Different way, same goal

Radio-oncologists and radiotherapists represented a large proportion of the doctors and clinicians who attended the ICTR-PHE 2012 conference. With them were also biologists and doctors of nuclear medicine. They presented the state of the art of their research that touches on the genetics and biology of tumours as well as on futuristic drugs that selectively target malignant cells. The future of cancer treatment seems to lie in the personalised approach.


When the members of the life sciences community took over from the physicists, the focus remained basically the same. Just another sign of the fact that the different communities are leading the same battle and have the same goal. However, the methodologies and issues can be very different.

The example of hadrontherapy illustrates the situation well: while for physicists this is a relatively well-established concept, medical doctors consider that the amount of patient data available is still very small. Several clinical trials are in progress but conclusive results will not be available for many years.

One of the weapons against cancer that biology can provide radiotherapy with is biomarkers, substances that, once injected into the body, can provide information about the metabolism or, more generally, the functioning of specific cells. The role of genetics and the effects of radiation on vital organs such as the heart or the lungs were discussed in depth at the ICTR-PHE 2012 conference. These studies could help understand why some tumours are radio-resistant, why some patients do not respond to therapy and why some clinical strategies that look foolproof on paper cannot always be used in patient treatment.

Another area where the role of life sciences is becoming crucial in the fight against cancer is in understanding the molecular mechanisms that lead cells into the hypoxic state. We know that malignant cells exposed to radiation can be more effectively damaged if oxygen is present, because oxygen is strongly reactive. However, in advanced tumour states, cells become hypoxic, i.e. they receive less oxygen, and therefore become more resistant to radiotherapy. Understanding the cascade of molecular mechanisms underlying these cell processes would certainly help doctors to develop more effective treatments. At the conference, speakers presented the case of the so-called “bioreductive cytotoxins” – new molecules currently under study that play a role in the response of hypoxic tissue to radiotherapy.

A great many molecules are currently being studied by scientists for the development of new drugs, new radiotracers and new radioprotectors. However, they do not seem to work in the same way in all situations. In other words, what seems to play a crucial role is the specific biological system in which these drugs are used. Every cancer, every structure of the neoplastic tissue, and above all every patient is unique. Understanding these differences can help to achieve a better response to therapy and to reduce toxicity and side effects, thereby decreasing healthcare costs and saving resources. This means that, although at the moment there is a generalised consensus that the combination of different therapies – surgery, radiotherapy and chemotherapy – is the best way to cure patients, doctors also have to take genetics and biodiversity into account in order to improve outcomes.

Several speakers emphasised once again the important role of the interdisciplinary approach. Merging state-of-the-art imaging, the latest findings in clinical medicine and pharmacology, high-tech radiotherapy and effective clinical trials are the key to success. However, such a merger is no trivial issue and cannot be achieved overnight. Meetings such as ICTR-PHE 2012 are vital to fostering these valuable dynamic exchanges. 

Read also previously published Bulletin articles on the ICTR-PHE 2012 conference.

by Antonella Del Rosso & Fabio Capello