Some solid tumours have areas with low oxygen levels, known as hypoxia. Tumours with low oxygen can be harder to treat. They often respond less well to radiotherapy, which means higher doses may be needed to control the cancer. This is a particular challenge in cervical cancer, where radiotherapy is one of the main treatments.

One possible way to make radiotherapy work better is to use medications that reduce the effects of hypoxia. These medicines may help radiotherapy be more effective, especially in the tumours with the lowest oxygen levels. However, we currently don’t have a reliable way to identify which patients have the most hypoxic tumours.

Researchers are studying two types of biomarkers—biological signs in the body—that may help:

• Gene‑based tests
• MRI scans that can show how oxygenated the tumour is

This study will combine information from both methods to help guide future research and, eventually, improve how treatment is personalised for patients.

If you join this study:

• You will continue with your normal cervical cancer treatment, exactly as decided by your usual cancer doctor.
• During your treatment, we will collect information about how radiotherapy affects the genetic and MRI‑based biomarkers.
• You will take part in the study for around 3 months.
• During this time, you will have:
  • A series of MRI scans
  • Two biopsy samples from the tumour (taken at different stages of treatment)

If your doctor feels it is helpful, you may be offered an additional MRI scan and biopsy around 12 months after treatment.

You may be able to join the study if:

• You are 18 years or older
• You have been diagnosed with cervical cancer
• You have not yet started treatment
• You are not pregnant

All treatment and research activities will take place at The Christie NHS Foundation Trust.