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21 March 2025
KHP has carried out a world-first in-human trial using magnetic resonance elastography to assess breast cancer tumours. Key findings show that the scans may prevent the need for surgery post chemotherapy and also detect how the patient is reacting after the first round of treatment with chemotherapy, allowing it to be changed if necessary.
In the blog below Prof Arnie Purushotham and Prof Ralph Sinkus, co-senior authors of the trial’s published paper, summarise the findings. Click here to read the full paper.
Some women diagnosed with breast cancer undergo several cycles of treatment with chemotherapy prior to surgery to shrink the tumour and lymph glands harbouring any cancer cells. This facilitates de-escalation of surgery, reducing the magnitude of any surgical procedure performed, thereby minimising side-effects and improving quality of life.
Currently, the imaging modalities used to assess response to chemotherapy during treatment have a defined limit of accuracy. We conducted a first-in-human study to see if a new technology, Magnetic Resonance Elastography (MRE), could be used to assess the stiffness and stickiness of the tumour tissue throughout the duration of chemotherapy treatment, and before surgery as a surrogate marker for response to the drug treatment.
These scans were conducted in addition to the standard imaging. The results showed two key findings:
- MRE performed at the end of treatment with chemotherapy prior to surgery accurately predicted for complete pathological response. This is where the tissue at surgery shows no evidence of residual cancer when examined under the microscope by the pathologist. This raises the prospect of such patients not requiring any surgery in the future following further validation in clinical trials.
- MRE performed shortly after the first cycle of treatment with chemotherapy identified patients who were unlikely to respond to the drug treatment that they were being given, raising the possibility that in future these patients could have their treatment changed to a different drug or undergo surgical intervention early. This would spare these patients from unnecessarily experiencing the side-effects of chemotherapy.
Ongoing work is being performed to correlate the MRE changes in biomechanical stiffness and stickiness observed with changes in tissue biological characteristics. This will enable a deeper understanding of the scientific findings and potentially have an impact on future patients undergoing similar treatment for breast cancer. Furthermore, MRE has the potential for investigation across other tumour sites in the future.
We are deeply grateful to our patients who participated in this trial at a difficult time of their cancer diagnosis and treatment. This work was a result of an extensive collaborative effort by a research team across King’s Health Partners and INSERM, France.
This trial was supported by the European Union’s Horizon 2020 Societal Challenges Health, the Cancer Research UK and Department of Health Experimental Cancer Medicine Centre, and the Wellcome Leap’s Delta Tissue Programme.
Prof Arnie Purushotham is co-leader of the KHP Cancer Clinical Academic Group. He is Professor of Breast Cancer at King’s College London, Consultant Surgeon at Guy’s and St Thomas’ NHS FT, and Director of the KHP Cancer Centre.
Prof Ralph Sinkus is Professor of Biomedical Engineering at King’s College London.
Sinha AP, Jurrius P, van Schelt AS, Darwish O, Shifa B, Annio G, Peterson Z, Jeffery H, Welsh K, Metafa A, Spence J, Kothari A, Hamed H, Bitsakou G, Karydakis V, Thorat M, Shaari E, Sever A, Rigg A, Ng T, Pinder S, Sinkus R, Purushotham A.
