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ERC Starting Grant for individualised high-tech radiotherapy

The major objective of Dr. Daniela Thorwarth, head of Biomedicical Physics in the Department of Radiooncology at Tübingen University Hospital, is to improve cancer patients’ chances of a cure by applying high-precision individualised radiotherapy. The scientist was awarded an ERC Starting Grant, a highly prestigious grant from the European Research Council that supports up-and-coming research leaders. Thorwarth will use the grant to improve the treatment of tumours without increasing side effects.

Dr. Daniela Thorwarth is a physicist and has been the head of Biomedical Physics in the Department of Radiooncology at the University Hospital in Tübingen since 2012. She has been awarded an ERC Starting Grant, a highly prestigious award from the European Research Council, for a project on individualised radiation therapy. © University of Tübingen

ERC Starting Grants are provided for a period of five years to up-and-coming European researchers with a scientific track record that shows great promise. Funding per grant amounts to up to 1.54 million euros and is provided to up-and-coming researchers for particularly innovative ideas. The EU explicitly pursues the principle of “high risk – high gain” and therefore funds projects with an innovative potential that might lead to a paradigm change in their respective field of research. 

Dr. Daniela Thorwarth, a physicist who specialises in medical physics and has been head of Biomedical Physics at the University Hospital of Tübingen since 2012, has been awarded an ERC Starting Grant for her project entitled “bio-iRT: biologically individualised model-based radiotherapy on the basis of multiparametric molecular tumour profiling”. A very complicated sounding title that actually involves work in the field of high-precision radiotherapy aimed at making radiotherapy more precise and reducing the side effects without compromising the effectiveness of radiation treatment. Thorwarth seeks to replace the current notion of anatomy-based dosage with a biologically individualised approach to radiation treatment – in terms of tailoring treatment of head and neck tumours to individual patients, tumours and tissues.

Anatomy-based approach considered as insufficient

Schematic representation of the project idea: the researchers hope that in a few years’ time the results will enable individualised radiation treatment of tumour patients. The researchers hope that the new method improves the treatment of tumour patients without increasing the number of adverse effects. © University of Tübingen

Radiotherapy – alone or in combination with surgery and chemotherapy  plays an important role in the treatment of cancer patients. However, despite modern treatment strategies, advanced tumours in the region of the head and neck can only be cured in around fifty percent of cases. This is partly due to a lack of oxygen in the tumours and other biological resistance mechanisms. 

In addition, current treatment and radiation dose determination is based on the anatomical characterisation of the head and neck tumours. Computed tomography is used to determine the size of the tumour and a biopsy for determining the tumour type. The researchers in Dr. Thorwarth’s team do not consider this to be sufficient and have set out to examine biological and genetic factors affecting a tumour’s response to radiation treatment, combined with functional imaging. 

The future: biologically individualised radiation therapy

Patient with head and neck tumour; immobilisation with a mask enables precision treatment in the radiation room. © University of Tübingen

The researchers in Thorwarth’s team have long been focussing on the development of new technological aspects and techniques to improve the treatment of cancer patients. They have developed more precise radiation sources and computer algorithms that enable the radiation dose to be determined according to a patient’s specific requirements. 

The ERC Starting Grant has now enabled the team to expand the project by numerous parameters; they can integrate other imaging methods into the current technology pool and focus on the biological and genetic properties that affect a tumour’s response to treatment. “We are still developing suitable experiments, but we hope to commence large-scale investigations in 2014,” Thorwarth said. “We want to include numerous new parameters and identify the functional, radiobiological characteristics of cancer cells in order to develop suitable methods for the individualised irradiation of tumours,” the scientist explained. “This knowledge would allow us to specifically treat any tumour.” The examinations of the biological and genetic factors affecting a tumour’s response to radiation treatment are combined with functional imaging in the form of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The research project will also involve statistics methods for analysing the large amount of data collected in the project. This is one of the first studies in the world that combines biological and genetic factors with functional imaging in a single model.

Clinical trials after a short time

The major objective of the radiooncologists from Tübingen: this could be the biologically individualised radiotherapy of the future. Computed tomography section of a patient with a head and neck tumour superimposed with information obtained with functional positron emission tomography (PET; colour-coded) on the potential lack of oxygen in the tumour. The information obtained with PET was used to adapt the radiation dose in the tumour area characterised by oxygen deficiency. The coloured lines represent isodose lines. © University of Tübingen

In contrast to their previous studies, for their new study Thorwarth and her team will use small-animal models with implanted tumours rather than patient data. A distinctive feature of the new study is the combination of many different parameters in a single mathematical model allowing treatment to be individually tailored to the patient – both locally and biologically.

The scientists expect the first concrete results to be available in about five years’ time. “Although individualised radiotherapy will not yet be standard treatment at that point, we still hope to be able to spend the last two years of the five-year project on a study involving a small patient cohort in order to prove the clinical applicability of the method,” Thorwarth says. “Of course we do not yet know whether we will be able to achieve a paradigm change in radiotherapy by replacing the current notion of anatomy-based dosage with a biologically individualised approach to radiation treatment. But whatever happens, we will be able to make new statements on functional imaging, tumour biology and their suitability for treating head and neck tumours,” Thorwarth says.

Further information:
Dr. Daniela Thorwarth
University Hospital of Tübingen
Department of Radiooncology
Biomedical Physics
Hoppe-Seyler-Str. 3
72076 Tübingen
Tel.: +49 (0)7071 29-86055
E-mail: Daniela.Thorwarth(at)med.uni-tuebingen.de

Website address: https://www.gesundheitsindustrie-bw.de/en/article/news/erc-starting-grant-for-individualised-high-tech-radiotherapy