More about CRUK RadNet City of London
RadNet City of London has five main themes that all our research works towards. Below is a brief summary and some more examples of links to radiation in everyday life and history.
1. Radiation resistance
Radiation resistance occurs when the tumour cells have the ability to continue growing after being treated with radiation. Across University College London, UCLH and the Crick we are working on this theme from a variety of angles:
• Radiation resistance in brain cancer: Glioblastoma Multiforme (GBM) is an aggressive brain cancer that is very difficult to treat, with an average survival of 15 months. Increasing evidence suggests that this disease relies on a subset of cancer cells with distinct proliferative properties, called cancer stem cells or tumour-initiating cells. We are investigating if these cells repair their DNA in a different way from other cells and are therefore resistant to radiotherapy. We aim to use this information to develop new targeted agents and increase the sensitivity of the cells to radiation in future.
Bar of ‘Caria Radium’ brand skin soap made with natural caria radium spa mud. Image credit: The Science Museum
• Role of oxygen availability in tumours: Work at the Crick is seeking to understand how hypoxia – the state of low oxygen availability – changes the way DNA is repaired, to see if the repression of proteins linked to DNA repair can be used to increase the sensitivity of low oxygen cells to radiation therapy.
The scientific community’s knowledge of radiation has come a long way since the discovery of radioactive materials such as radium and polonium by Marie Curie. Before the dangers of radiation were understood, it was used in a wide variety of products such as toothpaste and water. Unfortunately, this misuse caused many cases of radium poisoning.
Marie Skłodowska Curie. Image from mariecurie.org.uk
2. Radiation combinations
Groups across RadNet City of London are studying the effect of radiotherapy on the immune response in the cells around the tumour with the aim of attaining a combination of therapies which is more effective than the sum of their parts. In addition, we are looking at how agents that target cellular components such as centrosomes and microtubules, may influence response to radiotherapy. We are looking for combinations of therapies to increase immune response or increase radiation induced cancer cell death. For example, controlling blood vessels, and hence everything that they supply to the cells in the surrounding environment is likely to modulate the sensitivity of tumours to radiation. This is closely linked to the work on hypoxia in theme 1. In addition, we are studying the role of non-cancerous cells within tumours, such as immune cells and structural fibroblasts (cells that synthesise connective tissue), on the response to irradiation.
Treatments for cancer can come from many places such as the Pacific yew tree, where the drug Taxol originally comes from.
Photo by Jason Hollinger from Wikipedia Commons / CC BY 2.0
3. Targeting and technology
This theme aims to optimise the radiation dose delivered to tumours in order to maximise its therapeutic potential whilst minimising healthy tissue toxicity. This can be achieved by improving methods to:
1. Predict radiation dose delivery and biological response
2. Target radiation and radioactivity to tumour areas only
Molecular radionuclide imaging and magnetic resonance imaging are some of the imagining techniques used to predict and measure radiotherapy toxicity and outcomes. CT scans with new algorithms can also now account for age of the patient and current observations of toxicity in healthy tissue. This will maximise the benefits of novel precision radiotherapies, particularly during high energy proton therapy for children, who suffer from more serious side effects when their healthy tissue is damaged than adults. Take a look at this batman mask at The Science Museum for children to wear as they undergo radiotherapy:
Photo by Leeds Teaching NHS Hospital Trust from Science Museum Group Collections / CC BY-NC-SA 4.0
Molecular radionuclide therapy, i.e. injectable radioactive therapies, are also being investigated for their potential to deliver high radiation doses specific to tumours only.
4. Outcomes and risk predictions
In order to analyse outcomes and risk predictions effectively there must be a large amount of data to refer to, which can be difficult to obtain. We aim at creating a centralised hub of data, which will enable researchers to apply computational tools to a large sample size and fast track research. This will be a comprehensive platform for radiotherapy data with very detailed inputs such as clinical data, medical images and treatment details.
We are also developing novel methods for risk prediction which facilitate the application of deep learning techniques to rich datasets (such as the datahub) to allow further personalisation of radiotherapy. For example, inoperable non-small cell lung cancer which has a poor survival rate will potentially greatly benefit due to the large variability observed between individuals in this type of cancer.
Predictive anatomical models can also be used to improve the targeting abilities to radiation, to ensure radiation is optimally delivered to the tumour whilst sparing healthy tissues as much as possible. An example is by using computational models of how patients breathe and how tumours and surrounding anatomy change shape during treatment at the radiotherapy planning stage to create personalised treatments less sensitive to such anatomical variations.
Technology is always changing and advancing across the world, from the historical and vital introduction of antiseptics by Sir Joseph Lister, of which you can see some of the old equipment used at the Gordon Museum of Pathology, to using proton therapy technology in CT scans – which has not been done yet. However, you can see a theoretical model of what this might look like via the Wellcome Collection.
Photo by Nigel Allinson from Wellcome Collection / CC BY 4.0
5. Clinical translation
Radiotherapy works by interacting with cellular components such as DNA, which carries genetic information. When DNA is damaged beyond repair, cancerous cells are usually destroyed. Discover the complex structure of DNA with an interactive model. This principle underlies all radiotherapy.
The final stages of radiotherapy research often require the new knowledge and ideas to be tested in human trials to prove they work effectively. This is essential for transferring treatments into appropriate widespread use.
Hospitals across London will work with RadNet City of London in carrying out clinical trials. This includes St. Bartholomew’s, Guys’ and St. Thomas’ Hospital, University College Hospital and Royal Free Hospital. There are many projects at different stages of development.
Photo by Kings College London from Science Museum Collection / CC BY-NC-SA