Findings from a recent prospective study show promising safety and patient outcomes data for locally advanced and borderline resectable pancreatic cancer treatment using ablative stereotactic magnetic resonance imaging (MRI)-guided on-table adaptive radiation therapy, also known as SMART. Approximately 25% of the study’s participants were patients treated at the Henry Ford Pancreatic Cancer Center (HFPCC; Detroit, USA).
Titled “Stereotactic MRI-guided on-table adaptive radiation therapy (SMART) for locally advanced pancreatic cancer,” this study was the first phase II, prospective, international, multi-institutional study to deliver ablative doses of radiation to patients with pancreatic cancer.
“As a pioneering institution in the field of MRI-guided adaptive radiation therapy, Henry Ford Health is thrilled to have led this novel study, which was the largest international study of ablative radiation for pancreatic cancer in the world,” said Ben Movsas, Medical Director of Henry Ford Health Cancer and Chair of Radiation Oncology. “Henry Ford was first in the world to treat a patient using the MRIdian MRI-Guided Radiation Therapy system back in 2017. Since then, we have treated many cancer patients with MRI-guided radiation therapy.”
The primary endpoint outcomes from the study were presented at the 64th annual meeting of the American Society for Radiation Oncology (ASTRO; 23–26 October, San Antonio, USA) by Parag Parikh, the principal investigator of the study and Director of Gastrointestinal Radiation Oncology and MR-Guided Radiation Therapy at Henry Ford Cancer.
“In this study, 136 patients were treated with ablative MRIdian SMART at 13 international centres,” said Parikh. “The study’s primary outcome measured grade 3 or higher gastrointestinal toxicity, such as nausea, vomiting or abdominal pain, in the first 90 days after treatment. The study’s primary safety objective was met, with zero incidence of acute grade 3 or higher gastrointestinal toxicity definitively related to SMART treatment.”
Secondary measures of the study include overall survival, local control, distant progression-free survival, and changes in patient-reported quality of life, Parikh explained. While study patients are still early in the follow-up period, preliminary clinical outcomes data of one-year local control and distant progression-free survival were 82.9% and 50.6% respectively. One-year overall survival from diagnosis was 93.9%.