A gift left by a supporter in their Will has helped fund research which could lead to better ovarian cancer treatment contrast concentration within cancer tissue, shows promising potential in accurately monitoring treatment response and predicting patient outcomes.
The results of a ground-breaking pilot cohort study involving Paul Strickland Scanner Centre and Mount Vernon Cancer centre suggest that a new dual-energy CT imaging model could revolutionise the way response to treatment in patients with high-grade serous ovarian cancer is assessed. This innovative approach, centred around measuring CT iodine Legacy gift enables research discovery A gift left by a supporter in their Will has helped fund research which could lead to better ovarian cancer treatment contrast concentration within cancer tissue, shows promising potential in accurately monitoring treatment response and predicting patient outcomes.
The study was led by widely recognised ovarian cancer expert Prof Marcia Hall, Consultant Oncologist at Mount Vernon Cancer Centre.
The results were recently published in the journal Cancer Imaging, in an article titled Development of a dual energy CT based model to assess response to treatment in patients with high grade serous ovarian cancer: a pilot cohort study, authored by Prof Hall, Dr Zena Alizzi, Dr Emmanouil Karteris and Dr Andrew Gogbashian, lead consultant for CT at Paul Strickland Scanner Centre. Around 7,300 cases of ovarian cancer are diagnosed in the UK every year, with women in their mid-seventies at greatest risk.
Despite its name, ovarian cancer most frequently originates in the fallopian tubes rather than the ovaries. The cells in the fallopian tubes, responsible for catching eggs, divide very frequently to allow the podia to move over the surface of the ovary.
The frequency of cell division puts them at an increased risk of errors during cell division, leading to an increased risk of cancer. The challenge lies in detecting malignant cells, as they tend to drop off into the abdominal cavity, where they are impossible to visualise using conventional imaging techniques, until they grow to a mass of cells approximately 0.5cm, or 1/5 inch (the equivalent of 10 million cells).
Typically, doctors rely on the Response Evaluation Criteria in Solid Tumours (RECIST) to assess treatment response, which involves measuring changes in the size of tumour lumps. However, this method is not ideal for ovarian cancer, which often presents as tiny spots or sheets of disease, making it challenging for radiologists to measure accurately.
Prof Hall and her team explored an alternative approach based on iodine concentration measurements from dual-energy CT scans. They found that iodine concentration changes correlated more accurately with patient outcomes compared to RECIST measurements.
CA-125, a blood-based protein marker, is routinely used in the clinic to assess response to treatment for patients with ovarian cancer, although this can sometimes produce false results, it is the best test we have to confirm or refute response to treatment in these patients. However, the regulatory authorities do not accept CA125 response as proof that new treatments are effective. Changes in iodine concentration mirror CA125 responses to treatment much better than RECIST measurements and if validated may prove to be more acceptable as proof of efficacy for novel drugs.
Prof Hall said: “The results from this study suggest a more objective and reliable way to assess treatment responses, especially in patients without measurable lumps.
By analysing iodine concentration changes, doctors may be able to make better-informed decisions about the effectiveness of treatments, ultimately leading to improved patient care.” Despite the encouraging findings, further research and validation are necessary to establish this technique as the new standard for treatment assessment. Prof Hall hopes that evidence produced with additional funding and larger trials involving multiple centres could result in the technique being more widely adopted and lead to the development of more effective treatments.
She said: “The study has the potential to expand the pool of patients eligible for clinical trials, ensuring that even those with non-measurable tumours can benefit from innovative treatments. The research also highlights the need for objective imaging measures, which will contribute to the development of more targeted and effective therapies for high-grade serous ovarian cancer.”
Prof Hall hopes to explore such opportunities to advance this pioneering technique and bring it closer to clinical implementation. She said: “While our research is still in its early stages, the potential benefits for ovarian cancer patients are immense.
“The hope is that this breakthrough could transform the way doctors assess and treat high-grade serous ovarian cancer, providing a brighter outlook for patients.”
It was thanks to a gift left by a supporter in her Will that Paul Strickland Scanner Centre was able to jointly fund a research fellow post for Dr Zena Alizzi, which made this study possible, together with Mount Vernon Cancer Centre, the John Bush Academic Fund and the Cancer Treatment Research Trust.