Professor Saunders' main area of research over many years has focused on improving the outcomes of radiation treatment in all patients with cancer particularly those with head and neck cancer and lung cancer.

Professor Saunders' group was instrumental in introducing hypoxic cell radiosensitisers into clinical practice leading to major phase III randomised trials. The latest multicentre randomised trial of carbogen and nicotinamide in bladder cancer is about to be published. Following basic research in collaboration with the Gray Cancer Institute our group demonstrated that cell proliferation is an important cause of cancer failure and this led to investigations into altered fractionation techniques culminating in the randomised controlled trials of conventional radiotherapy versus an accelerated radiotherapy regimen called CHART in non-small cell lung cancer and head and neck cancer. These trials showed that proliferation is an important cause of failure to cure and in non-small cell lung cancer was significantly superior in terms of survival such that CHART has been recommended as the radiotherapy treatment of choice in early stage non-small cell lung cancer unsuitable for surgery.

The Groups current interest lies once again in attempting to improve the outcome of radiotherapy and this time returning to the subject of hypoxia but in our current research we are attempting to image hypoxia using novel tracers and PET imaging together with magnetic resonance imaging using BOLD and dynamic contrast sequences. This research is currently underway with the aim of delineating areas of hypoxia which are radio-resistant and can then be targeted with radiotherapy using the new technicological advances incorporated into intensity modulated radiotherapy.

The Group has for a long time been interested in the molecular profiling of tumours and we have had the opportunity to investigate the overexpression of epidermal growth factor receptor and in head and neck cancer. Using the CHART trials we have been able to show that patients whose tumour expressed EGFR respond better to an accelerated form of radiotherapy rather than conventional radiotherapy but that conventional does not prejudice their outcome.
At the present time The Group are co-operating with the Nuclear Medicine Department at University College, Mount Vernon Hospital and Guys/King's College in an effort to validate the novel hypoxia marker Cu64 ATSM and thus hopefully increase the knowledge as to the biology of tumours and their response to radiotherapy.