Scientists from the The University of Manchester in Manchester, United Kingdom, have identified a protein that could help doctors decide which bladder cancer patients would benefit from a treatment that makes radiotherapy more effective, according to a study [1] published in the British Journal of Cancer (BJC) on Wednesday.

The team from The University of Manchester, funded by the Medical Research Council, found that patients whose bladder tumor had high levels of a protein, called HIF-1?, were more likely to benefit from having carbogen ? oxygen mixed with carbon dioxide gas ? and nicotinamide tablets at the same time as their radiotherapy. The treatment, called ‘CON’, makes radiotherapy more effective.

By comparing levels of HIF-1? in tissue samples from 137 patients who had radiotherapy on its own or with CON, the researchers found the protein predicted which patients benefited from having CON. High levels of the protein were linked to better survival from the disease when patients had radiotherapy and CON. Patients with low protein levels did not benefit from having CON with their radiotherapy.

This fascinating new finding could help doctors adapt their treatments to patients with bladder cancer as well as shedding more light on the disease

The HIF-1? protein indicates low oxygen levels in tumour cells ? a state known as hypoxia. Tumor hypoxia drives cancer treatment resistance and reduces the efficacy of radiotherapy. The CON treatment works by adding oxygen to the oxygen-deprived tumour cells which makes them more sensitive to the radiotherapy. There is evidence hypoxia-modification strategies improve outcome in a number of cancers, including head and neck cancer and bladder cancer.

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Characteristics of bladder cancer
The study’s author, Professor Catharine West, PhD, a Cancer Research UK scientist at The University of Manchester, explained: “Although we have another biomarker that can predict responsiveness to CON and radiotherapy in bladder cancer patients, our findings tell us a bit more about the characteristics of bladder cancer tumors and how they may respond to this treatment.”

“But we desperately need to do more work to find ways to treat those patients who won’t see as much benefit from this.

“And it’s exactly this type of vital research that we and other scientists will be doing at the Manchester Cancer Research Centre ? bringing together a wide range of expertise to revolutionise cancer treatment.”

Nell Barrie, senior science manager at Cancer Research UK, noted: “This fascinating new finding could help doctors adapt their treatments to patients with bladder cancer as well as shedding more light on the disease. “Deaths from bladder cancer are falling in the UK, but more work needs to be done so that this trend continues. More research is needed to helps us find new and better ways to fight bladder cancer.”

For more information:
Hunter, BA, Eustace A, Irlam JJ, Valentine HR, Denley H, Oguejiofor KK, Swindell R, Hoskin PJ, et al. Expression hypoxia-inducible factor-1? predicts benefit from hypoxia modification in invasive bladder cancer (2014) British Journal of Cancer. doi: 10.1038/bjc.2014.315 [Article]

Photo: Bladder Cancer. Photo courtesy: The University of Manchester.

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