Study uses radiotherapy to treat and diagnose children’s brain tumours

A world first Cancer Research UK study is looking at radiotherapy to treat and diagnose children’s brain tumours and avoid invasive surgery.

Around 420 children are diagnosed with brain tumours each year in the UK, but groundbreaking radiotherapy research at the Cancer Research UK Cambridge Institute gives new hope for avoiding invasive and dangerous surgery.

The research, which could revolutionise the diagnosis and treatment of paediatric brain cancer, is initially focussing on children diagnosed with medulloblastoma – one of the most common children’s brain tumours.

Around 50 children are diagnosed with a medulloblastoma each year in the UK – accounting for 15-20% of all children’s brain tumour diagnoses. Around 7 in 10 children diagnosed with Medulloblastoma in the UK survive their disease for five years or more, but surgery, radiotherapy, and chemotherapy can cause long-term side effects, devastating a child’s quality of life.

Dr Jessica Taylor, from the CRUK Cambridge Institute, is working on game-changing research which aims to ensure children do not just survive but survive well.

Funded by Cancer Research UK and The Brain Tumour Charity, she is focusing on a type of medulloblastoma called WNT (wingless and integrated) – referring to how the tumour cells look.

She said: “WNT-medulloblastoma tumours typically grow in an area of the brain that is very difficult to operate on without damaging healthy brain. The risk is not only from surgery, but also these tumours have an excess of blood vessels feeding the tumour, which are more likely to haemorrhage during surgery. Around 25% of children who undergo surgery to this part of the brain can suffer from an increased risk of long-term effects such as memory problems, or speech issues.”

Dr Taylor said she hopes her research will create specific treatments in a less invasive and harmful way than the current standard-of-care.

She explained: “We are designing new antibodies that recognise specific proteins on the surface of WNT-medulloblastoma cells and bind to them. These antibodies will be labelled with a radiometal that is taken up by the tumour and we can see with a PET scan. If the tumour is visible on this scan, it would allow the health care team to know that this tumour is WNT-medulloblastoma, without removing the tumour surgically for analysis. We can then plan children’s treatment specifically for this subtype. For example, we know that WNT-medulloblastoma is highly curable with chemotherapy, which could help spare children the significant side effects of being treated with aggressive surgery.”

Using new techniques to distinguish different types of medulloblastoma also has huge potential for diagnosing and treating other brain cancers in future, as new bespoke radiotherapy treatments are being explored as part of the project.

Dr Taylor’s main focus is on harnessing cells in the body to deliver targeted treatment by using a different type of radiotherapy called radioisotope therapy. Traditional radiotherapy is given to children with brain tumours either to the area where the tumour was (if it was surgically removed), the tumour area or the whole brain or spinal cord. With radioisotope therapy, radioactive medicines are used to treat some types of cancer through a drink, capsule or injection. The radioisotope travels around the body’s bloodstream to the area where the cancer is. It is taken up by the cancer cells, delivering a high dose of radiation that destroys them while sparing healthy cells – which means less potentially life-changing side effects for youngsters whose brains are still developing.

Dr Taylor’s work will bind imaging antibodies to drugs and/or radioisotope therapy, simultaneously diagnosing and treating the tumour – also known as a “theranostic approach” – therefore reducing the impact on patients.

Her translational approach to research, and her collaborations with clinicians and researchers both in the CRUK Cambridge Centre, and worldwide, will allow these new theranostic therapies to be fast-tracked to the clinic.

Cancer Research UK scientists laid the foundations for modern radiotherapy back in the early 1900’s and Dr Taylor’s work builds on decades of work to innovate and improve it – all made possible by the generosity of the charity’s supporters. Today, more than 1,000 children and young people receive radiotherapy as part of their treatment in the UK every year That’s why she’s backing a call for people to help drive more progress like this by donating monthly to the charity at cruk.org/donate.

Dr Taylor is part-funded by Cancer Research UK’s RadNet network – seven centres of excellence in radiation, including Cambridge, which have received millions of pounds to develop ‘next-gen’ radiotherapy and make it more personalised and targeted so that everyone gets the best treatment for their cancer.

Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK said: “As the evolution of radiotherapy shows, we’ve been at the forefront of cancer research for over 100 years. From making it more targeted to combining it with other treatments and reducing the number of doses needed, Cancer Research UK has changed clinical practice worldwide and made radiotherapy kinder and more effective. But we must go further and faster.

“We want to bring about a world where everybody lives longer, better lives, free from the fear of cancer – no matter who they are or where they’re from. Powered by public donations, this latest RadNet funding for Dr Taylor’s innovative work will further accelerate improvements in radiotherapy in the clinic and could potentially change the landscape of current brain tumour diagnosis and treatment.”

Dr Taylor added: “Through developing these new therapies, we are collecting huge amounts of data that will allow us to gain a clearer understanding as to why some children get brain tumours. We want to understand why children get these brain tumours in the first place. They’re too young to have been exposed to the environmental factors that contribute to adult cancers. Is paediatric brain cancer all about tiny missteps in development? Could we reverse engineer this pathway and fix it? If not, can we diagnose earlier and treat using kinder therapies that consider quality of life as well as survival? That’s something that really appeals to me. Our long-term aim is to either reduce or completely transform the therapeutic journey.”