Imaging
The European Organisation for Research and Treatment of Cancer Imaging Programme
John Bean, Jocelyne Flament, Pascal Ruyskart and Françoise Meunier
European Organisation for Research and Treatment of Cancer
Abstract
The European Organisation for Research and Treatment of Cancer (EORTC), an international organisation under Belgian law, develops, conducts, co-ordinates and stimulates translational and clinical research in Europe aimed at improving the management of cancer and related problems by increasing survival and also improving patient quality of life. Imaging is now playing an increasingly important role in the treatment of cancer, and in order to further its mission to improve the standard of cancer treatment through the testing of more effective therapeutic strategies, the EORTC has initiated a cancer imaging programme. The objectives of this programme are to build an image exchange platform for cancer clinical trials, create an EORTC Imaging Group, network with stakeholders in cancer imaging, stimulate the integration of imaging components into EORTC studies, participate in major EU initiatives and link up with US co-operative groups. The EORTC is dedicated to improving the quality and consistency of evaluation of cancer treatment within its clinical trials through the incorporation of imaging technologies used for treatment definition for radiotherapy, staging, prediction and evaluation of response, or pathology.
Keywords
European Organisation for Research and Treatment of Cancer (EORTC), EORTC Imaging Group, cancer, oncology, translational research, clinical research, clinical imaging
Disclosure: The authors have no conflicts of interest to declare. Received: 5 March 2010 Accepted: 30 March 2010 Citation: European Oncology, 2010;6(1):92–5 Correspondence: John Bean, Communications Office – Medical Science Writer, EORTC European Organisation for Research and Treatment of Cancer AISBL-IVZW Avenue E Mounierlaan, 83/11, Bruxelles 1200 Brussel, Belgique – Belgïe. E:
john.bean@
eortc.be
There is currently growing interest in a new generation of anticancer agents – biological response modifiers – that is redefining the manner in which cancer clinical trials are conducted. These novel anticancer agents modulate signal transduction pathways and can affect tumour blood supply, cell growth, cell differentiation or other metastatic processes. These mechanism- based anticancer agents certainly hold promise with respect to fighting cancer, but they also raise new challenges for cancer clinical research.
As anticancer agents, biological response modifiers do not necessarily affect the size of a tumour. The therapeutic end-point for these agents might not be the disappearance of the tumour even though tumour growth itself might have ceased. Instead, subtle changes in the cancer density, the margins of the tumour or other features might signal a useful response status at a very early stage in therapy. It could be that features such as blood flow might provide a significant response measurement. In this context, the ability to measure metabolic changes takes on added significance.There is a need to be able to monitor these specific metabolic changes in order to determine whether these novel anticancer agents are indeed manifesting their intended effect.
For the past decade, a method referred to as Response Evaluation Criteria in Solid Tumours (RECIST) has been used to measure
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tumour response utilising imaging modalities such as computed tomography (CT).1,2
The European Organisation for Research and
Treatment of Cancer (EORTC) was part of the research group that proposed the RECIST criteria along with the National Cancer Institute (NCI) of Canada and the US National Institutes of Health (NIH) NCI. This group reviewed assessment methods for tumours visualised by diagnostic imaging and examined the existing World Health Organization (WHO) method of measurement for evaluating response to treatment in solid tumours. Their work enabled the standardisation of the evaluation of cancer treatment response in clinical trials and became a reference for both scientific publications and regulatory submissions.
RECIST is well suited for monitoring cytotoxic cancer therapies where the expectation is that treatment will lead to a decrease in size or even disappearance of a tumour. However, anticancer agents that modify biological responses require new approaches. There is a need to take into account the improved understanding of cancer biology, the new treatment modalities and the steady progress being made in imaging technologies. There is a need to develop biomarkers with specificity for particular biological processes as well as the means to monitor those biomarkers.
Imaging offers many benefits in cancer therapeutics. Imaging is non-invasive, as opposed to pathology for example, and early
© T O UCH BRIEFINGS 2010
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