The race is on

The ICR and The Royal Marsden have ambitious plans to ensure that research into treatments, diagnostics and prevention is rapidly adopted into routine healthcare

Twenty years ago, the usual course of treatment for women with early breast cancer included 25 doses of radiotherapy over a five-week period. But researchers began to suspect that fewer, higher doses might work better.

The landmark START trials, led by researchers at the ICR and The Royal Marsden, proved the theory correct and led to a complete overhaul of treatment schedules. Now, about 25,000 women a year benefit from fewer hospital appointments and reduced side effects from the shorter schedule of 15 higher doses given over three weeks.

Another trial, called CHHiP, is promising to change routine practice in a similar way for men with prostate cancer. It is this kind of direct, large-scale impact on the lives of patients that the ICR and The Royal Marsden – with the support of the BRC – are aiming to replicate across their research activities.

25,000

women benefit annually from reduced side effects thanks to START trials

"Our new research strategy emphasises getting advances in cancer treatment, diagnosis and prevention embedded into the clinic as part of routine care"

The new five-year joint research strategy, ‘Making the discoveries: our strategy to defeat cancer’, includes a greater emphasis on getting advances in cancer treatment, diagnosis and prevention embedded into the clinic as part of routine healthcare.

Under the ‘Making it count’ section of the strategy, it won’t be enough to simply develop a new treatment in early-stage trials.

The ICR and The Royal Marsden will together conduct practical cost-benefit analyses of novel treatments and strategies to show that they can be effective in healthcare systems, and drive adoption through a series of networks.

Mainstream gene testing

The ICR and The Royal Marsden have been instrumental in embedding genetic testing into everyday cancer care. Professor Mitch Dowsett’s TransATAC study, for instance, helped usher in an era in which molecular profiling is used routinely on the NHS to predict outcomes in breast cancer.

A new research programme is looking to make testing for major cancer risk genes – such as BRCA1 and BRCA2 – more routinely available on the NHS.

The Mainstreaming Cancer Genetics programme is led by the ICR alongside The Royal Marsden under the directorship of Professor Nazneen Rahman, Head of the ICR’s Division of Genetics and Epidemiology and The Royal Marsden’s Cancer Genetics Unit, and is largely funded by the Wellcome Trust, with additional support from the BRC.

Professor Nazneen Rahman, Head of the ICR’s Division of Genetics and Epidemiology and The Royal Marsden’s Cancer Genetics Unit, is leading the Mainstreaming Cancer Genetics programme

Under the programme, researchers at The Royal Marsden have piloted a streamlined approach to BRCA gene testing for women with ovarian cancer, and found it to be faster, simpler and preferred by patients.

The new approach offers patients gene testing at a routine cancer clinic appointment instead of having to be referred to a separate genetics clinic. This approach is being adopted by other hospitals in the UK and internationally.

A notable success of the programme is the creation of the TruSight Cancer test, developed alongside Illumina, which can pinpoint mutations in 100 genes known to be associated with cancer. Now in use by many labs, the panel test harnesses the latest DNA sequencing technology to make gene testing faster, cheaper and more accurate.

Joining forces

Collaborative working is a key aspect in ensuring that as many patients as possible benefit from innovations in cancer care. The ICR and The Royal Marsden cannot work in isolation, so partnerships with other organisations – pooling expertise and resources – are vital.

Professor Kevin Harrington, Joint Head of the Division of Radiotherapy and Imaging at the ICR and Consultant Clinical Oncologist at The Royal Marsden, will lead a collaborative project that aims to put three ground-breaking radiotherapy technologies into routine practice.

Professor Harrington has won a £4.3 million Cancer Research UK Centres Network Accelerator Award, which will support a community of researchers, hospitals and universities.

Professor Harrington will lead a collaborative project that aims to put three ground-breaking radiotherapy technologies into routine practice

Through a series of clinical trials, the team will assess how best to introduce stereotactic body radiotherapy, MR Linac image-guided radiotherapy and proton beam therapy into the NHS.

“New technologies have the potential to benefit patients cost-effectively by delivering better, more precise radiotherapy,” says Professor Harrington. “But we need to challenge the major discrepancies that exist in access to the newest, most effective therapies, which mean too many patients across the UK continue to miss out.”

Initiatives such as this network will play a key role in taking new technologies from the research stage into routine healthcare – helping the ICR and The Royal Marsden ensure that their research is made to count for patients.