IMAGING KEY TO PRECISION CANCER TREATMENT

There is enormous potential to improve cancer treatment with precision medical technology, according to Auckland Bioengineering Institute (ABI) researcher, Dr Hayley Reynolds.

Hayley Reynolds is a Senior Research Fellow at ABI where she leads a cancer imaging

group focused on developing predictive software tools for melanoma and breast cancer and imaging biomarkers for prostate cancer. She is supported by a Sir Charles Hercus Health Research Fellowship from the Health Research Council of New Zealand.


Reynolds gained her PhD majoring in Bioengineering in 2009 and a Bachelor of Engineering with Honours in Engineering Science in 2004, both from the University of Auckland. During her PhD, “I created a 3D computational model visualising patterns of melanoma spread using imaging data from thousands of patients. When melanoma and breast cancer metastasise, they are most likely to reach the draining lymph nodes first, and my software allows clinicians to predict where these nodes could be.”


She conducted postdoctoral research in the Biomechanics for Breast Imaging group at the ABI. In 2011, she moved to Melbourne, working at the Peter MacCallum Cancer Centre for eight years. The centre is Australia’s only public hospital solely dedicated to cancer. While there, she worked on developing novel approaches to prostate cancer radiotherapy using MRI and PET/CT, digital pathology assessment, and imaging biomarkers for kidney cancer.


“Recent technical advances in machine learning, big data and radiomics are now driving rapid growth in medical imaging research to optimise patient management decisions. New tools using these technologies have enormous potential to accelerate precision cancer treatment and are useful for disease screening, diagnosis, staging, patient stratification and assessing treatment outcomes,” says Reynolds.


The group has re-established Hayley’s earlier PhD and postdoctoral work at the ABI, further advancing predictive software for melanoma and breast cancer which could be used to guide treatment planning and treatment follow-up. For prostate cancer, they are working on a paradigm shift in prostate radiotherapy termed ‘biologically targeted radiotherapy’ where treatment will be personalised according to the patient’s cancer biology. As part of this, they are developing novel imaging biomarkers to improve upon the current standard of care, which will allow for early interventions if recurrent disease is detected.


Their research will also look at how Māori are affected by these three cancers. Māori have the highest overall cancer mortality rate when compared to New Zealanders with other ethnic backgrounds.


“They have consistently more new cancer registrations than non-Māori. While they have a much lower chance of developing melanoma, when they do their melanomas are often thicker and more serious. Māori men with prostate cancer have a significantly lower survival rate than non-Māori men and they will benefit from advances in follow-up assessment after prostate cancer radiotherapy treatment resulting from our work,” says Reynolds.


Māori women with cancer will also benefit from this research. “The incidence of breast cancer is much higher for Māori women than non-Māori women and when diagnosed, Māori are more likely to have advanced disease. This means the predictive melanoma and breast cancer software tools we’re developing will be particularly relevant for Māori.”


Reynolds has spent much of her career developing tools to improve treatment and how it could be delivered at the clinical level, returning to New Zealand two years ago to continue that work.


“There is huge potential to further develop cancer imaging technology here in New Zealand as part of the rapidly growing field of precision oncology. Ultimately, this will allow us to further tailor treatment to individual patients.”


There are challenges to be overcome. “More research and more imaging data are needed to advance this work. With this we will be able to further our understanding of cancer biology, patterns of metastatic spread and how to detect cancer recurrence after treatment,” says Reynolds.


ABI does a lot of computational modelling, and she says there’s more to be done. And then there’s the cost of infrastructure to deliver the diagnostic and treatment tools. Reynolds points out that while MRI and PET/CT has a role to play in cancer imaging, the machinery comes at a high price.


Breast and prostate cancer are the most commonly diagnosed cancers in New Zealand; melanoma is the fourth most common cancer, with the highest incidence rate in the world. Each year, cancer costs the public health system more than $500 million and projections show this will increase by over 20 per cent in 2021 as our ageing population grows.

Prostate cancer alone will account for 40 per cent of this growth. Reynolds sees it as imperative that patients are provided with the best tools available to ensure the most effective and cost-efficient treatment.