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Building the evidence for innovative radiotherapy

by Emlyn Samuel | Analysis

26 August 2014

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Radiotherapy
An image of a woman undergoing radiotherapy treatment.

We recently funded some exciting clinical trials using an advanced type of radiotherapy called Stereotactic Ablative Radiotherapy (or SABR for short).  This is pioneering research which we hope could lead to even better treatment options for patients with a range of hard-to-treat cancers.

Although we’re providing the direct funding to run these trials, they also – like all trials – have indirect costs too. So we need support from the NHS and an organisation called the National Institute for Health (NIHR) Clinical Research Network to make sure they happen.

So we were really happy to see that the Government has pledged to support these trials taking place.

The potential of SABR in treating cancer is exciting, but these are early stages for this research, and so we thought we should tell you a bit more about these trials and what it means for cancer patients.

But firstly, what exactly is SABR?

SABR  is a newer type of radiotherapy that uses specialist equipment and imaging to precisely target x-rays to kill cancers, which has made headlines in the past. The very precise nature of this type of treatment means it is given in very high doses, but fewer times (or fractions).

For example, a patient getting SABR might only receive 5-8 fractions to treat their tumour, rather than something like between 15-40 fractions with standard radiotherapy.

But at the moment SABR is only routinely used in the NHS to treat non-small cell lung cancer. This is because this is currently the only cancer type where there’s strong evidence that it is effective enough for routine use.

It has also been used to treat other types of cancer on a case-by-case basis, but critically, there’s no strong evidence for it to be routinely used on other cancer types.

This is why we need clinical trials, to build the evidence base so that if it is proved effective the NHS can make it available to patients on a routine basis.

The trials themselves

We are funding 4 clinical trials using SABR, one to treat pancreatic cancer, one to treat biliary tract cancer and two to treat lung cancer (that has started to spread). These trials are at different stages (or phases) of development and so, while some will be looking at what dose of radiotherapy to give, others will be looking at whether they increase survival rates from cancer.

In any case, they will be a really promising development in our understanding of how SABR could treat a wider range of cancers in the future.

Why do we need government support?

We’ve blogged before about need for the NHS to support research, and this is no different. The money announced at the weekend will provide the treatment costs for the trials to run on the NHS, which combined with NIHR support and the funding we are providing to run the studies and evaluate the trials, is crucial to ensure that research takes place quickly and successfully.

What does it mean for patients now?

We have only recently awarded funding for these trials, and so there will be a period of time before they start recruiting patients.

But we hope for these to be up and running in early 2015 – details will be posted on our clinical trials database when they’re up and running.

Emlyn Samuel is a senior policy manager at Cancer Research UK