Scientists develop scanners that illuminate aggressive cancer tumors for better treatment

Researchers used a chemical compound to illuminate treatment-resistant cancers on imaging scans, in a breakthrough that could help healthcare professionals better target and treat cancer.

The authors from King’s College London say the use of the radiotracer, an injected compound used in PET scans, could help inform doctors that a patient’s aggressive cancer will not respond to chemotherapy before treatment is administered. This would prevent patients from receiving unnecessary treatments and provide them with alternative options that give them the best chance of beating the disease.

The article “Imaging NRF2 activation in non-small cell lung cancer with positron emission tomography” published in Natural communicationsshows treatment-resistant non-small cell lung cancer tumors “lit up like a Christmas tree” on PET scans when the radiotracer is injected.

Tim Witney, Professor of Molecular Imaging at King’s College London and principal investigator of the study, said: “Currently, there is no rapid, early method to determine whether malignancies are resistant to treatment. Time is of the essence for lung cancer patients. and many cannot afford to wait to see if chemotherapy works. We wanted to increase the window of opportunity for treatment for these patients, giving them more choices and a better chance of survival.

Non-small cell lung cancer is the most common type of lung cancer in the UK and 47,000 people are diagnosed with it each year. Standard care includes surgery, radiation, chemotherapy and immunotherapy, but despite advances in treatment, survival rates have not improved much over the past decade.

Typically, patients with lung cancer will begin a treatment plan, such as chemotherapy, and then wait 12 weeks to have a CT or PET scan to see if the treatment has shrunk the tumor, or if the tumor stayed the same or grew. . But twelve weeks can often be too late to change treatment and end-of-life care is often the only option.

Researchers at King’s have repurposed a radiotracer, currently used as a diagnostic tool in clinical trials in the US and South Korea, to show treatment-resistant tumors on PET scans. The target molecule xCT, a tumor-associated protein found on treatment-resistant tumors. In the study’s images, PET scans from animal models show that tumor-resistant cancer cells glow more brightly than tumors that are sensitive to the treatment.

The authors will now test this in humans with a phase I clinical trial which will begin in January at St Thomas’ Hospital in London. The trial will enroll 35 patients and use the body PET scanner at the hospital’s PET center to visualize xCT with imaging before and after patients receive treatment.

Professor Witney added: “Our study is the culmination of five years of work. Often, cancer patients discover too late that the treatment they are receiving is not working. ¹⁸F-FSPG binds to tumor-resistant cells and lights up like a Christmas tree in imaging, clearly showing aggressive cancer.

“Using this technique, we can deliver the right treatment to the right patient, making it more cost-effective for the NHS and giving hope to patients with aggressive tumors.”

In the same paper, the researchers also show that xCT can also be targeted by an antibody-drug conjugate, a new class of drugs designed as a targeted treatment for treatment-resistant cancer cells, which selectively kills these cells while minimizing unwanted toxicity.

Although the research is still in its early stages, the authors hope it could offer a glimmer of hope to patients with the most aggressive and difficult-to-treat cancers, including lung, pancreatic and breast cancers. .