Project to refine and fine-tune radiotherapy treatment for cancer

The EU-funded GENEPI project will provide the facility for essential research which will improve and refine radiotherapy for European cancer patients, according to Dr Tobias Hölscher of University of Technology Carl Gustav Carus, Dresden, Germany speaking today (Tuesday 26th October 2004) at the 23rd Meeting of the European Society for Therapeutic Radiation and Oncology.

“We know that there is considerable person-to-person variation in the sensitivity of normal tissues, and tumour tissues, to radiotherapy and that this sensitivity may have a genetic basis”, explained Dr Hölscher. “It is evident also that surgery, chemotherapy drugs and some rare genetic syndromes can influence side effects of radiation, as may other factors such as age, hypertension, other medication and other diseases. Prediction of individual patient's sensitivity to radiotherapy would allow treatment to be tailored to minimise side effects for those most sensitive, whilst allowing more intense, and potentially more effective, treatment for those predicted to have better tolerance”.

The GENEPI (GENEtic pathways for the Prediction of the effects of Irradiation) project aims to provide a scientifically rigorous method of predicting both radiotherapy efficacy and side effects based on a wide range of genetic, physical and other patient-related factors. It will lead to the establishment of the only pan-European database on radiation-related morbidity and will be open to the scientific community all across Europe. A databank in Brussels will be linked to decentralised tissue banks (tumour, skin and blood samples from cancer patients and skin and blood samples from individuals without cancer) in several European countries. After obtaining informed consent, anonymous, coded clinical details will be stored centrally, and this will include information on the effectiveness and side effects of radiotherapy. This will form a detailed outcome-database from a large number of patients who received radiotherapy as part of their treatment for cancer.

GENEPI will therefore allow researchers to determine the incidence of radiotherapy-related morbidity and to investigate which factors influence an individual's response to radiotherapy and radiotherapy-related morbidity, and as such it will provide an essential infrastructure and tool for future research to help modify radiotherapy for specific groups of, and even individual, patients.

The project has started, the first patients have been registered and tissue and data have been collected for further research. Around 3,000 samples, from existing research trials, have already been integrated. The first results on response and side effects are anticipated within the next 2 years with mature data, which will also provide information on the late effects of radiotherapy, available in about 10 years. The collected tissues will be available to researchers for at least twenty years.

“It is estimated that 5-10% of cancer patients could tolerate higher radiotherapy doses, which would boost their chances of survival when using methods for accurately assessing individual radio-sensitivity”, said Dr Hölscher. “The data provided by GENEPI will contribute to a significant benefit in terms of reducing the incidence of late effects of radiotherapy, with associated important socio-economic benefits, while allowing more effective radiotherapy to be given to selected patients, thereby improving cure rates”.