Paving the way in cancer research
Dr Pippa Corrie, NIHR Clinical Research Network National Specialty Lead, reflects on how patient involvement, a diverse portfolio, innovative precision medicine, and trainee research collaboratives have revolutionised changes in cancer research. Her blog marks World Cancer Day.
Cancer research has a proud tradition of conducting large scale complex drug trials, whose outcomes have helped establish standards of care for literally millions of cancer patients across the globe. These trials remain the ‘bread and butter’ of the NIHR Clinical Research Network Cancer Portfolio.
In 2018/19 alone we saw over 44,000 people diagnosed with cancer take part in interventional trials and over 53,000 people in observational studies. In the 20 years since I started my journey as a consultant, I have seen great strides being made in attracting industry, with almost 6,000 participants recruited to commercial studies - an increase of 70% over the last five years.
Since the establishment of the NIHR Local Clinical Research Networks (LCRNs) in 2014, we have seen annual increases in the number of patients recruited to Cancer Portfolio studies, with 2018/19 being our best-ever year. With funding constraints and an increased workload, this is no mean feat, so I would like to say a huge ‘thank you’ to all of our medical and research support teams whose motivation and dedication is responsible for such impressive results. And of course, thank you to all the patients, carers, their families and friends too, who willingly engage in our research programmes.
Ground level impact
Most cancer drugs start their development in patients with cancers that cannot be treated and the survival rates observed are generally relatively modest. What’s interesting is how the Cancer Portfolio has changed since the establishment of the LCRNs. They have enabled a much wider range of patients, at different stages of their diagnosis and treatment pathway, to get involved in research. This has been a key element of making the big step changes in improving outcomes for cancer patients that we are now beginning to see.
Over the last six years or so, the NIHR CRN Cancer Specialty has focussed on promoting research activity in several cross-cutting under-represented areas: surgery, radiotherapy, children and young people’s cancer, supportive care and community-based research. We have seen significant growth of research activity in each of these areas, with the size of the Portfolio almost doubling in four years. This is great news.
Personalised medicine is increasingly being reflected in all stages of drug development and is now a much more intensive process compared to delivering late phase trials. Personalised trials are much smaller, much more difficult to deliver and often require two-step consent of patients, first for biomarker screening, second for randomisation into the study.
Dividing the Portfolio into the cross-cutting areas such as cancer surgery and radiotherapy has been a remarkable success story, driven by highly motivated senior consultants as well as junior trainees working up and down the country. It has had the added benefit of preventing siloed working, which cutting up the Portfolio into cancer disease types inevitably leads to. The work we have done with the trainee research collaboratives is driving research innovation and participation up to unprecedented levels and their enthusiasm is snowballing across all disease areas.
Embedding research into the heart of the next generation of investigators is essential to build tomorrow’s leaders, our research pioneers of the future.
Dr Pippa Corrie, NIHR Clinical Research Network National Specialty Lead for Cancer Late Phase and International Trials
In support of World Cancer Day we’re raising awareness of cancer research on our Be Part of Research website, visit the page to browse research studies near you, hear from people who have taken part in research and more.
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.