Dr Navita Somaiah

Research funded by the NIHR Biomedical Research Centre (BRC) at The Royal Marsden and The Institute of Cancer Research (ICR), London and pharmaceutical firm KORTUC Inc is investigating whether the common antiseptic hydrogen peroxide can enhance the cancer-killing effects of radiotherapy in breast cancer patients

Of the two million patients affected by breast cancer worldwide, 60-80 per cent are diagnosed with locally advanced disease. This can cause debilitating symptoms that affect their quality of life.

For these patients, radiotherapy with or without hormone therapy is often more appropriate than chemotherapy or surgery. Finding a simple, inexpensive way to improve the effectiveness of radiotherapy would therefore be highly beneficial for patients and health services around the world.

Hydrogen peroxide plays a vital role in normal cellular processes, but at higher concentrations could make tumour cells more sensitive to radiation therapy. Hydrogen peroxide breaks down into molecular oxygen in tumours, thereby potentially overcoming radiation resistance due to oxygen starvation. Dr Navita Somaiah, a Consultant Clinical Oncologist at The Royal Marsden and a Clinician Scientist at the ICR, led a Phase 1 trial to test injecting a gel solution of hydrogen peroxide directly into breast tumours before radiotherapy, and found it to be safe and well tolerated.

The effectiveness of this method is now being evaluated in a randomised, controlled Phase 2 trial called KORTUC, involving 184 patients at six UK centres – The Royal Marsden; Beatson West of Scotland Cancer Centre; The Christie; Royal Cornwall Hospital; Addenbrooke’s Hospital, Cambridge; and University Hospitals of North Midlands – with plans to expand to India. The aim is to apply for licensing of the treatment in the UK at the end of the trial.

Radiotherapy is one of the world’s most widely used cancer treatments, with most oncology centres having access to it in some form. As about 40 per cent of breast cancer patients worldwide are from Brazil, Russia, India and China – all countries with rapidly expanding radiotherapy resources – this safe and simple intervention could have a huge impact around the globe.

The gel is cheap and easy to produce and store, and doesn’t require state-of-the-art equipment to use – so, if approved, it could be quickly rolled out worldwide, including in low- and middle-income countries. And if it is proven to be effective in breast cancer, the intervention could be quickly evaluated for use with other challenging diseases, such as head and neck cancers, cervical cancer and soft-tissue sarcomas.