Preclinical X-ray radiation studies – a roadmap to the clinic
Preclinical trials that use relevant animal models must be undertaken to support clinical trials within medicine. However, historically this has not been the case for clinical radiotherapy trials, which have rarely been supported by preclinical studies. Verhaegen et al. have published an extensive review article that explains the reasons that underpin this situation, how things are changing and the challenges that remain to be met. To use the et al. here is somewhat misleading; this article involved 24 authors from The Netherlands, the UK, Germany and the USA who will be well known to you and are pioneers in the field. The authors conclude that the previous lack of emphasis on preclinical studies was due to a lag in the technology that was available to deliver precision irradiation and subsequently, to integrate such irradiation with imaging. The authors describe how, over the last 15 years, this technology has been developed rapidly and that combined with the availability of updated, clinically relevant animal models, the emphasis on preclinical studies is set to change.
The review article, published in Physics in Medicine and Biology (March 2023), has 11 sections. Each is focused on an aspect of preclinical radiation studies. In each case, the status of technology/research capabilities is described, followed by the current and future challenges that we face. Each section concludes with detail on the advances in science and technology that are required to meet the challenges identified. Broadly, the 11 sections address three major themes: the rapid development of preclinical technology, which facilitates more accurate and efficient radiobiological experimentation; the availability of novel biological models, which now enable the design of more realistic experiments; and a foreword-focused discussion of how we can translate preclinical findings effectively into the clinic. Finally, the exciting and crucial ways in which we can reverse-translate clinical data in order to refine preclinical models and understand the mechanism of clinical response, along with how these advances may inform the next generation of radiation-based cancer therapies, are considered.
We think this roadmap will become a highly valued handbook for our field, and we very much hope that the authors will consider revising and updating it as the field advances. Please consider showing your thanks to the authors by citing their considered and informative work widely.
Reference
Roadmap for precision preclinical x-ray radiation studies. Verhaegen F, Butterworth KT, Chalmers AJ, Coppes RP, de Ruysscher D, Dobiasch S, Fenwick JD, Granton PV, Heijmans SHJ, Hill MA, Koumenis C, Lauber K, Marples B, Parodi K, Persoon LCGG, Staut N, Subiel A, Vaes RDW, van Hoof S, Verginadis IL, Wilkens JJ, Williams KJ, Wilson GD, Dubois LJ. Phys Med Biol. 2023 Mar 31;68(6).
Ester Hammond
Department of Oncology
Oxford University
Oxford, UK
Ester.hammond@oncology.ox.ac.uk
Helen Bryant
Department of Oncology and Metabolism
Sheffield Medical School
Sheffield, UK
h.bryant@sheffield.ac.uk