Development of prognostic screening tools to predict patient response to neoadjuvant chemoradiotherapy treatment for oesophageal adenocarcinoma

Cancer of the oesophagus, or food pipe, is an aggressive type of cancer with poor outlook and is affecting a growing number of people. The main types of treatments are surgery, chemotherapy and radiotherapy, which may be given alone or in combination. Although chemoradiotherapy treatments work well for some, the majority of patients will not respond. Currently there is no way to identify responding or non-responding patients. This means the majority of patients with oesophageal cancer receive chemoradiotherapy treatment with no benefit.
We aim to develop ways of identifying patients who may benefit from chemoradiotherapy treatment, at the point of their diagnosis. Previous work in our lab shows that patients who have higher levels of a certain molecule in their tumours survive longer than patients with lower levels. This molecule is called human leukocyte antigen (HLA-DR). HLA-DR plays an important role in the immune system but it is not known how or why it increases in tumours. We will investigate the role of HLA-DR as a predictor of patient responses. We will also explore other methods of predicting patient responses by tumour tissue analysis. By analysing the levels of immune cells present in tumours, researchers have developed scoring systems that can successfully predict patient outcomes in colorectal cancer. So far these scoring systems have not been tested in oesophageal cancer. We will test whether such methods can be used to predict patient responses to treatment using tumour samples collected from patients enrolled on an on-going clinical trial testing two different treatment strategies.
By developing tools to predict patient responses to chemoradiotherapy treatment, this study will help doctors to decide on the best treatment options for patients, as well as increasing our understanding of the role of the immune response in tumours, which will aid development of improved treatments.

Award Date
23 October 2015
Award Value
Principal Investigator
Dr Margaret Dunne
Host Institution
Trinity College Dublin
Health Research Awards