Development of new optical coherence tomography technologies to enable individualized cancer therapy
Despite considerable progress in, and impressive effectiveness of various non-invasive cancer treatments such as radiotherapy (RT) and chemotherapy (ChT), the clinical outcomes are somewhat variable because of the variation in individual patient responses. If some convenient measurements from specific patients undergoing specific treatments could be made that report on treatment progress and response, these could be used to select responders from non-responders, alter ‘the doses’ for the remaining treatment, and in general optimize the therapies based on individual treatment feedback.
In this Nighnyi Novgorod + Toronto collaboration, we are developing the enabling optical coherence tomography (OCT) imaging technologies and conducting preclinical and selected clinical studies to come up with quantifiable metrics of tumour and normal tissue responses to a variety of minimally invasive therapies. Specifically, the OCT imaging platform is being expended / refined to enable multiple modes of operation, including direct structural, polarization-sensitive, angiographic, and elastographic regimes. These yields unique high-resolution imaging information on tissue cellular organization, connective tissue compartment, blood microcirculation, and tissue hardness / stiffness, respectively. The ability of these multiple important and complimentary information channels to detect treatment-induced changes is investigated preclinically in a series of normal and tumour-bearing small animals (mice, hamsters) undergoing ChT, RT, and also photodynamic therapy (PDT). A series of treatment-specific multi-modal OCT response metrics are derived, and then tested in a series of further clinical pilot studies of PDT, RT and ChT in the pathologies of oral cavity and skin. Representative project results will be highlighted in this presentation. It is hoped that the multimodal OCT technologies and treatment response metrics thus developed will help usher in the era of “personalized cancer medicine” of the 21st century.