Proton therapy center will lead research efforts for FLASH cancer treatment

Joshua Palmer writing on a whiteboard

Brain tumors wreak havoc on the nervous system, and in some cases, rob people of their lives. A tumor can destroy healthy cells and can take away talents or sensory functions such as speech or sight.

Early on in cancer treatment technology, radiation using high-energy X-ray beams wasn’t a precise science. Nearby healthy cells were subjected to radiation along with the tumor.

But during the past 60 years, the precision of radiation has become fine-tuned. Among the most recent advances is proton therapy, which uses positively charged particles instead of X-rays to accurately target tumors. The treatment zeros in on tumors without damaging healthy tissue and organs. In the coming years as more studies are completed, it’s possible it could shift to a new type of proton therapy treatment called FLASH.

“FLASH is an exciting treatment but not yet ready for primetime, given the lack of clinical evidence. We don’t know what diseases it will be best used for,” says Joshua Palmer, MD, who specializes in radiation oncology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). He focuses on the treatment of tumors that affect the central nervous system such as brain tumors or cancers of the spine and specializes in pediatric cancers.

A new $100 million proton therapy center will open in 2023 that will allow patients to receive revolutionary cancer care found in a limited number of U.S. hospitals. The new center will be located at a new 385,000-square-foot outpatient facility under construction on Ohio State’s west campus.

Read more about the new proton therapy center

“FLASH is still being tested pre-clinically, but we will have the ability to bring this to our cancer patients on clinical trials,” says Palmer, who will oversee the research.

Proton therapy is precise, but it can take numerous treatment sessions for patients. What makes FLASH so revolutionary is that it allows doctors to provide cancer treatment in one concentrated session.

Proton therapy has been used for about 10 years and there are about 30 to 40 proton therapy centers across the county.

“It’s still not easily available both within the United States and worldwide, but that will likely change,” Palmer says.

The centers are usually located in larger metropolitan areas. And oftentimes, they’re associated with large children’s hospitals.

The proton therapy center at the OSUCCC – James will partner with Nationwide Children’s Hospital and be the first of its kind in the Columbus metro area.

“Our focus is on clinical trials. It’s studying new therapies and bringing them to the clinic. We do that very well here. I think this allows us to break into a new space that we didn’t have before,” Palmer says. “I think it’s just an exciting time for everybody.”

He says the partnership will have a lasting impact.

Brain and spinal tumors affect a unique set of patients, because obviously we treat all different ages and genders. Radiation oncology as a specialty is also unique and unlike other specialties that are disease specific, or male or female specific conditions. We run the gamut, and treat everything.”

Read how Nationwide Children's Hospital will use proton therapy for pediatric patients

New therapy could lead to cancer treatment in a single dose

The focus is always to improve care and work consistently to improve treatments that not only lead to improving survival but also improve quality of life after treatment.

“Historical treatments with proton therapy were very rudimentary, kind of like radiation treatments 40-50 years ago using linear accelerators. (Linear accelerators use high energy X-rays or electrons for radiation treatments to treat tumors.) But we are very lucky to have the state-of-the-art proton technology coming that will allow us to provide the absolute best proton treatments anywhere in the world,” Palmer says.

His work will focus on better understanding the types of cancer that best respond to FLASH therapy.

“I think that’s kind of our challenge over the next five to 10 years. We have all these theoretical benefits with FLASH. Can we prove this therapy improves outcomes for our patients, since that is what really matters?” he says.

As technological advances continue, the proton therapy at the new center will allow patients to undergo difficult cancer treatments in a much safer manner.

“The initial phase of research will likely focus on pre-clinical and translational studies,” he says. “Once we get a good understanding of how to integrate FLASH, which will likely be earlier on within the first few years, then we’ll start designing studies to test in humans. My role will be to transition or translate our preclinical findings into the clinic, treating patients.”

A career focused on improving the standard of care

Palmer will use his talents and expertise to continue to eradicate tumors. It’s a specialty he has been passionate about for years.

“I am most interested in treating and running trials where the areas of need are the biggest. I want to focus my research where I can truly make a difference and improve care for our patients.”

Brain tumor research offers life-changing opportunity for patients

“I think it’s great for everyone. If we can change the standard of care, and improve the toxicity for our patients, I think that’s hugely important,” Palmer says. “It’s what brought me into the profession but also what brought me here to The Ohio State University. We have an opportunity to uniquely position ourselves to cause a paradigm shift in oncology care that helps people. Being able to write trials and publish data that helps inform the next standard of care is very important to me.”

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