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The Hadassah Medical Organization, the Jerusalem-based hospital system of Hadassah, The Women’s Zionist Organization of America, announces the prospective clinical results of a study demonstrating the feasibility, safety and early efficacy of gantry-less upright proton therapy for lung cancer re-irradiation – an area of critical unmet need in the most common cause of cancer-related deaths worldwide.
The findings confirm that the therapy can safely deliver thoracic re-irradiation while improving normal tissue sparing, a key barrier that has historically limited re-irradiation in lung cancer despite the disease's high prevalence.
P-Cure’s compact proton therapy system, which delivers a beam of radiation that precisely targets tumors, thereby preventing damage to nearby organs and healthy tissue, grew out of a two-year collaboration with oncologists, physicists and physicians at Hadassah.
Hadassah conducted the study at P-Cure’s Proton Therapy Center in Israel, the first and only facility in the world to routinely deliver proton therapy to patients using P-Cure’s upright technology. The Center has pioneered the compact, gantry-less system in partnership with Hadassah for almost three years.
Lung cancer is the leading cause of death from cancer globally, with millions of new cases diagnosed annually and a growing population of long-term survivors who may require additional treatment at a later date. As therapies extend survival, the demand for safe and effective thoracic re-irradiation grows.
Yet solutions remain extremely challenging because of the cumulative toxic radiation exposure to which critical organs – like the lungs, heart, esophagus and spinal cord – are exposed. This is especially so for lung cancer patients because of their often-compromised baseline pulmonary function.
The new study is a milestone for radiation oncology, providing the first prospective data supporting upright proton therapy for thoracic re-irradiation delivered without a rotating gantry. Until now, no prospective clinical data have been published demonstrating the use of gantry-less, image-guided proton therapy for this high-risk patient population.
"Thoracic re-irradiation carries a very narrow therapeutic window, and many lung cancer patients are simply not candidates for further radiation using conventional approaches," said Principal Investigator Aron Popovtzer, MD, director of the Hadassah Medical Organization’s Sharett Institute of Oncology. "For the first time ever, we have prospective clinical evidence showing that gantry-less upright proton therapy can be delivered accurately and safely in this setting."
Added lung-cancer expert and Co-Principal Investigator Philip Blumenfeld, MD, Director of Hadassah’s Advanced Radiotherapy Unit, "Given the sheer number of lung cancer patients worldwide, even incremental improvements in safety and tolerability can have an enormous clinical impact. The combination of excellent early tumor control, low acute toxicity and preserved quality of life is highly encouraging."
To evaluate late toxicity and long-term outcomes, patient follow-up is ongoing, as is continued patient enrollment.
All treatment was delivered using P-Cure’s Proton Therapy System, which integrates a compact proton synchrotron, a fixed horizontal beamline, vertical CT imaging and a robotic treatment support that can position the patient both seated and prone.
By eliminating the need for a rotating gantry, the compact system takes up much less space and is much less expensive than standard proton therapy equipment, which weighs 200 tons. That means that healthcare systems around the world will be able to offer advanced radiation treatments previously off-limits to all but the largest facilities (the cost to build and equip a single room able to accommodate traditional proton machinery can exceed $50 million).
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