An international study with the participation of the Bellvitge Health Campus (Bellvitge University Hospital, Catalan Institute of Oncology and IDIBELL) shows that an innovative technique based on nanoparticles injected directly into the tumor can reinforce the effect of radiotherapy on people with head and neck cancer who cannot receive conventional chemotherapy.
The research, published in the journal JAMA Otolaryngology-Head & Neck Surgery, evaluates the use of NBTXR3 intratumor radioenhancer combined with radiotherapy in people with locally advanced cancer, mainly of advanced age and with a high comorbidity load, a very common profile in clinical practice but with few therapeutic alternatives.
A clinical need not covered
In head and neck cancer, standard treatment usually includes chemotherapy with cisplatin associated with radiotherapy. However, up to a third of people cannot receive this drug for reasons such as age, fragility, or the presence of other health problems. The study focuses on this group often underrepresented in clinical trials and with an unmet clinical need.
“This strategy allows to enhance the effect of radiotherapy directly on the tumor, without exposing the person to the systemic effects of chemotherapy, which is especially relevant in elderly people or those with comorbidities”, explains Dr. Carlos Arranz, from the Maxillofacial and Oral Surgery Service of the Bellvitge University Hospital and researcher at the Bellvitge Biomedical Research Institute (IDIBELL).
An effective and secure strategy
From the radiobiological point of view, the study shows how this technology can improve the effectiveness of treatment without increasing toxicity. “The radioenhancer acts by amplifying the effect of radiotherapy in a very localized way, which allows to increase tumor destruction without increasing the damage to healthy tissues. This opens the door to more precise strategies adapted to people with complex clinical profiles”, says Dr. Isabel Linares, from the Department of Radiation Oncology of the Catalan Institute of Oncology and researcher of the ONCOBELL program of the Bellvitge Biomedical Research Institute.
The clinical trial, carried out in 20 European centers with the participation of 56 people, shows a tumor response of 82% in the primary tumor treated with the combination of NBTXR3 and radiotherapy, with complete responses in almost two thirds of cases. Global median survival is 18 months, a figure higher than historically described with radiotherapy alone in this type of population. In terms of safety, the observed adverse effects have been like the usual radiotherapy.
Although it is an initial phase study, the results have allowed a phase 3 clinical trial to be launched to confirm the effectiveness and safety of this strategy in a higher number of people.
A study framed in a reference oncological model
This work is part of the collaboration model of the Bellvitge Health Campus, which integrates assistance, research and teaching. This ecosystem and the joint work of the Bellvitge University Hospital, the Catalan Institute of Oncology, IDIBELL and the University of Barcelona has been accredited by the Organization of European Cancer Institutes (OECI) as the Comprehensive Cancer Centre (CCC), the highest European recognition for the comprehensive approach to cancer.
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center created in 2004 and specialized in cancer, neuroscience, translational medicine and regenerative medicine. It has a team of more than 1,500 professionals who, from 73 research groups, publish more than 1,400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centres accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the HR Excellence in Research program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL is an Accredited Center of the AECC Scientific Foundation (FCAECC).