Timothy N. Showalter
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View article: Artificial Intelligence impact on decision-making regarding short-term ADT with prostate radiotherapy: ASTuTE clinical trial interim results
Artificial Intelligence impact on decision-making regarding short-term ADT with prostate radiotherapy: ASTuTE clinical trial interim results Open
Short-term androgen deprivation therapy (ST-ADT) improves outcomes for intermediate-risk prostate cancer (IR-PC) but has toxicity. This trial assesses multimodal AI (MMAI) biomarkers in ST-ADT decision-making for men receiving radiotherapy…
View article: A multicentre implementation trial of an Artificial Intelligence-driven biomarker to inform Shared decisions for androgen deprivation therapy in men undergoing prostate radiotherapy: the ASTuTE protocol
A multicentre implementation trial of an Artificial Intelligence-driven biomarker to inform Shared decisions for androgen deprivation therapy in men undergoing prostate radiotherapy: the ASTuTE protocol Open
Background Androgen deprivation therapy (ADT) improves outcomes in men undergoing definitive radiotherapy for prostate cancer but carries significant toxicities. Clinical parameters alone are insufficient to accurately identify patients wh…
View article: A Multicentre Implementation Trial of an Artificial Intelligence-Driven Biomarker to Inform Shared Decisions for Androgen Deprivation Therapy in Men Undergoing Prostate Radiotherapy: The ASTuTE Protocol
A Multicentre Implementation Trial of an Artificial Intelligence-Driven Biomarker to Inform Shared Decisions for Androgen Deprivation Therapy in Men Undergoing Prostate Radiotherapy: The ASTuTE Protocol Open
Background Androgen deprivation therapy (ADT) improves outcomes in men undergoing definitive radiotherapy for prostate cancer but carries significant toxicities. Clinical parameters alone are insufficient to accurately identify patients wh…
View article: First Measurement: Proactive Immune Cell Sparing in Radiation Therapy
First Measurement: Proactive Immune Cell Sparing in Radiation Therapy Open
Purpose Radiation Therapy (RT) can modulate the immune system and generate anti-tumor T cells. However, this anti-tumor-activity is countered by radiation-induced immunosuppression (RIIS). Clinical advantages of proactively sparing RT dose…
View article: Validation of an artificial intelligence-based prognostic biomarker in patients with oligometastatic Castration-Sensitive prostate cancer
Validation of an artificial intelligence-based prognostic biomarker in patients with oligometastatic Castration-Sensitive prostate cancer Open
The ArteraAI MMAI biomarker is prognostic for OS and TTCRPC among patients with omCSPC and may predict for response to MDT. Further work is needed to validate the MMAI biomarker in a broader mCSPC cohort.
View article: The effect of one-room CT guided brachytherapy on procedure time and cost in the treatment of cervical cancer
The effect of one-room CT guided brachytherapy on procedure time and cost in the treatment of cervical cancer Open
The results indicate that reducing procedure time (using ORBT) can lead to cost savings, depending on the current workflow. Savings seem to depend mostly on applicator placement location, number of patients per year, and involved personnel.
View article: Prostate Cancer Risk Stratification in NRG Oncology Phase III Randomized Trials Using Multimodal Deep Learning With Digital Histopathology
Prostate Cancer Risk Stratification in NRG Oncology Phase III Randomized Trials Using Multimodal Deep Learning With Digital Histopathology Open
PURPOSE Current clinical risk stratification methods for localized prostate cancer are suboptimal, leading to over- and undertreatment. Recently, machine learning approaches using digital histopathology have shown superior prognostic abili…
View article: Impact of baseline lymphopenia on outcomes of definitive treatment for locally advanced cervical cancer
Impact of baseline lymphopenia on outcomes of definitive treatment for locally advanced cervical cancer Open
In this single institution experience of LACC treated with definitive CRT, we found that baseline lymphopenia trends toward inferior OS and PFS.
View article: Predicting radiation‐induced immune suppression in lung cancer patients treated with stereotactic body radiation therapy
Predicting radiation‐induced immune suppression in lung cancer patients treated with stereotactic body radiation therapy Open
Background Stereotactic body radiation therapy (SBRT) is known to modulate the immune system and contribute to the generation of anti‐tumor T cells and stimulate T cell infiltration into tumors. Radiation‐induced immune suppression (RIIS) …
View article: Systemic Anticancer Therapy and Overall Survival in Patients With Very Advanced Solid Tumors
Systemic Anticancer Therapy and Overall Survival in Patients With Very Advanced Solid Tumors Open
Importance Two prominent organizations, the American Society of Clinical Oncology and the National Quality Forum (NQF), have developed a cancer quality metric aimed at reducing systemic anticancer therapy administration at the end of life.…
View article: 629-E Randomized trial comparing conventional vs novel treatment planning technique to improve the immune system during lung SBRT
629-E Randomized trial comparing conventional vs novel treatment planning technique to improve the immune system during lung SBRT Open
Background Despite its common epigenetic suppression in multiple cancers, STING signaling has emerged as a major pathway for augmenting tumor cell antigenicity and initiation of T cell responses.1 2 Another aspect of intact activation of S…
View article: Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase-II Clinical Trial
Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase-II Clinical Trial Open
BACKGROUND: Precision breast intraoperative radiation therapy (PB-IORT) is a novel method of IORT that uses customized CT-based treatment plans and high-dose-rate (HDR) brachytherapy. We conducted a phase-II multi-institution trial to eval…
View article: End-of-Life Systemic Oncologic Treatment in the Immunotherapy Era: The Role of Race, Insurance, and Practice Setting
End-of-Life Systemic Oncologic Treatment in the Immunotherapy Era: The Role of Race, Insurance, and Practice Setting Open
PURPOSE Receipt of antineoplastic systemic treatment near end of life (EOL) has been shown to harm patient and caregiver experience, increase hospitalizations, intensive care unit and emergency department use, and drive-up costs; yet, thes…
View article: Telemedicine use among patients with metastatic breast cancer during the <scp>COVID</scp>‐19 pandemic: Differences by race, age, and region
Telemedicine use among patients with metastatic breast cancer during the <span>COVID</span>‐19 pandemic: Differences by race, age, and region Open
Purpose Our objective was to describe differences in telemedicine use among women with metastatic breast cancer (mBC) by race, age, and geographic region. Methods This was a retrospective cohort study of women with recurrent or de novo mBC…
View article: Dose differentiated high-dose-rate prostate brachytherapy: a feasibility assessment of MRI-guided dose escalation to dominant intra-prostatic lesions
Dose differentiated high-dose-rate prostate brachytherapy: a feasibility assessment of MRI-guided dose escalation to dominant intra-prostatic lesions Open
We re-optimized HDR brachytherapy plans to escalate DILs dose to a mean D90 of > 150% while maintaining favorable prostate coverage and OARs doses. We propose DIL D90 dose of > 150% (22.5 Gy) as an achievable goal.
View article: Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology
Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology Open
Moderately-escalated treatments were efficacious and well-tolerated. BED ≥ 40 Gy may improve LC, particularly for prostate cancer and patients with favorable survival.
View article: Pan‐cancer analysis of prognostic metastatic phenotypes
Pan‐cancer analysis of prognostic metastatic phenotypes Open
Although cancer is highly heterogeneous, all metastatic cancer is considered American Joint Committee on Cancer (AJCC) Stage IV disease. The purpose of this project was to redefine staging of metastatic cancer. Internal validation of natio…