Enhancing Radiation Therapy Through Cherenkov Light-Activated Phototherapy.

As the Director of both the Brain Tumor Immunotherapy Program and the Center for Brain and Spine Metastasis at Duke University, I focus our programmatic interests on the design, optimization, and monitoring of immune-based treatment platforms for patients with intracranial tumors, whether primary or metastatic. Within this broad scope, however, my own group looks more specifically at limitations to immunotherapeutic success, with a particular focus on understanding and reversing T cell dysfunction in patients with glioblastoma (GBM) and brain metastases. We employ a systematic approach to categorizing T cell dysfunction (Woroniecka et al, Clin Cancer Res 2018 Aug 15;24(16):3792-3802), and whereas our earlier work addressed concerns for regulatory T cell-induced tolerance, we now heavily study T cell ignorance and exhaustion, as well. Regarding the former, we recently published the novel phenomenon of S1P1-mediated bone marrow T cell sequestration in patients with intracranial tumors (Chongsathidkiet et al, Nat Medicine 2018 Sep;24(9):1459-1468). Regarding the latter, we have likewise recently identified and characterized exhaustion as a significant limitation to T-cell function within GBM (Woroniecka et al, Clin Cancer Res 2018 Sep 1;24(17):4175-4186). I very much look to collaboratively integrate our approaches with others investigating innovative treatment options. I continue my focus on combining strategies for reversing T cell deficits with current and novel immune-based platforms as a means of deriving and improving rational and precise anti-tumor therapies. It is my sincerest desire to forge a career focused on co-operative, multi-disciplinary, organized brain tumor therapy. Ultimately, my goal is to help coordinate the efforts of a streamlined and effective center for brain tumor research and clinical care. I hope to play some role in ushering in a period where the science and treatment arms of brain tumor therapy suffer no disjoint, but instead represent the convergent efforts of researchers, neuro-oncologists, medical oncologists, radiation oncologists, biomedical engineers, and neurosurgeons alike. I hope to see such synergy become standard of care.

Radiosurgery and SBRT
Image Guided Radiation Therapy (IGRT)
Quality Assurance (QA) in Radiation Therapy
3D Dosimetry

Dr Oldham is the Director of the Duke Medical Physics MS/PhD Graduate Program, and Professor in the Department of Radiation Oncology, with a secondary appointment in the Physics Department at Duke. 

Main current research interests include: FLASH radiation therapy, exploring FLASH mechanisms utilizing the Duke High Intensity Gamma Source (HIGS), a nuclear research accelerator on the Duke campus.  Recent work selected for best in Physics at the annual AAPM meeting.  Radiation and Immunotherapy utilizing mini-grids. Radiation Therapy Enhanced by Cherenkov photo-Activation (RECA) and Comprehensive 3D dosimetry.

Dr Oldham has patented and published on several novel radiation treatment techniques (including XPACT and RECA - Radiotherapy Enhanced by Cherenkov photo-Activation) with exiting potential to invoke systemic anti-cancer immunogenic response.  A phase I clinical trial of XPACT is underway.  The lab has pioneered novel pre-clinical treatment capabilities including mini-beam grids, and ultra-high-resolution IMRT.  The lab has also developed novel optical imaging techniques for high-resolution 3D imaging of vascular networks and fluorescent gene expression in un-sectioned tissue samples.