Tri-national cancer cooperation begins

PET scan of a brain tumour. Image courtesy National Cancer Institute

The focus will be on combining rationally designed, targeted agents with radiotherapy. ECCCA will deploy a combination of genomics, proteomics and preclinical evaluation tools to identify promising agents for combined use in early clinical trials.

At an inaugural symposium to be held at the Netherlands Cancer Institute tomorrow, ECCCA will present its strategic plan and announce the first three clinical translational trials that will be activated in the three participating centres.

Each institute has submitted a trial design that will be executed in all three institutes. In the trials, findings from laboratory analyses will be fed back directly to the clinic to continuously monitor efficacy of the respective treatments.

The first trial, sponsored by the Netherlands Cancer Institute, will assess a new concept in treating breast cancer in which only the tumour, rather than the whole breast, is irradiated. The radiation will be applied using image-guided techniques with a CT scan on a linear accelerator (Image Guided Accelerated Partial Breast Irradiation).

Tumour response to treatment will be measured with PET and MRI spectrometry. Simultaneously, genetic analysis will be carried on the tumour tissue, to assess the response. It is anticipated that by looking at the response, it can be predicted which patients are suitable for this limited, short treatment. The genetic changes during the radiation will also indicate which drugs may enhance the cell-killing effect of radiation.

A second trial will assess Stereotactic Body Radiotherapy (SBRT) in advanced lung cancer as an adjunctive treatment to chemotherapy. Using SBRT, tumours are irradiated with high precision, sparing damage to surrounding healthy tissue. This technology was pioneered at the Karolinska Institutet and is now being tested in various tumours. In this study, SBRT will be given to both primary tumours and metastases, followed by conventional chemotherapy.

The goal is to control tumours in locations that are identified by novel imaging techniques (PET/CT). After SBRT the tumour will regress to a less advanced stage, for which chemotherapy will be more effective. The goal of the treatment is to substantially prolong survival, while counteracting tumour-related symptoms.

The third trial, sponsored by the Institut Gustav Roussy, will assess the affects of inhibiting PI3-kinase/AKT/mTOR, one of the key pathways by which non-small cell lung cancer tumours develop resistance to radiotherapy.

This trial will combine radiotherapy for locally non metastatic lung cancer with chemotherapy and the drug everolimus, which is an inhibitor of mTOR. The first objective is to assess the safety of the combination. In parallel, prospective functional and metabolic imaging will be used (angio scanner and PET) to monitor tumour response. Tumour tissue will also be collected to define molecular patterns of responding tumours.