Improving how well radiotherapy works for patients with rectal cancer
Lead researcher: Miss Rachael Clifford
Location: University of Liverpool
Grant award: £32,500
Dates: August 2019 to August 2020
Bowel Cancer UK/RCS Research Fellow, Miss Rachael Clifford, looked at ways to improve how well radiotherapy works for patients with rectal cancer.
The challenge
Many patients with rectal cancer will be offered treatment before surgery. This is referred to as ‘neoadjuvant’ treatment and is likely to be a combination of chemotherapy and radiotherapy (chemoradiotherapy). Chemoradiotherapy shrinks the cancer and makes it easier for the surgeon to remove. For some people, this can treat the cancer without the need for surgery at all. Avoiding surgery could mean that patients have fewer long-term side effects.
Chemoradiotherapy works better for some people than others. Miss Clifford’s project aimed to find out if we can predict whose cancer might respond less well to the radiotherapy part of the treatment and if this can be improved, so more people could avoid surgery.
The science behind the project
Miss Clifford looked at an enzyme (a protein which helps chemical reactions happen in the body) called acid ceramidase. Radiotherapy is thought to work better in people with lower levels of this enzyme in their cancers. This project used cells taken from patients and grown into 3D model 'miniguts' to look at whether blocking this enzyme with drugs makes radiotherapy more effective.
Results
There are several drugs, some new and some already being used for other purposes, that reduce acid ceramidase levels in these lab models of cancer and increase their response to radiotherapy.
If you like, you can find out more about this work by reading this key research article, published by the researchers.
Other impact
Miss Clifford’s presentations of her research won best presentation at the 2019 British Association of Surgical Oncology conference, and second place at the 2019 Royal Society of Medicine John of Arderne Medal.
The team collaborated with researchers at the University of Cambridge to learn how to grow miniguts, bringing those skills back to the University of Liverpool.
What difference will this project make?
It’s hoped this research might help improve how well radiotherapy works in the future, potentially avoiding the need for major surgery for some patients with rectal cancer and so improving quality of life. Acid ceramidase levels could be used both to predict and improve treatment response in patients.
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