No Definitive Biomarker Predicts Cancer Response To Radiation Therapy Interview with:
Dr Ananya Choudhury

Consultant and Honorary Senior Clinical Lecturer, Clinical Oncology
The Christie NHS Foundation Trust,
Wilmslow Road
Withington, Manchester, UK

Medical Research: What is the background for this study? What are the main findings?

Response: Although more than half of newly diagnosed cancer patients are treated with radiotherapy, it is still not possible to select patients who will respond and tolerate radiotherapy compared to those who do not. There has been a lot of work done to try and isolate intrinsic biomarkers which will identify either radio-responsive or radio-resistant disease. We have undertaken a systematic view summarising the evidence for biomarkers as predictors of radiotherapy.

Despite identifying more than 500 references during a systematic literature search, we found only twelve studies which fulfilled our inclusion criteria. Important exclusion criteria included pre-clinical studies, studies with no control population and a sample size of less than 100 patients.

Only 10 biomarkers were identified as having been evaluated for their radiotherapy-specific predictive value in over 100 patients in a clinical setting, highlighting that despite a rich literature there were few high quality studies suitable for inclusion. The most extensively studied radiotherapy predictive biomarkers were the radiosensitivity index and MRE11; however, neither has been evaluated in a randomised controlled trial.

Medical Research: What should clinicians and patients take away from your report?

Response: Although these biomarkers show promise there is not enough evidence to justify their use in routine practice. Further validation is needed before biomarkers can fulfil their potential and predict treatment outcomes for large numbers of patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Robust research following the REMARK guidelines such as the importance of including a detailed assay method should be undertaken using where possible tissue collected from large clinical trials. The biomarker should be validated in multiple independent cohorts before being tested in a biomarker-driven phase III study.


Biomarkers of Tumour Radiosensitivity and Predicting Benefit from Radiotherapy
Forker LJ, Choudhury A, Kiltie AE.

Clin Oncol (R Coll Radiol). 2015 Jun 25. pii: S0936-6555(15)00235-6. doi: 10.1016/j.clon.2015.06.002.
[Epub ahead of print

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Dr Ananya Choudhury, & Consultant and Honorary Senior Clinical Lecturer, Clinical Oncology (2015). No Definitive Biomarker Predicts Cancer Response To Radiation Therapy