Dutch researchers at UMC Utrecht are expanding their research on potential treatments for pancreatic and head and neck cancers with MR-guided radiotherapy and ultrasound, respectively, using almost €1.5 million (over $1.6 million) provided by KWF Dutch Cancer Society.

Close to €1 million will be used to investigate the impact that combining MR-guided radiotherapy and chemotherapy has on survival and quality of life in patients with locally advanced pancreatic cancer (LAPC).

The rest will go toward research into whether using ultrasound improves blood flow in head and neck tumors, which would increase the efficacy of chemo- and radiotherapy.
MR-Linac radiotherapy for pancreatic cancer
Often detected late, pancreatic cancer is one of the most fatal types of malignancies, with only 4% of patients still alive after 10 years. When diagnosed, 40% already have developed LAPC, where tumors have spread into surrounding blood vessels, preventing patients from being initially operated upon to remove them.

Chemotherapy may shrink tumors, preventing the cancer from metastasizing and enabling surgery to be a possibility, but patients treated with it alone survive only 15 months on average.

Invented by UMC Utrecht and acquired by Elekta, the Unity MR-linac received FDA clearance in 2018. It uses MR imaging to adapt the radiation field to the precise location of the tumor, enabling more accurate radiotherapy delivery, even when tumors move due to breathing or peristaltic movements, and at a higher daily or total dose. This creates a less demanding treatment that spares surrounding healthy tissue, and cuts down on patient hospital visits.

The researchers predict that combining this high radiation dose with chemotherapy will slow down tumor growth, and are currently testing the approach in the the LAPSTAR trial, a collaboration among specialized radiotherapists from UMC Utrecht, Amsterdam UMC, Radboud UMC and Catharina Hospital, the Dutch Pancreatic Cancer Group and the Center for Human Drug Research.

Ultrasound for head and neck cancer
Approximately 3,000 Dutch people are diagnosed with head and neck cancer annually, with the disease having advanced locally within 60% that require surgery, radiotherapy, and chemotherapy.

While most effective in well-circulated, oxygenated tumors, the efficacy of chemotherapy and radiotherapy together are often limited by fragile and hard-to-control tumor blood vessels that obstruct blood flow.

Using ultrasound, the researchers will evaluate if injecting and making gas-filled microbubbles in the bloodstream vibrate with ultrasound in these blood vessels to improve blood flow.

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