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22/101 Management of bone metastasis and skeletal related events (SREs) in patients with advanced cancer commissioning brief

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Published: 31 August 2022

Version: 1.0 August 2022

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Introduction

The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the clinical effectiveness, cost-effectiveness and broader impact of healthcare treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.

This is a brief of broader scope from which the programme is interested in potentially funding more than one proposal.

The HTA Programme is interested in proposals for the evaluation of interventions related to the management of bone metastasis and skeletal related events (SREs) in patients with advanced cancer. Applicants should clearly define and justify their choice of patient group, study design and outcome measures, and explain how the research will fit into the remit of the HTA Programme. Primary research, including randomised and observational studies, and evidence syntheses will be considered. Epidemiology or exploratory studies are not included within the scope of this call. We are looking for studies of interventions with a sufficient prior evidence base which show patients to positively impact the translational pathway.  

Examples of topics of interest include, but are not limited to:

  • Effective treatments for bone metastasis 
  • Optimal timing to initiate antimetastatic therapy
  • Combining antimetastatic therapy with concurrent tumour-specific standard of care
  • Long-term care of patients with bone metastasis
  • Management of bone-related pain in cancer patients
  • Managing bone metastases and SREs in patients with comorbidities and complex needs
  • Bone-targeted diagnostic measures during routine follow-up (e.g. imaging, biomarkers, liquid biopsies)  

Rationale

The frequency of bone metastasis is on the rise as cancer incidence increases and survival improves. While the overall incidence and prevalence of UK patients with bone metastasis or bone-only metastasis is unknown, estimates suggest tens of thousands of patients are affected. Given the poor prognosis and significant impact of bone metastasis on morbidity and mortality, new therapies and treatment strategies are urgently needed.

SREs are a common complication of bone metastasis that can lead to severe pain, increased risk of death, increased health care costs and reduced quality of life. These include debilitating events such as bone pain, pathological fractures, spinal cord compression and humoral hypercalcemia of malignancy.
 
Together, bone metastases and their associated complications have serious negative consequences for patients and result in a high economic burden for the healthcare system. This calls for research to identify better treatment approaches and improve the management of SREs.

Additional commissioning brief background information

A background document is available that provides further information to support applicants for this call. It is intended to summarise what prompted the call and the existing evidence base, including relevant work from the HTA and wider NIHR research portfolio. It was researched and written on the basis of information from a search of relevant sources and databases, and in consultation with a number of experts in the field. If you would like a copy please email htaresearchers@nihr.ac.uk.

Making an application

If you wish to submit a Stage 1 application for this call, the online application form can be found on the Funding opportunities page. To select this call, use the filters on the right of the screen or search using the call name and/or number.

Your application must be submitted on-line no later than 1pm on the 4 January 2023. Applications will be considered by the HTA Funding Committee at its meeting in March 2023.

Guidance notes and supporting information for HTA Programme applications are available.

Important: Shortlisted Stage 1 applicants will be given eight weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in July 2023.

Applications received electronically after 1300 hours on the due date will not be considered.

For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team. There may be unusual circumstances where the same person could be included on more than on application eg a lead from a named charity or a unique national expert in a condition.

For such exceptions (i) each application needs to state the case as to why the same person is included (ii) the shared co-applicant should not divulge application details between teams and (iii) both teams should acknowledge in their application that they are aware that one of their co-applicants is part of a competing application and that study details have not been shared.

Should you have any queries please contact us by email at htagb@nihr.ac.uk.