Why you should deliver cancer research in the UK
The UK has an international reputation for cancer research and has, through the NIHR Clinical Research Network (CRN), a highly developed and effective infrastructure to enable the timely set-up and delivery of cancer research studies across all of the cancer sites as well as in cross-cutting areas such as supportive/palliative and primary care, psycho-social oncology and survivorship.
Each of the 15 Local Clinical Research Networks, which cover the whole of England, has identified Cancer Subspecialty Champions and this community of around 200 research-active clinicians work at both local and national levels to deliver cancer research studies to time and target in the NHS and the wider health and social care environment.
We have seven national clinical leads who have a wealth of experience and can provide specific advice on: early phase clinical studies, late phase and international trials, radiotherapy, cancer surgery, studies involving children/young people and community based supportive/palliative care research.
We work in close partnership with the National Cancer Research Institute (NCRI) which supports 19 Clinical Studies Groups which comprise of leading academic clinicians and researchers with the expertise needed to develop pipelines of high quality research studies for all cancer sites.
The UK is a leading member of the European Organisation for Research and Treatment in Cancer (EORTC), enabling studies to be coordinated across several countries e.g. of rare cancers through the International Rare Cancers Initiative (IRCI).
Access to patients
There are around 990 cases of cancer diagnosed each day in the UK with breast, prostate, lung and bowel cancers accounting for around half of these. Around 1,900 children and 2,600 teenagers and young adults are diagnosed with cancer each year.
The CRN is committed to offering as many of these patients the opportunity to participate in high quality research studies as possible. In 2018/19, 22 per cent of adult cancer patients were involved in clinical research studies, the majority being interventional trials. In the UK, research is embedded in the clinical treatment for almost all children with cancer.
The Cancer Specialty covers over 200 diseases, encompassing solid tumour oncology and malignant haematology in adults, children and young people. Our track record:
- world-leading rates of cancer patient participation in clinical research;
- over 122,000 participants were recruited into studies in 2018/19;
- 99 per cent of acute trusts recruited a cancer patient into a study in 2018/19;
- the Cancer Specialty actively recruited to 1,084 studies during 2018/19;
- in 2018/19 the Cancer Specialty achieved one global first and three European first participants.
The Cancer Specialty works closely with a wide range of stakeholders, notably the many cancer research charities in the UK, the Experimental Cancer Medicine Centres, specialist centres (such as the European Neuroendocrine Tumour Society centres of excellence) and Clinical Trials Units to deliver a continual pipeline of high quality research studies which improve the diagnosis, treatment, care and outcomes of cancer patients.
In collaboration with Cancer Research UK (CRUK), we have established a Cancer Industry Alliance to promote academic partnerships with individual pharmaceutical companies to optimise early phase testing of new anticancer therapies which do not form part of the company’s main research and development plans.
Case study: FOCUS4-C
A collaborative approach between the NIHR, CRUK, Medical Research Council and AstraZeneca has powerfully demonstrated how basic research findings can be rapidly translated into clinical trials. Within two years of the discovery that mutated SETD2 genes in cancer cells made them susceptible to targeted therapies, a new arm (FOCUS4-C) of the existing FOCUS4 trial was opened providing the opportunity to get this exciting science tested clinically in bowel cancer patients. Recruitment is open in 100 hospitals across the country supported by the NIHR and current recruitment stands at over 1,500 participants.
The CRUK/NIHR-funded FOCUS4 trial (molecular selection of therapy in colorectal cancer) opened in 2014 and is designed to be adaptive so that new drugs can be tested quickly, helping patients benefit from new discoveries sooner.
Case study: Precision-Panc
Pancreatic cancer is associated with one of the worst cancer survival outcomes and represents a global unmet need for effective treatments. Through a collaboration involving CRUK, NIHR, NCRI and Industry partners established in 2017, the UK now has a national pancreatic cancer genomic sequencing programme, called Precision-Panc. Precision-Panc is funded to pump-prime molecular stratified pancreatic cancer interventional studies.
A UK-wide master protocol enables molecular profiling of patients with pancreatic cancer, and is embedded within the standard diagnostic pathway to facilitate subsequent enrolment in Pancreatic Cancer Individualised Multi-arm Umbrella Study (PRIMUS) clinical trials asking specific biomarker questions. PRIMUS trials have so far targeted DNA damage response deficiency as well as enhancement of checkpoint blockade by inhibiting CXCR2.
The Precision-Panc Therapeutic Testing Board provides an open forum for academics and industry to explore novel science, biomarkers and therapeutic strategies with potential to translate into real live pancreatic cancer clinical trials.
Case study: Euro Ewing
This international, randomised controlled study compared VIDE (vincristine, ifosfamide, doxorubicin and etoposide) to VDC/IE (vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide). The study recruited from both the adult and paediatric population and has successfully been completed on time and to target. Euro Ewing 2012 was funded by CRUK and recruited 242 participants, including 215 from 26 NIHR supported sites in England.