Lost in application: Measuring hypoxia for radiotherapy optimisation

Niluja Thiruthaneeswaran, Becky A S Bibby, Lingjang Yang, Peter J Hoskin, Robert G Bristow, Ananya Choudhury, Catharine West

Research output: Contribution to journalReview articlepeer-review

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The history of radiotherapy is intertwined with research on hypoxia. There is level 1a evidence that giving hypoxia-targeting treatments with radiotherapy improves locoregional control and survival without compromising late side-effects. Despite coming in and out of vogue over decades, there is now an established role for hypoxia in driving molecular alterations promoting tumour progression and metastases. While tumour genomic complexity and immune profiling offer promise, there is a stronger evidence base for personalising radiotherapy based on hypoxia status. Despite this, there is only one phase III trial targeting hypoxia modification with full transcriptomic data available. There are no biomarkers in routine use for patients undergoing radiotherapy to aid management decisions, and a roadmap is needed to ensure consistency and provide a benchmark for progression to application. Gene expression signatures address past limitations of hypoxia biomarkers and could progress biologically optimised radiotherapy. Here, we review recent developments in generating hypoxia gene expression signatures and highlight progress addressing the challenges that must be overcome to pave the way for their clinical application.

Original languageEnglish
Pages (from-to)260-276
Number of pages17
JournalEuropean journal of cancer (Oxford, England : 1990)
Early online date20 Mar 2021
Publication statusPublished - May 2021

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


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