Capital Expansion > On the Cutting Edge of Care

On the Cutting Edge of Care

Michael Story, Ph.D., assembled a team of top-level investigators to push the boundaries of what we know about using carbon ion therapy to treat cancer.

By Dan Samorodnitsky, Ph.D. Photography by Paul Flessland

Michael Story, Ph.D., was on the road to retirement.

It was 2022, and at the end of that road he would complete an illustrious 35-year career at the interface of cancer, advanced radiation treatments and charged particle radiobiology. He’d been a renowned cancer researcher at MD Anderson Cancer Center and University of Texas-Southwestern Medical Center in the aftermath of completing his Ph.D. in cellular and molecular radiation biology from Colorado State University.

There was just one big goal he’d have to leave behind — a carbon ion radiotherapy facility. Though the original technology and facility was created in the Lawrence Berkeley National Laboratory in California, it closed in the early 1990s, leaving no facility in the United States. This left carbon ion technology to be adopted by other nations, while Dr. Story and others toiled for decades to bring it back to the U.S.

“We kept getting slapped back — the financial climate, the Great Recession and then COVID-19,” he recalls. He started to think his big goal would be just that — fleeting images in his mind of a world-class carbon ion therapy center in the United States — until Mayo Clinic picked up the gauntlet and decided to build a carbon ion radiotherapy center at the Florida campus.

Not really wanting to retire, and especially not with a new facility so close to fruition, he called colleagues at Mayo Clinic to see if there would be any interest in having someone with his background as a part of the Mayo Clinic in Florida carbon ion radiotherapy team. The answer he got back was resounding. So much so, he now sits in his new office in the Department of Cancer Biology and Radiation Oncology at Mayo Clinic in Florida.

Retirement can wait. Dr. Story is reenergized by helping build the first hospital-based carbon ion radiation therapy center in Jacksonville.

Right Treatment, Right Patients

“That kind of work just hasn’t been done for carbon ion radiotherapy. We’re on the bleeding edge."

Dr. Story is quick to point out that not every person with cancer will be eligible for carbon ion therapy. It’s critical to get patients the exact treatment modality that will work for their cancer, whether it’s chemotherapy, surgery, immunotherapy or some form of radiotherapy. The key is to have as many options as possible.

For example, many patients can be treated with X-rays or protons and have long-lasting positive results. Carbon ions are best used for people with tumors that are radioresistant, like sarcomas and a variety of pancreatic and lung cancers, among others. In an ideal world, it would be best to tailor a patient’s therapy to treatments that are the most appropriate for their disease, whether via carbon ions or some other radiation treatment.

Dr. Story's research aims to personalize cancer treatment by using genetic analysis to find specific patterns in tumor DNA. These patterns can indicate whether a patient might resist traditional radiation therapy. By identifying these genetic markers, doctors can better determine which patients may benefit from alternative treatments, like carbon ion radiotherapy.

“Looking at biomarkers, especially for patient selection, is a critical feature for personalizing therapy,” says Dr. Story.

The Science Behind
Carbon Ion Therapy

Mayo Clinic is pioneering the reintroduction of carbon ion therapy in North America with the construction of a new facility in Jacksonville, Florida. This will be the first clinical carbon ion radiation therapy center of its kind on the continent.

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies? Discover the science behind the treatment.

Abundance of Experts

Dr. Story’s job is to develop the radiobiology research arm of the carbon therapy program and build a program led by multiple top-level investigators. The overall effort in radiation oncology must be multidisciplinary by its nature. It includes researchers from other disciplines, such as Chris Beltran, Ph.D., the program’s lead physicist; Sungjune Kim, M.D., Ph.D., a radiation oncologist and immunologist who leads translational biology efforts; and Brad Hoppe, M.D., M.P.H., the carbon ion radiotherapy medical director.

Together, they’re pushing at the boundaries of what we know about using carbon ion therapy to treat cancer. “Drs. Kim, Beltran and Hoppe are excellent scientists,” Dr. Story says. “We’ll be able to adapt their research from X-rays and protons to use with carbon ions quite readily.”

Mayo Clinic researchers will sample cancerous and normal tissues and examine end points of treatments to see how the course of treatment affects them — to find either advantageous or deleterious effects. This kind of work has been done for many other cancer treatments like chemotherapies, but carbon ion radiation treatment is new to the United States.

“That kind of work just hasn’t been done for carbon ion radiotherapy. We’re on the bleeding edge,” Dr. Story says.

Better understanding the effects of carbon ion therapy on healthy and cancerous tissues will allow clinicians to better tailor treatment for each patient, combining therapies to maximize their cancer-killing power and minimize off-target damage. One area of particular interest is in understanding how DNA repair pathways respond to radiation damage. Every cell in the body has these pathways to fix damage in DNA when it occurs. If there is too much damage, the cell dies. This is the idea behind all radiation therapy — overwhelming cancer cells with DNA damage while avoiding damaging normal tissues as much as possible.

Dr. Story and his team are examining how different DNA repair processes are utilized after radiation therapy to determine which pathways can be amplified or reduced to improve the efficacy of carbon ion therapy.

“What mutations in DNA repair pathway genes could make cancer cells more sensitive to carbon ion radiation?” asks Dr. Story. “What genes can be knocked down, or knocked out, that would make carbon ions that much richer?”

And, just as importantly, what cellular pathways should be protected to keep normal tissues healthy and shielded from damage to give patients the most effective treatment with the best possible outcomes?

Together, the team is working to find ways to genetically prime tumors to be destroyed, prime the immune system to target tumor cells, shield normal tissues from inadvertent damage, and put patients into the treatment pathways that will help them with speed and care.

"Drs. Kim, Beltran and Hoppe are excellent scientists. We’ll be able to adapt their research from X-rays and protons to use with carbon ions quite readily."

Forging Ahead

There will be time for Dr. Story to explore Jacksonville’s restaurants and beaches, the types of things one might do in retirement. For now, he’s busy with his new research lab while watching the Florida campus carbon ion radiotherapy center become a reality, and looking forward to the day when the first patient is treated there.