Friday 17 February 2012
Scientists at The Institute of Cancer Research (ICR) and The Royal Marsden Hospital have shown that a specialist type of MRI scan can be used to predict which patients will respond to a targeted radiotherapy and monitor response to treatment. The work may help to ensure that patients with advanced neuroendocrine cancers - cancers arising from hormone-producing cells, often in the lungs or gastrointestinal tract - receive the most effective treatment.
The outlook for patients with neuroendocrine tumours that have spread to the liver is poor, with only 20 to 30 per cent surviving for five years or longer. For many patients surgery isn’t possible and some patients don’t respond to chemotherapy. Peptide receptor targeted therapy, a type of radiotherapy which enables radiation treatment to be directed to tumours, avoiding damage to non-cancer cells, offers an important alternative. However, until now doctors have not had a satisfactory way to predict which patients are likely to benefit from treatment or assess whether patients are responding.
In a paper published online today in the journal Radiology, Dr Dow-Mu Koh, Professor Martin Leach, Professor Val Lewington* and colleagues at the Cancer Research UK and EPSRC Cancer Imaging Centre at the ICR and The Royal Marsden have shown that dynamic contrast enhanced (DCE-)MRI can be used to monitor and predict response to peptide receptor therapy. DCE-MRI is a new technique which is particularly effective at measuring blood vessels. As neuroendocrine tumours have a large blood supply, the research team reasoned that they would be able to measure when treatments were working by looking at the reduction in the blood supply as a proxy for the effect on tumours.
Professor Leach says: “Radiopeptide therapy is an important treatment option for patients whose cancer has spread. This test may help doctors to make decisions about which patients should be offered this targeted therapy, and whether to stop treatment if patients aren’t responding, avoiding side-effects for those who won’t benefit.”
Dr Koh says: “We were able to reliably map patients’ livers using a completely non-invasive technique. Importantly, this type of MRI can be carried out on standard equipment, which is already available in hospitals around the country.”
Researchers scanned 20 patients with neuroendocrine liver metastases before treatment and two months after receiving radiopeptide therapy. Rapid and repeated imaging was performed over the tumour area after injection of an intravenous contrast agent. By tracking the time course of the contrast material through the tumour tissue, it is possible to measure the tumour blood supply. By comparing these measurements before and after treatment, the team was able to map whether there had been any reduction in tumour blood supply after treatment.
Importantly, patients who responded to treatment were also found to have a lower contrast material distribution volume and a higher proportion of arterial flow, which could be helpful in assessing whether patients are likely to respond.
Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “Accurately predicting patient response helps doctors to make prompt decisions about the best course of treatment for each individual and this is one of a number of studies that are showing the promise of MRI techniques in helping to achieve this aim.”
The study was carried out at the Cancer Research UK and EPSRC Cancer Imaging Centre at the ICR and The Royal Marsden. The study was funded by Cancer Research UK, the Engineering and Physical Sciences Research Council, the Medical Research Council and the Department of Health.
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Media Contact: ICR Science Communications Manager Jane Bunce on 0207 153 5106 or after hours 077217 47900
Notes to editors:
“The use of dynamic contrast-enhanced magnetic resonance imaging to monitor and predict radiolabelled octreotide therapy response in patients with neuroendocrine tumor liver metastases” with first author Dr Keiko Miyazaki from The Institute of Cancer Research is published online in Radiology on Friday 17 February 2012.
* Professor Val Lewington joined King’s College London in February 2011
The Institute of Cancer Research (ICR) is one of the world’s most influential cancer research institutes.
Scientists and clinicians at the ICR are working every day to make a real impact on cancer patients’ lives. Through its unique partnership with The Royal Marsden Hospital and ‘bench-to-bedside’ approach, the ICR is able to create and deliver results in a way that other institutions cannot. Together the two organisations are rated in the top four cancer centres globally.
The ICR has an outstanding record of achievement dating back more than 100 years. It provided the first convincing evidence that DNA damage is the basic cause of cancer, laying the foundation for the now universally accepted idea that cancer is a genetic disease. Today it leads the world at isolating cancer-related genes and discovering new targeted drugs for personalised cancer treatment.
As a college of the University of London, the ICR provides postgraduate higher education of international distinction. It has charitable status and relies on support from partner organisations, charities and the general public.
The ICR’s mission is to make the discoveries that defeat cancer. For more information visit www.icr.ac.uk
The Royal Marsden NHS Foundation Trust
The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.
Today, together with its academic partner, The Institute of Cancer Research (ICR), it is the largest and most comprehensive cancer centre in Europe treating over 44,000 patients every year. It is a centre of excellence with an international reputation for groundbreaking research and pioneering the very latest in cancer treatments and technologies. The Royal Marsden also provides community services in the London boroughs of Sutton and Merton and in June 2010, along with the ICR, the Trust launched a new academic partnership with Mount Vernon Cancer Centre in Middlesex.
Since 2004, the hospital’s charity, The Royal Marsden Cancer Charity, has helped raise over £50 million to build theatres, diagnostic centres, and drug development units. Prince William became President of The Royal Marsden in 2007, following a long royal connection with the hospital.
EPSRC
The Engineering and Physical Sciences Research Council (EPSRC) is the UK’s main agency for funding research in engineering and the physical sciences. The EPSRC invests around £800 million a year in research and postgraduate training, to help the nation handle the next generation of technological change. The areas covered range from information technology to structural engineering, and mathematics to materials science. This research forms the basis for future economic development in the UK and improvements for everyone’s health, lifestyle and culture. EPSRC also actively promotes public awareness of science and engineering. EPSRC works alongside other Research Councils with responsibility for other areas of research. The Research Councils work collectively on issues of common concern via Research Councils UK.
About Cancer Research UK
- Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research
- The charity’s groundbreaking work into the prevention, diagnosis and treatment of cancer has helped save millions of lives. This work is funded entirely by the public.
- Cancer Research UK has been at the heart of the progress that has already seen survival rates in the UK double in the last forty years.
- Cancer Research UK supports research into all aspects of cancer through the work of over 4,000 scientists, doctors and nurses.
- Together with its partners and supporters, Cancer Research UK's vision is to beat cancer.
For further information about Cancer Research UK's work or to find out how to support the charity, please call 020 3469 6699 or visit www.cancerresearchuk.org