There has been an encouraging increase in the number of cancer therapies over recent years but this has left a challenge. How do we get the right patients on the right drugs quickly? There are several strategies to address this problem but non-invasive imaging is the only one that can look at the whole tumour as it evolves over time. Conventional imaging techniques measure the size and location of suspicious lesions and allow doctors to make decisions about patient management but they fail to look at how the tumour is functioning, therefore they inform up to a point but they can also sometimes be misleading. There is an emerging range of molecular imaging techniques that try to address the problem of assessing tumour function. The most widely applied of these functional assessments is radionuclide imaging, of which the most promising is a technique called positron emission tomography or PET. PET visualises labelled molecules that are injected into the body, these molecules specifically ‘home in’ to the tumour and give a visual readout of tumour characteristics. Doctors can then use this information to guide treatment decisions, which might include giving a patient a particular therapy or crucially taking them off a therapy that is not working (and may be causing side effects) onto drugs that are most likely to have clinical benefit. This is important in order to get the best outcome for the patient but is also a cost-effective way to administer new cancer drugs.
There has been a lot of investment in these technologies in Glasgow over the last few years from almost all parts of the Glasgow Cancer Centre, but with the staff and facilities available we can only support limited work. The Glasgow PET teams routinely makes a PET tracer called FDG, a labelled sugar, which is administered to cancer patients and reports back on how much of the sugar their tumour is consuming. Unfortunately, this only measures one aspect of tumour function and we now know from critical work performed in Glasgow and by others that cancers often use, and can be dependent on, nutrients other than this sugar. This opens up great opportunities for potential new treatments but without being able to identify these patients using PET imaging there is a less chance that we can realise these findings in the clinic.
In order to address these challenges, we are asking for extra equipment, staff and consumables to enable us to make a range of promising PET tracers. In the first instance, this will build on a solid research foundation before rationally moving forward and making these molecules available for the benefit of Beatson cancer patients. This initiative will be sustained through further investments and grant applications and will form part of a core strategy for cancer research in Glasgow, with a long term ambition to use this work to leverage funding for a third clinical PET scanner that will increase capacity for patient care as well as research in Glasgow.