Common metal found in body key to targeted cancer treatment
Scientists have unlocked how a trace metal in tumours could transform cancer care, potentially ending the era of one-size-fits-all radiotherapy treatment.
A common metal found in minuscule quantities within the human body could be critical to the future of cancer treatment, as scientists look to unlock the full potential of radiotherapy.
Personalised medicine has swept across the oncological field in recent years, revolutionising surgery, chemotherapy, immunotherapy and a band of new treatments. But radiotherapy seemingly defied personalisation, a fact a team of Australian scientists believes a new assay test, called Radnost, could change.
The test estimates the body’s natural radiation resistance by gauging the manganese content within a patient through a tumour biopsy. Manganese is a trace mineral in the body and a natural radiation sink; the higher the manganese content, the less responsive someone will be to radiotherapy.
Radiotherapy is administered at standardised levels across all patients for safety, but the Radnost test gives oncologists the opportunity to scale up or down a patient’s radiation dosage based on their own responsiveness.
It also provides the chance to either abstain entirely from radiotherapy where it would be useless, or add it into a treatment plan where it could be particularly effective on a certain patient.
Atomic Oncology, the Australian private company behind the Radnost test, stressed there was much more to do before the test could be widely distributed, with tests under way on its effectiveness across glioblastoma brain cancer, breast cancer, prostate cancer and lung cancer.
Theoretically, measuring manganese content can determine radiation resistance in every cancer form.
“If you’ve got high manganese, then options for radiotherapy for you are not on the table. You need surgery,” radiation oncologist Gerald Fogarty told The Australian. “It means that you will no longer have useless therapies. You’ll have a therapy that works.
“It’ll help us in triaging people to the appropriate modality they need. It’ll stop failures. It means that people won’t get unnecessary treatment, and that’ll have an impact on the health economics of the whole thing.”
Cancer survivor Diana Connell said the test could spare people like herself incredible heartache and months spent undergoing ineffective treatment. Ms Connell has endured six different forms of cancer over more than a decade, tying it to stress she incurred after a period of homelessness escaping family violence alongside her two children.
Through it all, she faced down pancreatic, lung and breast cancer, requiring surgery and, in the final case, reconstruction. She is currently tackling a bone cancer diagnosis.
“There’s a lot of women out there that have, you know, got cancers on top of a horrible history of domestic violence … it’s all linked,” the Geelong domestic violence advocate said. “The scars remain.
“That’s just the emotional toll, but it’s also your health as well. The faster the treatment, the better, if you know that it’s going to work. And if you have a test and know that it’s not going to work, you don’t have to go through all of that.
“This gives hope, and I hope in the next person’s journey that (treatment) might be a bit kinder on them.”
Radiotherapy is used in 50-70 per cent of cancer patients. Proper triaging would reduce billions of dollars in spending on overtreatment and misapplication of radiotherapy.
Atomic Oncology chief executive Michael Lyon said the next step was to test whether treatments could alter manganese levels inside the body to make patients more receptive to radiotherapy.
“The questions that we typically get are: If you can measure the apex predictor of radiosensitivity in any solid tumour, can you manipulate it? And do you know how to? And the answer is ‘yes’ to both questions,” he said.
“We are going down that road.”
The Radnost test was first revealed at the Royal Australian New Zealand College of Radiologists conference on Thursday.
“There’s early promising results stimulating us to go further, and assisting us to get together the people and the resources to be able to investigate this more closely, and hopefully leading to strengthening the clinicians who are treating people suffering from cancer,” Atomic Oncology medical adviser Peter Warfe said.
“Radiotherapy is a really important therapeutic modality, and we’re trying to enhance it to make it a more precise therapeutic tool.”
This revelation comes after the Peter MacCallum Cancer Centre detailed a new colon cancer blood test that could gauge chemotherapy suitability.
The test measured for small tumour DNA fragments in the bloodstream after surgery to show how much cancer remained in the body.
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