Personalising chemotherapy

An interesting clinical trial is under way at Leicester and Loughborough universities, to see whether chemotherapy can be tailored more closely to the needs of the individual patient.

Barry Sharp of Loughborough, the project leader, outlined the move towards “personalised chemotherapy” at the British Science Festival in Guildford.

Compounds based on platinum (cisplatin, carboplatin and oxaliplatin) are used in about 65 per cent of chemotherapy. All patients receive a standardised treatment regime based on their body size and kidney function, although response to the drugs varies substantially.

The aim is to develop a test that clinicians can use before and after dosing, to personalise the regime to maximise benefit and minimise side effects.

Thirty people are taking part in the pilot trial. Researchers take 20ml blood samples and use mass spectroscopy to quantify how much of the administered drug has bound to the target DNA.

They hope to see how the drug dose is distributed through the cells and thereby predict both efficacy and side effects.

If it turns out that test results correlate well with clinical data, then clinicians could for the first time make decisions about dosing on the basis of numerical data from an objective test.

As Dr Sharp says, the benefits to patients in terms of improving effectiveness and reducing harm from platinum chemotherapy are potentially huge.

But at least five years more work will be needed before clear clinical guidelines emerge.

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