Radiation Oncology Integration and innovation: Enhancing Lymphoma Trial Design and Establishing a Particle Therapy Research Pathway - PROJECT SUMMARY/ABSTRACT Radiation therapy (RT) is a crucial component of treatment for many hematologic malignancies but remains underrepresented in the design and implementation of cooperative-group clinical trials. This R50 Research Specialist Award will support my national and institutional leadership roles integrating RT within the National Clinical Trials Network (NCTN) and Mayo Clinic Comprehensive Cancer Center (MCCCC). My work includes: 1) advancing NCTN lymphoma trial design, 2) establishing high quality RT quality assurance (RTQA), 3) providing mentoring for young investigators, 4) developing infrastructure to enhance NCTN clinical trial enrollment at MCCCC, and 5) develop framework to incorporate carbon ion radiotherapy (CIRT) into NCTN research. As Co-Chair of the NRG Hematologic Malignancies Working Group (NRG-HEM), former Vice-Chair and current Steering Committee member of the Children’s Oncology Group Hodgkin Lymphoma (COG-HL) Committee, and Radiation Oncology Co-Chair of multiple NCTN studies (e.g., AHOD 2131, EA 4241), I have unified national efforts to harmonize RT volumes, dose constraints, and credentialing across NRG, COG, SWOG, ECOG-ACRIN, and ALLIANCE. I lead cross-group mentorship initiatives that have produced consensus guidelines on target nomenclature, organ-at-risk constraints, and total body irradiation techniques for hematologic malignancy trials. At MCCCC, as Particle Therapy Medical Director, I oversee the integration of proton and carbon ion therapy into clinical research. I lead investigator-initiated trials—PROSPER (NCT05033288), a multi-continent comparison of CIRT, proton therapy, and surgery for pelvic sarcomas, and POSEIDON (NCT06386315), a phase II trial testing reduced-dose RT for indolent lymphoma, now the top-accruing lymphoma study at Mayo Clinic Florida. I continue to work with other researchers and programmers to build more effective tools to enhance patient experiences and improve trial accrual through improved access for rural and underserved patients. The R50 will provide 30% protected time to continue current work and expand through three new initiatives: 1. Accrual Growth: Increase NRG-contributed accruals to NCTN hematologic studies by 25% annually through dedicated NRG study champions. Increase MCCCC accruals to NRG trials by 10% annually through RadOnc-GPT platform. 2. AI-Driven RTQA: Develop and validate an AI-based auto-contouring and plan-review tool for lymphoma NCTN trials, building on the AHOD 2131 RTQA framework. 3. CIRT Infrastructure: Establish credentialing, QA processes, and standardized protocol language to enable the inclusion of CIRT within future NCTN protocols. By advancing innovative trial design and RTQA, and mentoring the next generation of clinical investigators, this R50 will strengthen radiation oncology’s role across NCTN and expand access to high-quality cancer research.
