Research to Match Tumours With the Most Effective Treatments

Testing tumour cells to predict whether radiation or surgery would be the best form of treatment.

When treating people with cancer, time can be of the essence, and work is going ahead at the University of Leicester to learn how to predict which tumours can be treated more effectively by radiation therapy and which by surgery; this could save several weeks of inappropriate treatment and hopefully improve treatment outcome.

When you treat bladder cancers with radiation therapy, some will be cured and some will not. Radiotherapy can last for five weeks, and it is only after a period of 3-6 months when it is possible to know whether the treatment has worked.

Those people for whom radiation treatment has failed then have to undergo surgery, which in turn may be less effective because of the time that has passed since diagnosis and because the surgeon is now dealing with irradiated tissue.

If you could test tumour cells and predict accurately whether radiation or surgery would be the best form of treatment, then those who needed surgery could have it much sooner and the surgeon would be dealing with healthy tissue.

Dr Don Jones, who is leading this research in the University’s Biocentre, part of the Department of Cancer Studies and Molecular Medicine, is one of very few people in the UK working in this field.

His research team has identified a biological test called Comet Assay, which, through recording variation in the extent of DNA damage, formation and repair, seem able to predict those cells which are sensitive to radiation and those which are not. They are now working towards transforming the laboratory method for use in clinics, working with bladder tumours. Dr Jones commented:

“For about half of the patients with muscle invasive bladder cancer radiation therapy fails. These patients are disadvantaged as they are exposed to the additional risks associated with both radiation treatment and subsequent surgery, and may experience further disease progression before any secondary treatment is considered. Consequently, the appropriate choice of primary treatment is critical for the outcome of the patient.

“Unfortunately, there is currently no method of predicting outcome prior to radiation treatment. If radiation response could be predicted in advance, the appropriate treatment option could be identified at an earlier stage; radiation treatment could be promoted in patients with tumours expected to respond, whilst patients with non-responsive tumours could be identified and offered surgery at an earlier stage. In this way, hopefully, cure rates and hence survival could be improved and unnecessary treatment avoided.

“We are trying to investigate protocols we use in the lab as predictive tests. Comet Assay might not be the tool that actually goes into clinics. We need to see how we can translate our lab work into a clinical setting. We may need to find out how Comet Assay results occur first.”

Success will lead to the first clinical use of predictive test of tumour Radiotherapy response, and will increase understanding of tumour radiosensitivity.

The research has received funding from Cancer Research UK (CRUK) and involves researchers and clinicians based at the University of Leicester, the Leicester General Hospital and the University of Ulster.

Cancer Research UK relies almost entirely on public donations to fund its life-saving research, and its annual Race for life, supported by Tesco, will take place in Leicester this year on Sunday 10 July, at Western Park.

Leicestershire organisers are hoping to raise £235,000, topping last year’s figure of £226,849. Countrywide, Race for Life aims to raise £23M. The charity funds more than 3,000 scientists, doctors and nurses based throughout the UK. In 2003/2004, Cancer Research UK’s total science spend was around £213M.

Cancer Research UK’s 5 km Race for Life is a series of 162 fundraising walks or runs open to all women across the UK. To enter, log on to www.raceforlife.org or call the hotline on 08705 134 314.