Perelman School of Medicine at the University of Pennsylvania

Clinical Research - Gastrointestinal Cancer

Strategic direction and overarching themes for the service

Clinical and translational research in the gastrointestinal team in the department of Radiation Oncology at the University of Pennsylvania focuses on:

  • The impact of high-dose radiotherapy on local control and survival in esophageal and pancreatic cancer
  • The nexus of immunotherapy and radiation in pancreatic cancer
  • The use of proton therapy to reduce side effects and escalate radiation dose in a number of disease sites, including esophageal cancer, pancreatic cancer and anal cancer
  • Exploring the role of proton therapy and SBRT in hepatocellular carcinoma.

Description of programs and protocols within the service

Esophageal Cancer


This Phase I trial seeks to identify the maximally tolerated radiation dose (MTD) of dose-escalated proton radiotherapy in combination with carboplatin/paclitaxel for esophageal cancer.  Patients who are 18 years of age or holder with a diagnosis of adenocarcinoma of the esophagus are eligible to participate. Patients on study will receive chemoradiation for 5 weeks followed by surgery 4-8 weeks after. Radiation therapy dose will be escalated to determine the MTD.   Patients on study will have the option of participating in two ancillary studies which include blood draws for analysis of CTCs and a FDG PET imaging Scan. These are being done to assess their utility of use as a treatment response predictor for chemoradiation. Patients will be on study for up to 16 weeks.

Principal Investigator: John Plastaras, M.D.
Coordinator: Jennifer Arrington, MPH
Office: (215) 615-0580

Pancreatic Cancer

UPCC 32213: A phase I dual dose escalation study of radiation and nab-paclitaxel in patients with unresectable and borderline resectable pancreatic cancer

The rationale for this trial is based on a number of recent discoveries in the field of pancreatic cancer:

  1. In some patients, local control (rather than distant metastases) seems to be the dominant clinical problem and the determinant of survival.
  2. Intensification of local therapy with radiation dose escalation has been shown to improve local control and survival in a phase 2 trial.
  3. Nab-paclitaxel (Abraxane) is a promising new drug in pancreatic cancer and preliminary data indicate that it may be a better, more specific, radiosensitizer that those currently in use (5FU and gemcitabine).

We hypothesize that local therapy intensification with radiation dose escalation and pancreatic cancer-targeted radiosensitization with nab-paclitaxel will improve local control and survival in patients with unresectable or borderline resectable pancreatic cancer.

In this clinical trial we will also examine the role of a number of novel biomarkers as predictors of response to the study treatment. These include SPARC, caveolin-1, circulating tumor cells and SMAD4.

Principal Investigator: Edgar Ben-Josef, M.D.
Coordinator: Dana Patsch
Office: (215) 615-5645

 UPCC 14213: A pilot study to evaluate radiotherapy-induced anti-tumor immunity in metastatic carcinoma of the pancreas (details)

Recent evidence suggests that radiotherapy can induce immune response in a number of malignancies, and that this systemic effect may be exploited and augmented with a number of immune modulators to improve cancer control. In this clinical trial, we are characterizing the immune response induced by radiotherapy in patients with metastatic pancreatic cancer.

Principal Investigator: Edgar Ben-Josef, M.D.
Coordinator: Sue Prendergast, R.N.
Office: (215) 662-4267

Hepatobiliary cancer

UPCC 07211: Phase II Study of Proton Beam Irradiation for the Treatment of Unresectable Hepatocellular Cancer and Cholangiocarcinoma (details)

Radiotherapy for liver cancer is largely limited by the dose deposited in liver tissue uninvolved by the cancer. Excess radiation to the uninvolved liver can lead to liver damage and serious toxicity. Due to the unique physical characteristics of protons, this therapy offers significant advantages over standard photon radiation in the treatment of liver tumors. Protons deposit less dose in the liver on the entrance path to the target and almost no dose beyond the target. In this study, we hypothesize that high dose proton therapy will improve the local control and survival of patients with liver cancer.

Principal Investigator: Edgar Ben-Josef, M.D.
Coordinator: Kristi Lelionis M.S., CCRP
Office: (215) 615-3273

UPCC 16213: A Pilot randomized trial of Transarterial Chemoembolization (TACE) with or without Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma (HCC) patients awaiting liver transplantation  (details)

Liver transplant is the best treatment for HCC in patients with advanced cirrhosis, but dropout rates from the waiting list are significant, ranging from 10-20% for tumor progression. “Bridging” therapies such as TACE are used to delay HCC progression and keep patients within transplant criteria

Stereotactic Body Radiation Therapy (SBRT) is a powerful new method of treating liver metastasis. Recent data suggests that it may be useful in HCC as well. The goal of this trial is to find if the addition of SBRT to TACE in patients with HCC awaiting liver transplantation will improve local control and allow more patients to remain on the transplant list.

Principal Investigator: Edgar Ben-Josef, M.D.
Coordinator: Sally McNulty, R.N.
Office: (215) 662-4267

Anal cancer

A Pilot Feasibility Study of Definitive Concurrent Chemoradiation with Pencil Beam Scanning Proton Beam in Combination with 5-Fluorouracil and Mitomycin-C for Carcinoma of the Anal Canal

Anal cancer is highly curable with a combination of chemotherapy and radiation. However, the toxicity of this treatment is high. Proton therapy allows us to deliver similar doses to the pelvic targets but with less dose to normal organs uninvolved by the cancer. We anticipate that this reduction in radiation dose to normal tissue will increase treatment compliance, reduce interruptions (which are potentially detrimental to cancer control) and reduce side effects significantly.

Relavent publications from service members


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