Michael Baine, MD, PhD

The scientific focus of Dr. Michael Baine's lab surrounds two main topics: 1) the development of novel methods to improve efficacy and reduce toxicities associated with radiation therapy for patients undergoing radiation treatment for cancers of the prostate and bladder and 2) leveraging the vast data derived from routine diagnostic imaging to improve our understanding of how subclinical radiologic characteristics can provide a better understanding of patient-specific disease characteristics and improve treatment decision making using advanced radiomics techniques. In pursuit of this, researchers in the Baine lab are pursuing multiple active projects.

Project 1

In collaboration with Becky Deegan, PhD, a primary project surrounds investigating the role that that tissue may play in both short- and long-term toxicities following pelvic radiation therapy. Specifically, our preliminary data has demonstrated that adiponectin may have significant protective effects against radiation damage to healthy tissues, thus reducing both acute and chronic toxicities following radiation treatment, but does not afford the same protective ability to cancer tissues. Importantly, it is well-established that obesity is associated with higher toxicity levels following radiation therapy as well as is the fact that obese patients, despite having higher levels of adipose tissue in general, paradoxically have lower serum levels of adiponectin. Thus, these findings may provide a biochemical and physiologic mechanism for however clinical observations of higher toxicities associated with obesity. We continue to investigate this association between adiponectin and radiation toxicities through an ongoing observational clinical trial for patients undergoing definitive intent radiation therapy for newly diagnosed prostate cancer.

Project 2

One of the greatest toxicities associated with curative intent radiation therapy is the lifestyle and financial burden encountered by patients undergoing highly fractionated, prolonged radiation treatment courses. While treatment regimens for prostate cancer continue to shorten with many patients currently treated using five-fraction SBRT techniques, a large proportion of prostate cancer patients do not have disease that is amenable to such treatment options and thus are relegated to 28-40 fraction treatment options provided over 5.5-8 weeks. Prophylactic treatment of regional lymph nodes is often employed in patients with a high relative risk of subclinical lymph node involvement but precludes treatment with SBRT. Additionally, recent data has demonstrated that the combination of external beam radiation therapy and brachytherapy provides the highest likelihood of cure of any treatment modality currently available for newly diagnosed prostate cancer. Interestingly, several small studies have suggested that a five-fraction technique can be used to safely and effectively treat lymph nodes prophylactically in conjunction with external beam only treatments in the setting of prostate cancer, however no data currently exists on the safety or efficacy of such a treatment following a brachytherapy procedure. In light of this, we are launching a single institution Phase II clinical trial investigating the use of a five-fraction radiation technique delivered to prostate, seminal vesicles, and regional lymphatics following an HDR brachytherapy boost to determine if the increase in convenience allowed by such a regimen can also be met with acceptable effectiveness and toxicity profiles.

Project 3

Radomics is an exciting and blossoming field with significant problems in both diagnostics and prognostication. Our group is currently investigating the ability of radiomic signatures derived from pre-treatment diagnostic MRIs to predict likelihood of prostate cancer disease recurrence in patients undergoing radical prostatectomy or definitive intent radiation therapy. These radiomics signatures are being used both in combination with, and independent of, current clinically utilized nomograms to determine how they may be able to improve or potentially replace these tools. Additionally, we are investigating the spatial resolution of these radiomic signatures and begin to investigate their association with histologic and genetic alterations within tumor samples to begin to better understand the underlying foundations that results in variable radiomic signatures and how they relate to overall patient outcomes.