Most ovarian cancers are detected after the tumour has already spread and although patients initially respond well to radical surgery and platinum and taxane-based chemotherapy, most relapse after an average of 18 months. Subsequent treatments generally become less effective as patients build up resistance, so scientists are looking for ways to identify non-responsive patients early in the course of treatment.
In a paper published online this week in the journal Radiology, Professor Nandita de Souza and colleagues at the ICR and The Royal Marsden find that a technique called diffusion -weighted MRI can be used to show a change after just one 21- or 28-day cycle.
“This test could allow us to predict after just one month whether a patient will benefit from the full six month course of chemotherapy,” Senior author Professor de Souza from the ICR and The Royal Marsden says. “This would help make decisions on treatment and mean that patients could avoid the unpleasant side-effects of ineffective treatments.”
From November 2008 to September 2010, forty-two women with ovarian cancer had diffusion-weighted MRI scans before and after their first and third cycles of chemotherapy. Each scan was then used to calculate a figure called an Apparent Diffusion Coefficient (ADC), a measurement of water movement within tissue, which is lower in tumour compared to normal tissue. The team found ADCs rose after just one treatment cycle for many women who were later assessed to have benefited from treatment, and did not change for patients who did not respond.
The MRI technique can also help determine the extent of the cancer, as it is able to detect tiny cancer seedlings that have spread from the ovaries into the peritoneum. Importantly, Professor de Souza says that the scans also have the potential to identify individual tumour deposits that are not responding to treatment for which other treatment options including surgical removal can be considered.
First author Dr Stavroula Kyriazi from the ICR and The Royal Marsden says: “We will be starting a larger trial in four UK hospitals later this year that will assess this technique alongside the current blood tests and scans. We hope to find that it consistently detects the effects of treatment earlier, and that it provides more information about individual tumour sites than standard tests. This test can be done on existing MRI equipment, so if it is found to be effective it could potentially be used to help doctors make treatment decisions for their patients right across the country.”
The research was carried out at the Cancer Research UK and EPSRC Cancer Imaging Centre, Research Data Management and Statistics Unit and Department of Gynaecological Oncology at the ICR and The Royal Marsden. The study was funded by Marie Curie Actions, the ICR, Cancer Research UK and the ESPRC.
Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “We hope that this new approach will allow doctors to monitor tumours much more closely in the future and make quicker decisions if treatments aren’t working. Advanced ovarian cancer is difficult to treat and we’re pleased to be funding the next stage of this research that will develop this test further.”
Media Contact: Science Communications Manager Jane Bunce on 0207 153 5106 or after hours 077217 47900
Notes to editors:
Assessing Chemotherapy Response of Metastatic Ovarian and Primary Peritoneal Cancer with Diffusion-Weighted Magnetic Resonance Imaging: Value of Histogram Analysis of Apparent Diffusion Coefficients by Kyriazi et al is published in Radiology.
* Standard treatment monitoring comprises serum CA125 measurements and CT imaging before and after the 3rd and 6th cycles of chemotherapy.
The Institute of Cancer Research (ICR)
- The ICR is Europe’s leading cancer research centre
- The ICR has been ranked the UK’s top academic research centre, based on the results of the Higher Education Funding Council’s Research Assessment Exercise
- The ICR works closely with partner The Royal Marsden NHS Foundation Trust to ensure patients immediately benefit from new research. Together the two organisations form the largest comprehensive cancer centre in Europe
- The ICR has charitable status and relies on voluntary income
- As a college of the University of London, the ICR also provides postgraduate higher education of international distinction
- Over its 100-year history, the ICR’s achievements include identifying the potential link between smoking and lung cancer which was subsequently confirmed, discovering that DNA damage is the basic cause of cancer and isolating more cancer-related genes than any other organisation in the world
- The ICR is home to the world’s leading academic cancer drug development team. Several important anti-cancer drugs used worldwide were synthesised at the ICR and it has discovered an average of two preclinical candidates each year over the past five years.
For more information visit www.icr.ac.uk
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.
For more information, visit www.royalmarsden.nhs.uk
Marie Curie Actions
The EU’s Marie Curie Actions provide grants at all career stages from post-graduate level to encourage international mobility among Europe’s best researchers. Every year, through the Marie Curie Actions, the EU gives 8 000 researchers the opportunity to work abroad and stimulates partnerships between research and business. The EU will allocate more than €4.5 billion under the scheme between 2007 and 2013. A total of 50,000 researchers have been supported by the Marie Curie Actions since 1996.
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 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 7121 6699 or visit www.cancerresearchuk.org