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Expert opinion: A faster way of knowing if an anticancer treatment is working

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One of the greatest challenges in cancer medicine and in conducting clinical trials for new cancer treatments is to be able to accurately determine their effectiveness as soon possible after administration.

This is important both for an individual patient, who could be switched to a different treatment if the initial approach is ineffective, hence saving time and preventing needles side effects, and also in clinical trials, which often depend on long term end points such as how long patients survive for.

A new technique, currently being tried for the first time in the UK by a group in Cambridge, aims to significantly reduce the length of time needed to determine whether or not a drug is working. It depends on the ability of tumour cells to rapidly use a chemical called pyruvate, which is made naturally in the body during metabolism. In this new technique one of the carbon atoms in pyruvate is changed to a slightly heavier version, which is not radioactive but can be detected using magnetic resonance imaging (MRI).

Dosing patients with this form of pyruvate then allows doctors to determine how fast the tumour is using pyruvate. Normally tumours use pyruvate very quickly, which allows them to be distinguished from normal cells in the body. However, when tumour cells start to die after exposure to an anticancer drug they use pyruvate far more slowly, and this change can be detected within hours, long before the tumour actually shrinks. As a results, doctors can make treatment decisions very quickly, for example whether or not to continue to use the same drug or to switch to a different one.

This approach could also help drastically shorten some clinical trials for new anticancer drugs, which might in turn reduce the costs of producing these drugs, and enable patients to benefit from them far sooner.

reacting to BBC News article on New test measures cancer drugs success.