Los Angeles-Area Biology-Guided Radiation Therapy (BgRT)

City of Hope® Cancer Center Duarte was one of the first three centers in the world to deliver SCINTIX® Biology-Guided Radiation Therapy (BgRT) to treat both early-stage and metastatic cancer, and the second center in the world to deliver radiation using the RefleXion X1 machine.

Advantages of BgRT

SCINTIX® BgRT is delivered using the RefleXion linear accelerator machine, which uses positron emission tomography (PET) signals from the tumor to accurately deliver cancer-killing radiation beams directly to the tumor cells in real time. Tumors are metabolically active, lighting up on PET scans that track metabolic activity (like 18F-fluorodeoxyglucose, or FDG), which allows the machine to precisely target the cancer. The system has the ability to track tumors and the patient’s movements, allowing for a more precise radiation treatment. With this machine’s advanced technical capabilities that allow for better visualization and tracking of tumors, there is potential to improve outcomes for patients with both early-stage and limited metastatic disease. The technology allows clinicians to combine radiation with other novel drugs to improve patient outcomes.  

Present and Potential Future Benefits of Real-time BgRT

SCINTIX® BgRT is used to treat both early-stage and metastatic disease. Potential benefits include:

• Targeting moving tumors by using PET monitoring to enable real-time tumor tracking, which is especially critical when treating tumors in organs with significant movement (for example, the lung)
• Treating oligometastatic and/or oligoprogressive disease (with one to five cancer sites), since BgRT enables same-session treatment of multiple tumors at a time
• Treating difficult-to-find tumors, which normally can’t be clearly detected using standard daily imaging available on most current radiation machines
• Reducing damage to surrounding tissue while using high doses of radiation to eliminate tumors
• As the technology evolves in the future, BgRT could potentially be used to treat polymetastatic disease (more than five tumor sites in a single treatment session)

Who Is Eligible for BgRT?

As of today, the U.S Food and Drug Administration (FDA) has cleared City of Hope’s RefleXion linac for the delivery of:

• BgRT to lung and bone lesions
• Stereotactic ablative radiotherapy (SABR) or stereotactic body radiotherapy (SBRT)
• Intensity modulated radiotherapy (IMRT)

SCINTIX BgRT Clinical Trials at City of Hope

City of Hope currently offers several clinical trials to advance the use of SCINTIX BgRT:

• A Prospective Study of the RefleXion [18F]- FDG PET-CT Subsystem Imaging Performance in Patients with Various Malignancies (IRB 22668)
• Prospective Data Registry and Quality of Life Assessment of Patients Undergoing Radiotherapy with the RefleXion Medical Radiotherapy System (PREMIER) (IRB 21643)
• A Feasibility Study of Bridging Radiation to All Sites of FDG-Avid Disease for Commercial CAR T-Cell Infusion in Patients with Large B-Cell Lymphoma (IRB 22141)
• Phase II Trial of the addition of Biologically Guided Radiation Therapy (BgRT) and Stereotactic Body Radiation Therapy (SBRT) to Tyrosine Kinase Inhibitor in Oligoprogressive Oncogenic Positive Non-Small Cell Lung Carcinoma (IRB 22624)
• Performance and Safety of Biology-Guided Radiotherapy using the RefleXion Medical Radiotherapy System in Different Anatomic Regions (BIOGUIDE-X2) (IRB 24569)
• Posluma (18F-rhPSMA) PET Guided Radiotherapy Planning in Prostate Cancer: A Prospective Study Evaluating POSLUMA PET Tumor Detection on Radiation Therapy Planning and on BGRT Planning on the RefleXion X1 System (IRB 24163)
• A pilot study of BGRT for bone metastases (IRB 23937)