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Review
. 2024 Jul;34(3):351-364.
doi: 10.1016/j.semradonc.2024.04.008.

Navigating the Critical Translational Questions for Implementing FLASH in the Clinic

Billy W Loo Jr  1 , Ioannis I Verginadis  2 , Brita Singers Sørensen  3 , Anthony E Mascia  4 , John P Perentesis  4 , Albert C Koong  5 , Emil Schüler  6 , Erinn B Rankin  7 , Peter G Maxim  8 , Charles L Limoli  8 , Marie-Catherine Vozenin  9
Affiliations
Review

Navigating the Critical Translational Questions for Implementing FLASH in the Clinic

Billy W Loo Jr et al. Semin Radiat Oncol. 2024 Jul.

Abstract

The "FLASH effect" is an increased therapeutic index, that is, reduced normal tissue toxicity for a given degree of anti-cancer efficacy, produced by ultra-rapid irradiation delivered on time scales orders of magnitude shorter than currently conventional in the clinic for the same doses. This phenomenon has been observed in numerous preclinical in vivo tumor and normal tissue models. While the underlying biological mechanism(s) remain to be elucidated, a path to clinical implementation of FLASH can be paved by addressing several critical translational questions. Technological questions pertinent to each beam type (eg, electron, proton, photon) also dictate the logical progression of experimentation required to move forward in safe and decisive clinical trials. Here we review the available preclinical data pertaining to these questions and how they may inform strategies for FLASH cancer therapy clinical trials.

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Figures

Figure 1.
Figure 1.
Summary of answers to critical translational questions based on current preclinical data.
See this image and copyright information in PMC

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