Background to project
Ways of measuring response to treatment of prostate cancer in bone do exist, such as X-rays, bone scans, CT scans and MRI, but these imaging techniques aren't great. It can be several months before a response (or lack of it) can be measured, which means that many patients will experience side effects from treatment they are not benefiting from. This project will evaluate a new method of imaging to help guide effective treatment for men with prostate cancer that has spread to their bones.

What they set out to do
Single photon emission computed tomography (SPECT) is a process by which gamma rays are used, in a similar way to an X-ray, to provide a 3D image. The team used the technique to measure quantities of a small molecule called 99mTc-maraciclatide which should be attracted to cancer cells and make them stand out more clearly in the images produced. The team used this technique on 17 men with advanced prostate cancer, which has spread around the body. They measured up to 5 cancers outside of the prostate, in each man before and after treatment. An oncologist then assessed the scans without prior knowledge of the men or their cancers in order to see if the new techniques’ images give the same or better information than current images.

What they found out
The results showed that the 99mTc-maraciclatide was more attracted to cancerous cells and built up within these cells to show a clearer image on the scan where the cancers were. Any men with cancers that had responded to treatment or had stayed stable did not show a build-up of the 99mTc-maraciclatide molecule. The results indicate that this imaging technique can be used to show if the treatment is working. It could also allow any undetected cancers in other parts of the body to be found.

How will this benefit men?
The results indicate that this imaging technique can be used to show if treatments are working or not. The results indicate that measuring treatment effectiveness non-invasively with imaging, could be valuable in monitoring advanced prostate cancer. This would mean that non-responding patients can undergo earlier transition to different treatment and be saved from potential side effects from non-effective therapy. 
However, this is a proof of principle study, which means that the researchers need to do a bigger study to confirm the results. 

Institution - St Thomas' Hospital, London
Researcher - Professor Gary Cook
Grant award - £49,900
Duration - 2013-2015
Reference - PA12-04 Cook

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