Using hyperpolarisation and MRI, we can potentially tell whether the drug is working within a few hours of starting treatment.
- Kevin Brindle
There was a time when diagnosing and treating cancer seemed straightforward. Cancer of the breast was breast cancer, for example, and doctors could only choose treatments from a limited arsenal.
Now, the picture is much more complicated. A study published in 2012, led by Carlos Caldas, showed that breast cancer was actually at least ten different diseases. In fact, genome sequencing shows that even one ‘type’ of breast cancer differs between individuals.
While these developments illustrate the complexity of cancer biology, they also offer the promise of drugs tailored to an individual. Chemotherapy is a powerful, but blunt, instrument – it attacks the tumour, but in doing so also attacks several of the body’s other functions, which is why it makes patients so ill. The new generation of cancer drugs aim to make the tumour – and not the patient – sick.
But telling if a patient is sick is easy; telling if the tumour is sick is more challenging. “Conventionally, one assesses whether a tumour is responding to treatment by looking for evidence of shrinkage,” explained Professor Kevin Brindle from the Cancer Research UK (CRUK) Cambridge Institute, “but that can take weeks or months. And monitoring tumour size doesn’t necessarily indicate whether it is responding well to treatment.”
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Image: An abdominal tumour (outlined in white) 'feeding on' carbon-13-labelled glucose (orange) provides a means of testing when cancer drugs are effective enough to affect the health of the tumour
Credit: Kevin Brindle; published in Nature Medicine (2014) 20, 93-97
Reproduced courtesy of the University of Cambridge
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