Jacob Scott, MD, DPhil, of Lerner Research Institute is not your average doctor. In his every day practice, Dr. Scott leverages a multi-dimensional background. From his time studying astrophysics and nuclear engineering while working aboard a submarine, he utilizes his expertise in computer science and mathematical biology to improve patient care. With two innovative technologies, Dr. Scott looks to maximize radiation therapy efficacy and minimize toxicity in his patients.
Says Dr. Scott, “In the last 30 years, we’ve seen a lot of technological advances in medical physics to better shape, aim, and target beams, but we’ve come to the point where it’s hard to see how we can get a lot better.” Leveraging his understanding of biological systems over time, Dr. Scott focused on the aspect of tissue repair to give radiation therapy the next-generation capabilities it so desperately needs.
Considering the different repair rates of various tissue types, Dr. Scott's “Temporal Dose Feathering” concept (also known as temporally feathered radiotherapy (TFRT)) allows for intricate plans of precisely aimed beams that diffuse harmful radiation to surrounding tissues over time. As with standard treatment, beams are arranged to hit the tumor region of interest. In subsequent treatment, however, the beams are placed in a different arrangement to avoid previously hit tissues – allowing them to regenerate. These highly detailed arrangement plans would continue through said patient’s treatment, keeping in mind the repair of all surroundings. In “feathering” the radiation over time, Dr. Scott anticipates delivery of the same amount of radiation with less side effects, or stronger radiation for better results, with the same side effect profile.
Dr. Scott's technology has become multi-faceted as he further considers the concept of time in treatment. In light of recent data in support of re-radiating patients with metastatic disease, Dr. Scott began treating some patients up to a dozen times. Pressured to know his patients’ level of toxicity with each treatment, he developed a technology to temporally correct dose accumulation. With his new algorithm, Dr. Scott is able to map the body of a patient to see all instances of radiation and where it’s been detained. The technology may one day allow for personalized treatment on par with a professionally crafted radiation plan – even to those treated at less advanced institutions.
Through Innovations, Dr. Scott has patents pending for his technologies. Mid-2018, Dr. Scott and team published the TFRT treatment planning strategy and are expecting a second publication early 2019. Dr. Scott has been awarded a small institutional grant to conduct a feasibility study of the treatment with the help of resident physician Shireen Parsai, MD. The trial is underway, having enrolled the first patient in the wee days of 2019. An RO1 has been written and submitted to the NIH to expand trials of the technology to show efficacy. Should the trials be successful, Dr. Scott expects interest from several tech companies and opportunities for licensing through Innovations.