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Oxygen Levels in Tumors Influence Patient Response to Treatment

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Based on a recent study conducted by researchers from the Manchester Cancer Research Centre, the genetic make-up of a patient’s tumor could be used to personalize their treatment and help determine whether they would benefit from receiving supplemental medication as part of their radiotheapry treatment plan.

Tumors with lower levels of oxygen, known as hypoxia, aren’t known for responding too well to radiation therapy. There are numerous agents that can be administered to patients prior to radiotherapy to help decrease hypoxia, but these are not issued as standard. Being able to calculate how well-oxygenated a patient's tumor is would enable doctors to identify which patients have the most to gain from treatment with hypoxia reducing agents prior to radiotherapy.

Hypoxia has previously been examined by looking at the appearance of certain genes, and Manchester researchers have devised a genetic profile for tumors that should be able to specify the overall level of oxygenation.

Researchers at The University of Manchester, part of the Manchester Cancer Research Centre, performed the study in patients diagnosed with cancer of the bladder and larynx. These patients then underwent either traditional radiotherapy or radiotherapy with the addition of two agents which in combination are known to increase oxygenation: nicotinamide and carbogen.

The team tested patients' tumor samples for 26 genes in order to categorize them as more or less hypoxic, and then analyzed whether this hypoxia score related to the results of treatment.

"Our goal is to find ways of predicting how patients will respond to different treatments. Future cancer treatments will be personalized so that patients get the best therapy for their tumor. Personalizing therapy will not only increase the number of people surviving cancer but also decrease side-effects, as patients would be spared from having treatments that are unlikely to work in their tumor,” said lead researcher Professor Catharine West, from The University's Institute of Cancer Sciences.

A paper recently published in Clinical Cancer Research details how the group discovered that for laryngeal tumors, those specified as more hypoxic saw a considerable benefit from receiving additional agents in accordance with radiation therapy. However, in bladder cancer, patients with more hypoxic tumors did not benefit from adding extra agents.

"We will now test how the hypoxia score works in the clinic in a trial starting in December in patients with head and neck cancer. I have studied ways of measuring hypoxia in tumors for many years so this is a very exciting finding that could help us optimize how we use radiotherapy to get the best outcome for patients,” said West.

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