Around half of all people with solid tumours receive radiotherapy as part of their cancer treatment. However, some tumours do not respond as well as expected because they are hypoxic—meaning they have low oxygen levels. More than 1 in 4 cancer patients have hypoxic tumours, and these tend to be harder to treat successfully.
Why does this matter?
Radiotherapy works best when tumours contain enough oxygen. When oxygen levels are low, treatment is less effective, and outcomes are generally poorer. The good news is that outcomes can improve if treatment is intensified—for example by:
- Giving oxygen‑rich air and a medicine called nicotinamide (CON)
- Using certain chemotherapy drugs alongside radiotherapy (chemoradiosensitisation)
- Increasing the radiotherapy dose
- Adding other systemic treatments
These approaches have been shown to help hypoxic tumours respond better.
The challenge is: we currently don’t have an approved test in routine NHS practice to identify which tumours are hypoxic.
The SELECT programme aims to:
- Develop clinical trials to test whether using hypoxia‑targeted treatments only in patients who need them can improve survival.
- Work with the North West Genomics Hub to further develop a reliable test that can measure tumour hypoxia from tissue samples, with the long‑term goal of making this test available across the NHS.
- Collect imaging, blood and tissue samples to help researchers learn how best to detect hypoxia and personalise treatment.
Who Can Take Part?Patients receiving radiotherapy on the MR‑Linac at The Christie for:
- Bladder cancer
- Prostate cancer
- Cervical cancer
may be invited to join.
What Taking Part Involves?If you take part, you will be asked to provide:
- A blood sample
- A hypoxia MRI scan (special imaging that helps measure oxygen levels in the tumour)
- A diagnostic tissue sample (this may be from a biopsy already taken as part of your care)
These samples will help researchers understand which tumours are hypoxic and whether personalised treatment could lead to better outcomes.