ADVANCE
The magazine for the UK’s only Biomedical Research Centre dedicated to cancer
Autumn/Winter 2020
Rapid response How our researchers are rising to the COVID-19 challenge
Immunotherapy
Landmark trial
Positive results
Pushing the boundaries
Unleashing the immune system against cancer
New hope for men with advanced prostate cancer
Presenting our work to a global audience at ESMO
Professor looks back at a four-decade career
As the UK’s only Biomedical Research Centre dedicated to cancer, our mission is the rapid translation of advances in research to improve the outcomes for patients with cancer through precision treatment. This is our ‘bench to bedside’ approach.
Groundbreaking research
World-class facilities
Training and development
Patient and public involvement
Across eight themes, we translate our findings into advances in treatments for cancer patients.
Including the Drug Development Unit, Centre for Molecular Pathology and West Wing Clinical Research Centre.
We are the UK’s largest training centre for oncology, with a proud history of championing women in medical research.
We incorporate and integrate the perspectives of patients, carers and the public into our research.
The Biomedical Research Centre is a partnership between The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. Together, we receive funding from the National Institute for Health Research. Find out more: cancerbrc.org | royalmarsden.nhs.uk | icr.ac.uk | nihr.ac.uk
Contents 04 Forefront The latest research news 07 Reflecting on an illustrious career Professor David Dearnaley looks back at a life in oncology 08 Rising to the challenge Studying COVID-19 and cancer 11 Q&A Professor Nicholas James on the STAMPEDE trial 12 Cells on the counterattack Our continuing work in immunotherapy 14 A global audience Key research presented at the virtual ESMO Congress 15 Profile Dr Susanne Cruickshank, Strategic Lead for Applied Health Research
Editorial advisory board Professor David Cunningham Director of the NIHR BRC Professor Paul Workman Chief Executive and President, the ICR Professor Nicholas Turner Team Leader, the ICR, and Consultant, The Royal Marsden Dr Naureen Starling Associate Director of Clinical Research, The Royal Marsden
Welcome to the latest edition of Advance, which highlights the worldleading work carried out through the National Institute for Health Research Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research, London – the only BRC in the UK dedicated solely to cancer. In this issue, we focus on the work being done to understand the links between COVID-19 and cancer, and the impact of the pandemic and the disease on cancer treatment. Both The Royal Marsden and the ICR have played a crucial role throughout what has been an unprecedented situation for us all. We also look at the research presented at the recent ESMO conference and how that is changing patient care, as well as the latest research news in prostate and paediatric cancers. I hope you enjoy reading this issue of Advance.
Rachael Reeve Director of Marketing and Communications, The Royal Marsden Elaine Parr Head of PR and Communications, The Royal Marsden Richard Hoey Director of Communications, the ICR Published in partnership with Sunday: wearesunday.com
Cover photograph: Dr Samra Turajlic, Consultant Medical Oncologist at The Royal Marsden
Professor David Cunningham Director of the NIHR BRC at The Royal Marsden and the ICR and Consultant Medical Oncologist
Š The Royal Marsden 2020. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Geoff Neal Group.
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FOREFRONT
Dr Lynley Marshall
Opening up treatment options for young patients The Royal Marsden is the first hospital in the UK to open an innovative clinical trial to test the benefits of drug and treatment combinations that were previously unavailable for children and young people. ESMART allows several treatment options – including targeted drugs, immunotherapy, radiotherapy and chemotherapy – to be tested and made available 4 ADVANCE
“The knowledge we’re building up will help to drive future treatments”
for patients with relapsed cancers under one trial. Patients first have their tumour screened via the Stratified Medicine Paediatrics (SMPaeds) programme. Led by The Royal Marsden and the ICR, SMPaeds routinely analyses tissue from all children in the UK with solid tumours whose cancers have come back. ESMART uses this molecular information to match patients
to one of 10 treatment arms (with five more awaiting regulatory approval). This speeds up access to targeted treatments for young patients, as standard clinical trials may only test one or two treatment options. Dr Lynley Marshall, Oak Foundation Consultant in Paediatric and Adolescent Oncology Drug Development and UK Chief Investigator of the ESMART trial, said: “We’ve spent years trying to get a more targeted approach to children’s cancers in place, and we’re really proud to have helped develop ESMART and to have it available in the UK. “The knowledge that we’re building up about molecular targets to attack in paediatric cancers is really exciting. It will help to drive future treatments and future trials and really help patients.” ESMART has been designed collaboratively under the umbrella of Innovative Therapies for Children with Cancer, a Europe-wide paediatric earlyphase clinical trial consortium in which UK centres and investigators play key roles. The trial is open in three UK centres – The Royal Marsden, and in hospitals in Manchester and Birmingham – and is due to open in two further UK sites.
FOREFRONT
New type of cancer drug targets DNA defences A new drug that is the first of its kind can target cancer’s ability to repair its DNA, promising results from a clinical trial at the ICR and The Royal Marsden show. Berzosertib is the first in a new family of drugs that block a key DNA repair protein called ATR. DNA damage is a fundamental weakness in cancer cells, so drugs that can target this flaw could be a potent new treatment for cancer.
“These drugs could boost the effect of treatments like chemotherapy”
The new Phase I trial, designed to test the safety of berzosertib, also showed that more than half of patients with solid tumours who were given the drug on its own or with platinum chemotherapy saw their cancer stop growing. Professor Johann de Bono, Head of Drug Development at the ICR and The Royal Marsden, said: “Our trial is the first to test the safety of a brand-new family of targeted cancer drugs in people. “In the future, these drugs could boost the effect of treatments like chemotherapy that target cancer DNA, and overcome resistance to other targeted treatments.” Further reading doi.org/10.1200/jco.19.02404
Berzosertib was trialled in patients with solid tumours such as melanoma
53% of patients who received berzosertib either on its own or with chemotherapy saw their tumour stop growing
71% of patients who received both berzosertib and chemotherapy saw their disease stabilise
Rising stars of radiotherapy research to join BRC Three academic consultants, who all trained at The Royal Marsden and the ICR, are to join the organisation following a Cancer Research UK RadNet grant and other successful applications for radiation-related funding. Focusing on bladder and prostate cancer in the Urology Unit, Dr Anna Wilkins will explore combining radiation and immunotherapy to improve tumour control and reduce treatment side effects. Dr Ben O’Leary joins the Head and Neck Unit to look at how tumour evolution allows some cancers to escape control by radiation, chemotherapy and immunotherapy. And Dr Magnus Dillon in the Gastrointestinal Unit will research whether using radiation with DNA damage response inhibitors can activate immune responses to improve tumour control.
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FOREFRONT
Technicians calibrate a radiotherapy machine at The Royal Marsden
Radiotherapy trial changes practice for breast cancer A clinical trial led by researchers at the ICR and The Royal Marsden has shown that treating patients with fewer but larger doses of radiotherapy after breast cancer surgery is as safe in the long term as daily radiation treatment. The 10-year results of the FAST trial, led by Professor Judith Bliss and Professor John Yarnold at the ICR and The Royal Marsden, showed that delivering larger 6 ADVANCE
doses per session – but less radiation overall – was safe, with side effects remaining low a decade later. Giving radiotherapy once a week for five weeks was found to be as effective as 25 smaller daily doses for women with early-stage breast cancer. The findings, published in the Journal of Clinical Oncology, have already supported a change in clinical practice to cut hospital visits for women with breast
“These findings confirm that it is safe to deliver radiation in fewer doses”
cancer, relieving pressures on the NHS and helping to keep patients safe during the COVID-19 pandemic. Study co-leader Professor Bliss, Professor of Clinical Trials at the ICR and Director of its Cancer Research UK-funded Clinical Trials and Statistics Unit, said: “Our initial results showed that when the total dose is adjusted appropriately, it is safe to deliver radiotherapy in fewer doses. Now we can confirm that this is still the case 10 years down the line. “These findings have supported changes in clinical practice, and it is great to see that after so many years, side effects from fewer but larger doses of radiation are still low.” Professor Yarnold, Professor of Clinical Oncology at the ICR and Consultant Clinical Oncologist at The Royal Marsden, is the chief investigator of the FAST trial. He said: “People are increasingly living longer with their cancer thanks to smarter, kinder treatments – so establishing the long-lasting safety of treatments is of the utmost importance to help them live well with their condition.” Further reading doi.org/10.1200/jco.19.02750
EXPERT VOICE
Reflecting on an illustrious career Professor David Dearnaley, Professor of Uro-Oncology at the ICR and Consultant Clinical Oncologist at The Royal Marsden, is retiring after 40 years in oncology
Throughout my career, I’ve always tried to push the boundaries of how cancer is managed – in particular, the way prostate cancer is treated with radiotherapy. I’ve been lucky to have wonderful colleagues, and together we have challenged the status quo for the good of patients. We’ve always been passionate about developing curative treatments with fewer side effects, and improving patient outcomes and quality of life. After completing posts as a junior doctor, I joined the ICR and The Royal Marsden in a training position in radiotherapy and oncology. I did a research degree on novel detection methods for breast cancer bone micrometastases – small groups of cancer cells that have spread from the original tumour. The
detection and management of bone metastases has remained a career-long interest. During my tenure at the ICR, I was responsible for leading a range of clinical trials and studies into radiotherapy, including the development of conformal, intensity-modulated, imageguided and hypofractionated radiotherapy. I was also involved in early-phase and subsequent Phase III trials of abiraterone and biphosphonate drugs that target bone metastases – treatments for prostate cancer whose effects will continue to change lives for many years to come. I was able to develop and lead several key radiotherapy trials, such as the Cancer Research UK-funded CHHiP trial and the Medical Research Council-funded RT01 trial. Both have resulted in major changes to treatment guidelines globally, with patients receiving radiotherapy regimens that have a greater impact on their cancers while shielding healthy tissue from damage. I have always enjoyed setting up and contributing to collaborations, and I’ve had the privilege of working with some outstanding colleagues and students at the ICR and The Royal Marsden. My work with Professor Steve Webb, Professor of Radiotherapy and Imaging, developing intensity-modulated radiotherapy, as well as with Professor Emma Hall, Deputy Director of the Clinical Trials and Statistics Unit, on clinical trials, has been particularly satisfying – but there are so many more examples. The foundation of my career was the very special clinical partnership I had with Professor Alan Horwich in clincial academic radiotherapy and urology. I’m delighted that this work continues to go
from strength to strength, now with a wonderful new team of consultant oncologists and clinician scientists. The future is in good hands. Professor Dearnaley’s work has changed best practice on a global level, affecting the lives of an untold number of cancer patients and advancing cancer research. In tributes to Professor Dearnaley on his retirement, students spoke of his generosity, kindness and mentorship. Last year, a symposium held in his honour attracted participants from around the world, many of whom had been trained by Professor Dearnaley and were delighted to celebrate his work with him. In recognition of his outstanding achievements in the field, Professor Dearnaley has been made Emeritus Professor at the ICR.
“My colleagues and I have challenged the status quo for the good of patients”
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Rising to the challenge Experts at The Royal Marsden and the ICR have responded to the COVID-19 pandemic by rapidly launching studies into how the virus affects cancer treatment
Left: Dr Samra Turajlic aims to understand the interactions between COVID-19 and cancer. Above: The Royal Marsden and the ICR have launched several studies during the pandemic. Above right: Dr Sheela Rao is leading research into antibody tests for cancer patients. Far right: Dr Richard Lee is using artificial intelligence to determine the cause of changes in the lung
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CO V I D -19 R E S E A R C H
With the support of the NIHR BRC, The Royal Marsden and the ICR have played a crucial role throughout the COVID-19 pandemic. Together, we have implemented changes to improve how we work, carried out innovative research and continued to provide the highest standards of care for cancer patients. The Royal Marsden took a leading role in delivering urgent treatment, particularly surgery, by working with local cancer alliance RM Partners to establish a Cancer Hub at the height of the pandemic. Using existing networks and new partnerships enabled by a landmark deal the NHS made to buy up capacity in the private healthcare sector, this ensured that cancer patients could have the surgery they
needed. To date, more than 2,000 patients have been able to access surgery through the Cancer Hub. The Royal Marsden and the ICR, supported by the BRC, also led on critical research to assess the impact of COVID-19 on cancer treatment and care. In May, The Royal Marsden launched several clinical studies at unprecedented speed. Funded by The Royal Marsden Cancer Charity – which is raising more than £500,000 to support research – and the ICR’s fundraising efforts, our studies cover several cancer types and services. Tapping into the key clinical and research strengths of a world-leading cancer centre, we worked with commercial and academic partners and NHS trusts across the country to help
“We are uniquely placed to look at COVID-19 in a cancer setting and its impact on patients”
inform treatment decisions and improve outcomes for patients. “We are uniquely placed to look at COVID-19 in a cancer setting, investigating the pandemic’s impact across a wide range of patients,” says Professor David Cunningham, Director of the NIHR BRC. “The trials we have launched call on our multidisciplinary expertise in areas such as systemic therapies, radiotherapy, circulating tumour DNA – which is detectable in blood tests – surgery and holistic care. We hope these studies will have a national and international impact.”
Joining the effort Dr Richard Lee was one of a number of Royal Marsden staff to be seconded to help lead the creation of the NHS Nightingale Hospital at London’s ExCel Centre at the height of the pandemic. He was seconded as Clinical Lead for the ‘step down’ (or recovery) team and joined a group of colleagues led by The Royal Marsden’s Chief Nurse, Eamonn Sullivan, at the temporary hospital.
Understanding the virus The CAPTURE study, led by Dr Samra Turajlic, Consultant Medical Oncologist at The Royal Marsden, is analysing data from more than 1,200 patients and 200 hospital staff to understand the biology and interactions between COVID-19, immunity, cancer and cancer treatment. Preliminary data, presented at the American Association of CANCERBRC.ORG 9
CO V I D -19 R E S E A R C H
Cancer Research conference, has shown that a wide range of antibody levels and COVID-19specific T-cells were detected in 30 per cent of cancer patients, but the potential impact of cancer type on the immune response must be considered for further analysis. A commentary article titled Cancer, COVID-19, and Antiviral Immunity has been published in the journal Cell. The CAPTURE team is also opening up the trial in centres in Edinburgh and Southampton, and will be evaluating viral transmission patterns and antibody and T-cell response in all participants. Meanwhile, Consultant Medical Oncologist Dr Sheela Rao is leading the CARDS trial, which is seeking to establish an effective and rapid diagnostic point-of-care antibody test for cancer patients, by mapping out a timeline of when immunity is developed to enable the safe resumption of cancer treatments. Researchers hope it will shed light on how the pandemic affects this particularly vulnerable group, and whether cancer patients require specific timing of antibody tests in contrast to the general population. Dr Richard Lee, Consultant Physician in Respiratory Medicine and Early Diagnosis at The Royal Marsden, who is funded by the Charity, is leading a team in collaboration with the ICR and Imperial College London on the OCTAPUS-AI trial. By using artificial intelligence to analyse almost 200 cancer patient scans, the trial aims to provide clinicians with information on whether changes in the lung are caused by COVID-19, another infection or a side effect of treatment. Also at The Royal Marsden, the Prevail trial, led by Consultant Medical Oncologist Dr Naureen Starling, is exploring whether a ‘liquid biopsy’ blood test can be used as an additional tool to 10 ADVANCE
Researchers have developed new ways of running trials of novel cancer drugs during the pandemic aid certain diagnostic methods that cannot be carried out due to the increased risk of contracting the virus. And fellow Consultant Medical Oncologist Dr Susana Banerjee is leading the national COVID-NOW study on Wellbeing and Workability, focusing on the oncology workforce during the pandemic.
Innovative methods Researchers at the ICR and The Royal Marsden have also led the way in developing new approaches to running early-stage clinical trials of novel cancer drugs. These methods have enabled our research to continue during the pandemic, even as many staff work from home – and, in the future, will help trials to run more efficiently. Other scientists at the ICR have initiated a range of projects in response to COVID-19, including
Professor Clare Turnbull
On the front line
creating a dynamic database – driven by artificial intelligence – which is collecting the world’s research on the virus in a single online space. Overseen by Professor Bissan Al-Lazikani, the ICR’s Head of Data Science, this vast database will accelerate the search for new drugs, ensuring we learn rapidly from international efforts to understand and overcome the disease. And Professor Terry Rabbitts, Professor of Molecular Immunology at the ICR, has started a project that could lead to a new method of testing people for COVID-19 using antibody ‘tetramerisation’ technology, which has already been developed by his team. The research may lead to a new way of treating patients with symptoms by giving them artificial antibodies that could boost their own immune response to the virus.
Early in the pandemic, Professor Clare Turnbull, Professor of Translational Cancer Genetics at the ICR and Consultant in Clinical Cancer Genetics at The Royal Marsden, was one of several staff and students at the ICR who suspended their research to take up clinical roles at The Royal Marsden and elsewhere in the NHS to help cope with the surge in COVID-19 cases. Working with colleagues from Imperial College London and elsewhere, Professor Turnbull also led studies that have modelled the effect of COVID-19-related disruption to cancer services on patients. Her work has shaped the national debate around the importance of maintaining the best possible treatment for cancer patients in the face of the ongoing pandemic.
Q&A
“This trial has been a major contributor to changes to the standard of care in advanced prostate cancer”
Q&A
Professor Nicholas James The Professor of Prostate and Bladder Cancer Research at the ICR and Consultant Clinical Oncologist at The Royal Marsden discusses the pioneering STAMPEDE trial
What is the background to the STAMPEDE trial? STAMPEDE is a landmark clinical trial for people with high-risk prostate cancer. Since it opened in 2005, more than 12,000 participants have joined the trial and 10 different therapies for prostate cancer have been tested against the current standard of care. We have already reported that adding two different drugs – abiraterone and docetaxel – to standard hormone therapy can significantly improve survival.
These findings have changed practice worldwide.
the UK, has been a major contributor to changes to the standard of care in advanced prostate cancer, significantly improving the lives of many men living with the disease. When we started the trial, men with advanced prostate cancer survived around three and a half years on average. Now, it’s around seven to 10 years – and STAMPEDE can claim a significant chunk of the credit for that. STAMPEDE’s innovative trial design has influenced the way new trials are run in the UK because it’s been so successful at bringing new treatments through.
Why is this trial important?
What is so innovative about the trial?
Prostate cancer accounts for around a quarter of all male cancers, and in the UK, there are about 48,000 new cases and 11,000 deaths each year. New ways to treat the disease are needed to give men new hope and a better quality of life. The STAMPEDE trial, which has recruited patients from The Royal Marsden and across
It’s a multi-arm trial, which increases the chances of finding effective treatments by testing more treatments more quickly. It’s also cheaper to run and can recruit patients faster. STAMPEDE’s design is highly efficient and can be adapted as time goes on to evaluate new treatments and patient groups. Each arm of the trial tests a
specific treatment in a group of patients, and new arms can be added to test new treatments or in new groups.
How does your research help patients with cancer? Cancer research is a spectrum – starting from basic science, via research into possible drug targets, through to trials testing treatments to see if they work. My work mainly involves running multi-centre, largescale clinical trials – which means my research lies at the clinical end of the spectrum. The goal of trials like STAMPEDE is to improve survival outcomes for cancer patients. We know that not every drug works for every patient – so figuring out who responds to treatment, who doesn’t, and why, helps us tailor treatment and find alternative options for those who may need them. Until we can find a cure for diseases like prostate cancer, it’s important to find ways to help people live longer and better lives with their loved ones. CANCERBRC.ORG 11
Cells on the counterattack The BRC’s work in immunotherapy is continuing to bear fruit, with research focusing on novel treatment combinations that unleash the immune system against cancer 12 ADVANCE
IMMUNOTHER APY
Below: Professor Alan Melcher. Left: Professor Kevin Harrington
The immune system is an ever-changing arrangement of cells and molecules that fight infections and tackle diseases. Its secret lies in its ability to distinguish between cells that are truly ‘you’ and those that are either invaders (like bacteria) or damaged (like cancer cells). Although our immune system is usually successful in its efforts, cancer cells will evade detection as much as possible. They cloak themselves, deceiving our natural defences, hiding away while they grow and spread. In one programme of work at the ICR and The Royal Marsden, researchers are attempting to stimulate the immune system into action in combination with drugs that target genetic mutations, launching multiple attacks on the cancer simultaneously.
Triple threat In a recent study led by Professor Alan Melcher, Professor of Translational Immunotherapy at the ICR and Consultant Clinical Oncologist at The Royal Marsden, and Professor Kevin Harrington, Professor of Biological Therapeutics at the ICR and Consultant Clinical Oncologist at The Royal Marsden, a triple-threat combination was used to target thyroid cancers with promising results in mice. Although it is early-stage research, it has exciting implications for patients. The work relied on tackling the BRAF genetic mutation, which occurs in some thyroid cancers and melanoma, and can be effectively targeted with a BRAF inhibitor drug. However, many tumours quickly develop resistance to
“Viral therapy doesn’t just have a direct killing effect, it also alerts the immune system to get into gear”
the drug, ‘outsmarting’ it and finding new ways to survive. Effective long-term treatment requires a multi-pronged approach. To combat this resistance and kick the cancer while it’s down, the team employed a second mode of attack in the shape of an immunotherapy – in this case, a form of herpes virus genetically engineered to burst cancer cells. This viral therapy, developed through the work of teams across the ICR and The Royal Marsden, has two effects. “It doesn’t just have a direct killing effect,” explains Professor Melcher, “it also alerts the immune system to get into gear, attracting immune cells to the site of the cancer and giving them a chance to do their work.” The third and final blow to the cancer comes in the form of a checkpoint inhibitor – a drug that tells the immune system to take the brakes off and let rip against cancer cells. In the trial, this three-in-one approach produced a curative effect in mice with thyroid cancers.
Combined forces Getting our work from bench to bedside is a long process, and is achieved through rigorous clinical trials. CheckMate 067 was one such trial, and it has already had a significant impact on how advanced melanoma is treated.
The trial found that when combined, ipilimumab and nivolumab – both checkpoint inhibitors – allowed the immune system to get to work and prevented the cancer from staying under the radar. It was led by Professor James Larkin, Consultant Medical Oncologist at The Royal Marsden and Professor in the Division of Clinical Studies at the ICR, who this year was appointed to the role of NIHR Senior Investigator in recognition of his outstanding contribution to clinical research. At the prestigious ESMO Annual Meeting in Barcelona last year, Professor Larkin said: “In the past, metastatic melanoma was regarded as untreatable. Oncologists considered melanoma different to other cancers – it couldn’t be treated once it had spread. This is the first time we can say that the chances of being a long-term survivor of advanced melanoma are now over 50 per cent, which is a huge milestone.” Guiding the immune system into action against tumours is an intricate process of removing blockades and raising flags to ensure that clinicians can induce the right response in the right place at the right time. The future of research in this area looks bright. Further reading jitc.bmj.com/content/8/2/e000698 nejm.org/doi/full/10.1056/NEJMoa1910836 CANCERBRC.ORG 13
ESMO
Professor James Larkin (left) with patient Alex Green, whose melanoma was treated with immunotherapy
A global audience Our experts presented their pioneering research to their peers around the world at the virtual European Society for Medical Oncology Congress In September, research leaders from The Royal Marsden and the ICR presented at the European Society for Medical Oncology (ESMO) Congress, Europe’s most influential oncology platform, which this year was held virtually. Our experts presented the results of the global monarchE study, which represent one of the most promising breakthroughs for patients with early-stage hormonereceptor-positive (HR+) breast cancer in the past 20 years. It found that the drug abemaciclib – one of a new generation of treatments known as CDK 4/6 inhibitors – reduced 14 ADVANCE
the risk of cancer recurrence in patients with this type of disease. Roughly 70 per cent of breast cancer patients have HR+ tumours – and of those, around 30 per cent will have a higher risk of relapsing in the first two years. The study, which involved 5,637 patients in 38 countries, found that when abemaciclib was added to standard hormone therapy, there was a 25 per cent reduction in recurrence compared with patients treated with hormone therapy alone for two years. Professor Stephen Johnston, Professor of Breast Cancer Medicine and Consultant Medical Oncologist at The Royal Marsden
The results of the monarchE study represent one of the most promising breakthroughs for 20 years
and the ICR, said: “There have been no significant advancements for the large group of patients who have HR+ breast cancer since the late 1990s, when aromatase inhibitors were introduced. This research could potentially save many lives in the future.” More good news came from Dr Susana Banerjee, Consultant Medical Oncologist in The Royal Marsden’s Gynaecology Unit and Team Leader at the ICR, who presented five-year follow-up results from the SOLO-1 trial. The findings showed that almost half of patients who received the targeted drug olaparib during treatment for newly diagnosed BRCA-mutated advanced ovarian cancer remained disease-free after five years. The final results from the PROfound trial, co-led by Professor Johann de Bono, Consultant Medical Oncologist at The Royal Marsden and Regius Professor of Cancer Research at the ICR, demonstrated that olaparib can also extend the lives of some men with prostate cancer and should become a new standard treatment for the disease. It was shown to be more effective than the modern hormone treatments abiraterone and enzalutamide at slowing down the growth and spread of prostate cancer in patients with advanced disease. There were also positive results from Professor James Larkin’s CheckMate 238 trial, which showed that using the immunotherapy drug nivolumab as an adjuvant therapy led to a significant improvement in recurrence-free survival in stage 3 melanoma patients whose cancer had been removed. More than half of patients who received the drug survived for four years or more following treatment without their cancer returning.
PROFILE
Dr Susanne Cruickshank Strategic Lead for Applied Health Research at The Royal Marsden
“Fear of breast cancer returning can lead to anxiety, loss of sleep and intrusive thoughts”
Dr Susanne Cruickshank recently joined The Royal Marsden as Strategic Lead for Applied Health Research. She was previously at the University of Stirling, where she was Associate Professor in Cancer Nursing and led a cancer care research group. In her new role, she aims to build capacity in applied health research, focusing on clinical academic research opportunities for nurses, allied health professionals, pharmacists and radiographers. Applied health research describes research that evaluates interventions, services, systems and national policies that affect healthcare. It provides evidence to inform clinical decisions and ensure the best possible care for
patients. It is not exclusive to any professional group, so building capacity, says Dr Cruickshank, “requires collaboration and partnership, connecting research experts wherever possible, and always engaging with patients and the public”. Much of Dr Cruickshank’s own research looks at living well with and beyond breast cancer. She recently completed a pilot trial testing a complex psychological intervention – Mini-AFTERc – designed to identify and address high levels of fear of recurrence among breast cancer patients. She says: “Fear of breast cancer returning can lead to anxiety, loss of sleep and intrusive thoughts, as well as frequent requests to engage with cancer services as people seek reassurance. Our results indicate high levels of acceptability among patients and nurses using this type of targeted intervention, and applicability to other cancer groups.” Dr Cruickshank is a coinvestigator on a trial led by the University of Exeter that is researching fundamental nursing care for patients in hospital with COVID-19. The trial will examine academic literature from previous viral outbreaks and undertake a survey of innovations from NHS clinical teams. The researchers have designed specific nursing procedures for these patients that will be tested through a ‘rapid-cycle’ trial, allowing the team to quickly determine their impact. Dr Cruickshank has worked with charities such as Breast Cancer Now, as well as chairing the Royal College of Nursing’s Cancer and Breast Care Forum between 2015 and 2019. She is also involved with the International Society of Nurses in Cancer Care, and sits on the editorial boards of several journals.
CV 1996 Appointed Clinical Nurse Specialist in NHS Borders and sets up a nurse-led chemotherapy unit 2003 Joins Edinburgh Napier University and became Reader in Cancer Nursing 2014 Completes PhD from Edinburgh Napier University 2016 Appointed Associate Professor in Cancer Nursing at University of Stirling 2020 Appointed as Strategic Lead for Applied Health Research at The Royal Marsden
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Take the conversation online Involving and engaging patients and the public ensures that both our research and our services function better for the communities we serve. Our new Patient Voices digital platform is a quick, easy and secure way for patients, carers and the public to have their say about improving cancer treatment and care online. It gives a wide range of people the chance to share their views and ideas, contribute to research projects, or join moderated discussions – in their own time and at their own convenience via their computer or smartphone. If you are a patient, carer or member of the public who is interested in this exciting new way to collaborate, we’d love to hear from you.
Please email patientsvoice.online@rmh.nhs.uk to find out more, or contact Steven Towndrow, our Digital Patient Engagement Coordinator, at steven.towndrow@rmh.nhs.uk