a standard radiation machine. Investigators from Miami Cancer Institute recently published the first clinical outcomes of chemotherapy followed by MR-guided SABR on an MR-Linac for inoperable pancreas cancer in Practical Radiation Oncology.
“A significant number of our patients have surpassed the expected survival for this deadly disease, with many alive several years after their initial diagnosis,” said Michael Chuong, M.D., director of MRI-Guided Radiation Therapy at the Institute and a radiation oncologist specializing in gastrointestinal cancers. Dr. Chuong is encouraged that patient survival beyond two years after initial diagnosis may be more than doubled through the use of the higher radiation dose.
The Miami Cancer Institute study included 35 patients ranging in age from 34 to 89 years and reported that one year after SABR nearly 90 percent of patients had their cancer controlled locally. Some patients who initially had inoperable pancreas cancer ultimately were able to undergo successful surgery because of their excellent response to SABR.
Some 57,600 people in the U.S. will be diagnosed with pancreatic cancer this year, according to the American Cancer Society. While the death rate for some cancers has dropped significantly in the last decade, it has not improved for pancreas cancer, which often goes undetected until it is an advanced stage. Because the pancreas sits in the abdomen near the stomach, small intestine, liver and spleen, and involves many blood vessels, it can be difficult to remove surgically and radiation must be precisely delivered to avoid damage to nearby structures.
In addition to being effective, the new radiation technology is well tolerated by patients. “It is remarkable that we have seen such little treatment toxicity given the incredibly high radiation dose that is delivered to tumors in the pancreas that are surrounded by ― and sometimes literally touching ― the stomach and intestines,” Dr. Chuong said. “Patients are in and out within about an hour. They go back to work or play golf and do their normal activities.”
Dr. Chuong is a national co-principal investigator of a phase 2 clinical study on the MRIdian Linac known as the SMART (Stereotactic MRI-guided On-table Adaptive Radiation Therapy (SMART) trial. It is currently enrolling patients. Dr. Chuong encourages those with inoperable pancreatic cancer to speak with their doctors about receiving MR-guided SABR, ideally at a high-volume center with significant experience such as Miami Cancer Institute. The Institute offers a host of other clinical trials and cutting-edge treatments for pancreatic cancer as well.
The MR-Linac is also being used at Miami Cancer Institute to improve outcomes for patients with many other cancers, including those of the prostate, liver, lung, esophagus, rectum, adrenal gland and kidney.
Click here for more information on Miami Cancer Institute’s clinical trials.