ArticleEBioMedicine2019
Utilizing the genomically adjusted radiation dose (GARD) to personalize adjuvant radiotherapy in triple negative breast cancer management.
Article in EBioMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 59 citations in OpenAlex.
- Toward genomic personalization of breast cancer radiotherapy: foundations, challenges, and a roadmap for clinical integration.Breast (Edinburgh, Scotland) · 2026Review
- Analysis of the Radiosensitivity Index in Paired Preneoadjuvant and Postneoadjuvant Therapy Triple-Negative Breast Cancer.International journal of radiation oncology, biology, physics · 2026Article
- Genomic analysis of radiosensitivity in breast cancer : Identifying pathological determinants and assessing genomic-adjusted radiation dose (GARD) for personalized dose escalation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Radiogenomics and the DNA damage response: opportunities for biomarker-guided radiosensitization in pancreatic cancer.Frontiers in oncology · 2026Review
- Targeting kinesin family member 20A sensitizes stem-like triple-negative breast cancer cells to standard chemotherapy.The Journal of clinical investigation · 2025Article
- Personalized treatment in HPV+ oropharynx cancer using genomic adjusted radiation dose.The Journal of clinical investigation · 2025Observational
- Narrative Review of the Use of Genomic-Adjusted Radiation Dose (GARD) in Radiotherapy.Cancers · 2025Review
- Personalization of Radiotherapy Dose in HPV Positive Oropharynx Cancer Using GARD.medRxiv : the preprint server for health sciences · 2025Article
- Evaluating the Radiation Sensitivity Index and 12-Chemokine Gene Expression Signature for Clinical Use in a CLIA Laboratory.Cancer research communications · 2025Article
- NRG Oncology White Paper on the Relative Biological Effectiveness in Proton Therapy.International journal of radiation oncology, biology, physics · 2025Review
- Genomic predictors of radiation response: recent progress towards personalized radiotherapy for brain metastases.Cell death discovery · 2024Review
- Breast cancer radiobiology: The renaissance of whole breast radiation fractionation (Review).Molecular and clinical oncology · 2024Review
- Evaluating the Radiation Sensitivity Index and 12-chemokine gene expression signature for clinical use in a CLIA laboratory.bioRxiv : the preprint server for biology · 2024Article
- The art of war: using genetic insights to understand and harness radiation sensitivity in hematologic malignancies.Frontiers in oncology · 2024Review
- Review
- Individualising radiation therapy decisions in breast cancer patients based on tumour infiltrating lymphocytes and genomic biomarkers.Breast (Edinburgh, Scotland) · 2023Review
- Integrating Radiosensitivity Gene Signature Improves Glioma Outcome and Radiotherapy Response Prediction.Medicina (Kaunas, Lithuania) · 2022Article
- Exploring breast and prostate cancer RNA-seq derived radiosensitivity with the Genomic Adjusted Radiation Dose (GARD) model.Clinical and translational radiation oncology · 2022Article
- Breast Cancer in Geriatric Patients: Current Landscape and Future Prospects.Clinical interventions in aging · 2022Review
- Pan-cancer prediction of radiotherapy benefit using genomic-adjusted radiation dose (GARD): a cohort-based pooled analysis.The Lancet. Oncology · 2021Article
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundUtilizing the linear quadratic model and the radiosensitivity index (RSI), we have derived an expression for the genomically adjusted radiation dose (GARD) to model radiation dose effect. We hypothesize GARD is associated with local recurrence and can be used to optimize individual triple negative breast cancer (TNBC) radiation dose.
methodsTN patients from two independent datasets were assessed. The first cohort consisted of 58 patients treated at 5 European centers with breast conservation surgery followed by adjuvant radiotherapy (RT). The second dataset consisted of 55 patients treated with adjuvant radiation therapy.
findingsIn cohort 1, multivariable analysis revealed that as a dichotomous variable (HR: 2.5 95% CI 1-7.1; p = .05), GARD was associated with local control. This was confirmed in the second independent dataset where GARD was the only significant factor associated with local control (HR: 4.4 95% CI 1.1-29.5; p = .04). We utilized GARD to calculate an individualized radiation dose for each TN patient in cohort 2 by determining the physical dose required to achieve the GARD target value (GARD ≥ 21). While 7% of patients were optimized with a dose of 30 Gy, 91% of patients would be optimized with 70 Gy.
interpretationGARD is associated with local control following whole breast or post-mastectomy radiotherapy (RT) in TN patients. By modeling RT dose effect with GARD, we demonstrate that no single dose is optimal for all patients and propose the first dose range to optimize RT at an individual patient level in TNBC.
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