Case Studies: Supporting safe and effective therapies

Measurement challenges

A wide range of physical, chemical and biological approaches are used to treat diseases and otherhealth conditions, including drugs or physical therapies such as radiotherapy and ultrasound. All ofthese have risks as well as benefits, and accurate measurement is essential to ensure that thetreatment delivered will cure or manage the condition while minimising any harmful side-effects.
All therapies require practical, accurate measurement methods and tools for use in healthcare environments.

Examples for research addressed by EMRP are given in the following case studies:

Better flow measurement, safer patients

Vulnerable patients receiving drug infusions in intensive care or for palliative relief require low volume drug delivery over extended time periods. Infusion systems operating at very slow rates are used to deliver these drugs. Accurate calibrations of the entire infusion system, from the drug reservoir to the patient are required, but current European calibration facilities cannot match hospital needs. Improved EU calibration facilities are required to support delivery of these crucial drugs.

The EMRP project 'Metrology for Drug Delivery' developed primary standards and characterization methods which have enabled the healthcare community to assess the performance of drug delivery devices. Device properties such as flow rate and temperature dependency need to be well-characterized to ensure safe and efficient patient treatment, as dosing errors can have critical consequences for patients – for example, dangerous under and overshoot of blood pressure in preterm neonates. The measurement tools developed by the project, together with a greater emphasis on the causes and impact of dosing errors, will ultimately reduce these dosing errors.

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Fast track to drug discovery

Identifying new drugs is an expensive business. Drug discovery takes time and may offer developers a relatively low payback, especially for new antibiotic compounds. New, rapid methods to identify potential drugs could reduce cost and accelerate the introduction of new treatments. This is particularly important for antibiotics where many of our current drugs are becoming ineffective as resistance to them develops in the microorganisms they are designed to attack.

The EMRP project 'Metrology for biomolecular origin of disease' established critical design principles which link a drug’s molecular structure to its desired therapeutic effect and demonstrated the use of these principles for creating next-generation antibiotics in the fight against antimicrobial resistance. The results have improved the precision and specificity with which therapeutically-relevant biological activity can be measured, evaluated and exploited. This makes the design process for drugs such as antibiotics more commercially attractive and will support the development of more effective treatments.

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Metrology for molecular radiotherapy

The EMRP project 'Metrology for molecular radiotherapy' was the first European project to develop standard methods for measuring the absorbed dose received by patients undergoing molecular radiotherapy (MRT). This enables radiation doses to be better tailored to individual patients, increasing the effectiveness of treatment for conditions such as cancer and thyroid disease while minimising side effects. The project results will form a valuable basis for implementing individual dosimetry in MRT clinics across Europe and
improving treatment outcomes.

Accurate dose means effective therapy

Molecular radiotherapy can target cancers by going directly to the cancer site. Getting the right amount of a radioactive drug to the cancer is critical, but we are all different and individual responses vary to the same treatment. Accurate radioactivity measurements and sophisticated imaging techniques with the potential to measure the drug’s delivery inside the body are needed to ensure effective personalised cancer care.

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Traceability Boosts Cancer Therapy

Molecular radiotherapy (MRT) effectively targets cancer while minimising damage to healthy tissue. It relies on safely getting short-lived radioactive products directly to the tumour and monitoring up-take using complex patient imaging. The accuracy of these measurements depends on the calibration of instruments for measuring radioactivity, using a method that gives traceability to the SI. Reducing the existing calibration chain will increase administered drug accuracy and lead to optimised individual MRT patient therapies.

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Hitting the target for cancer

Molecular radiotherapy (MRT) is an innovative treatment that effectively targets cancer cells and has great potential to offer personalised treatment tailored to an individual patient’s needs. The key to wider use of MRT is accurate measurement. Improved measurement methods and use of sophisticated medical imaging techniques are needed to ensure that the dose delivered to the tumour can be confidently predicted from the measured radioactivity of the pharmaceutical or device before use.

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High intensity ultrasound treatments

High Intensity Focused Ultrasound (HIFU) is a promising new cancer treatment technique. It uses multiple soundwave beams which travel to tumours without harming healthy cells on the way – enabling safer treatment and opening possibilities for treating cancers deep within the body and brain. But as a new technology, it so far lacks standards and measurement methods to ensure accurate delivery of the sound energy that destroys the cancer.

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Targeting tumours accurately

External radiotherapy is aimed at killing cancerous cells, but can be dangerous to healthy ones. Modern radiotherapy machines focus multiple radiotherapy beams on tumours, which minimises harm to surrounding healthy tissue. To ensure that just the right amount of energy is delivered to kill the cancer, clinicians rely on beam strength measurements. As beam areas get smaller, new measurement methods are needed to accurately measure the strength of the highly focused beams used.

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