ADVANCE
The magazine for the UK’s only Biomedical Research Centre dedicated to cancer
Autumn/Winter 2019
Liquid assets How a simple blood test could revolutionise how we detect cancer
Uncommon cancers
Rethinking clinical trials
Precision radiotherapy
Starter programme
Our quest to understand and treat the rarest diseases
Could smarter studies bring new drugs to patients faster?
Groundbreaking research with the MR Linac
The BRC’s molecular pathology training
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 Time to work smarter Professor Christina Yap argues for more efficient clinical trials 08 Rare talents Studying uncommon cancers in adults and children 11 Q&A Dr Helen McNair on research using the MR Linac 12 Blood will tell Better cancer detection and monitoring with ‘liquid biopsies’ 14 Supporting specialists Our Molecular Pathology Starter Programme 15 Profile Professor Nandita deSouza, Professor of Translational Imaging
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 our research in uncommon cancers, including neuro-oncology and paediatric cancers. As one of our eight BRC themes, uncommon cancers are a key focus for researchers and clinicians at both institutions. We also look at our work in liquid biopsies. This is an incredibly promising area of research that is already making a real difference to patients’ treatment and quality of life across a range of tumour types – primarily breast cancer. 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: Professor Nicholas Turner, Team Leader at the ICR and 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
© The Royal Marsden 2019. 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 Pureprint.
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FOREFRONT
Professor Kevin Harrington
Immunotherapy trials results open up new possibilities Two recent studies conducted by the ICR and The Royal Marsden have shown that immunotherapy may offer new options for patients with drug-resistant cancers and help some avoid the side effects of treatment. The first study showed that patients with bowel cancer who have stopped responding to the targeted drug cetuximab could benefit from immunotherapy. 4 ADVANCE
“We found that pembrolizumab is effective for head and neck cancer patients”
The research looked into bowel tumour samples from 35 patients and found that genetic changes often weren’t enough to explain drug resistance. In five out of seven patients who had stopped responding to cetuximab, their tumours had become heavily infiltrated by non-cancerous cells from surrounding tissue, which helped the cancer cells to grow during
treatment. But after treatment with cetuximab, these tumours became more visible to the immune system – leaving them vulnerable to immunotherapy. Dr Marco Gerlinger, Team Leader in Translational Oncogenomics at the ICR and Consultant Medical Oncologist at The Royal Marsden, said: “Our findings could lead to better tests so that people with changes in their tumours that mean they’re unlikely to respond to cetuximab – or likely to stop responding – could be spared unnecessary treatment.” Meanwhile, a second study has shown that patients with advanced head and neck cancers could benefit from the immunotherapy drug pembrolizumab. These patients currently receive a cocktail of two chemotherapy drugs and a targeted antibody treatment. A third of patients treated with pembrolizumab and chemotherapy were alive three years after starting treatment, compared with one in 12 of those receiving aggressive chemotherapy. Professor Kevin Harrington, Professor of Biological Cancer Therapies at the ICR and Consultant Clinical Oncologist at The Royal Marsden, said: “We have shown that pembrolizumab, either on its own or in combination with platinum chemotherapy, is effective as a first-line treatment for patients with advanced head and neck cancer.” Further reading doi.org/10.1016/j.ccell.2019. 05.013 ascopubs.org/doi/abs/10.1200/ JCO.2019.37.15_suppl.6000
FOREFRONT
Chemo and drug combination keeps breast cancer at bay Guiding chemotherapy to tumours by attaching it to the breast cancer drug Herceptin is an effective way to extend the lives of some women whose cancer has stopped responding to existing treatments, a clinical trial led by researchers at the ICR and The Royal Marsden has found. The two-in-one treatment was shown to keep disease at bay in women with HER2positive breast cancer. The study assessed the treatment – which linked the chemotherapy agent duocarmazine with Herceptin, an antibody treatment that recognises and targets the HER2 protein – in patients
Professor Udai Banerji
for the first time. The combination halted disease progression in women with HER2-positive breast cancer for more than seven months, and was also found to be active in a subset of women possessing lower HER2 levels who currently have no treatment options. Study author Professor Udai Banerji said: “With the antibody acting as a guide to find and target the cancer, duocarmazine can be released directly to the tumour cells, destroying them while minimising the damage to surrounding healthy cells.” Further reading doi.org/10.1016/S14702045(19)30328-6
7.6 MONTHS
The length of time that duocarmazine and Herceptin halted disease progression in women with advanced HER2-positive breast cancer
Experts present latest research findings at ESMO Congress Consultants from The Royal Marsden and the ICR presented at the European Society for Medical Oncology Congress (ESMO) in Barcelona, where 25,000 attendees convened this autumn to learn about new advances in oncology. Professor James Larkin, Consultant Medical Oncologist, shared study results showing that a combination of two immunotherapy drugs has stopped metastatic melanoma advancing in more than half of cases, with one in two patients living beyond five years. Professor Chris Parker, Consultant Clinical Oncologist, presented his findings from the largestever trial of postoperative radiotherapy in prostate cancer, which indicated that men with the disease could be spared radiotherapy after surgery. Finally, Professor Sanjay Popat, Consultant Medical Oncologist, presented insights into his mesothelioma trial, the results of which could provide clues to developing improved treatments for many lung cancer patients.
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FOREFRONT
Trial leader Professor Johann de Bono
Olaparib benefits men with BRCA gene mutations Two new clinical trials led by researchers at the ICR and The Royal Marsden have shown that a gene-targeted drug – already licensed for breast and ovarian cancer – can benefit some men with prostate cancer. In research presented at ASCO, the world’s biggest annual clinical cancer conference, scientists showed that 80 per cent of men whose tumours had mutations in the BRCA breast 6 ADVANCE
80%
of men whose tumours had BRCA mutations responded to olaparib
cancer genes responded to the targeted drug olaparib. After screening the tumours of 592 men, researchers found that 27 per cent had alterations in one or more genes linked to repairing damaged DNA, including the BRCA genes. Following this, a Phase III trial, led by Professor Johann de Bono, selected men who had one of 15 faults in genes involved in DNA repair.
The preliminary results of the PROfound trial, published in August, show that men given olaparib lived longer – and without cancer progression – than those given the hormone therapy enzalutamide, or another targeted treatment, abiraterone. Professor Johann de Bono, Regius Professor of Cancer Research at the ICR and Consultant Medical Oncologist at The Royal Marsden, said: “Our clinical trial is the first to deliver precision medicine to men with advanced prostate cancer. “It’s enormously rewarding to see more than 15 years of work come to fruition – from our initial findings in the laboratory through to improving the treatment of men suffering from prostate cancer. “We’re now eagerly awaiting the final analysis of the trial. If the results look as good as these initial data suggest, men with advanced prostate cancer who have BRCA mutations should be able to benefit from olaparib – a tablet that doesn’t have the side effects of chemotherapy – in the next couple of years.” Further reading ascopubs.org/doi/abs/10.1200/ JCO.2019.37.15_suppl.5005
EXPERT VOICE
Time to work smarter A new approach to clinical trials can help us get novel drugs to patients faster, says Professor Christina Yap, Team Leader in the ICR’s Clinical Trials and Statistics Unit
In medicine, we use clinical trials to compare the effect of one treatment with another. These are particularly crucial in the development of new medicines, where new drugs will go through a series of phases to test whether they are safe and effective. But bringing innovative drugs and treatments to patients with cancer is a lengthy and expensive process. On average, it takes 10-12 years to bring a new cancer drug to market – from the point of patenting through to licensing. We know that the cost and time investment needed also has implications for the development of novel compounds. A more innovative, efficient and flexible approach to running trials – including the design of how one is carried out, and the data analysis
that takes place within them – is part of the answer to ensuring patients with cancer benefit earlier from better treatments. The Clinical Trials and Statistics Unit at the ICR has a track record of designing and delivering highquality trials with widespread clinical impact. We work in an integrated way to bring together the researchers working in drug discovery, the clinical investigators leading a trial, the doctors and nurses at The Royal Marsden who discuss the study with patients and, most importantly, the patients themselves. I am motivated by a desire to ensure that trials are utilised to their maximum potential. By conducting trials in a smarter, more efficient way, we can make sure patients get the drugs best suited to them and are switched to an alternative treatment more quickly when there are signs that a drug isn’t working. We also know that intelligent trial design plays a vital role in reducing the time it takes for new treatments to reach patients. This is because it helps generate the required standard of evidence for drug approvals from regulatory bodies such as NICE more quickly. A key part of this is introducing dynamic and efficient statistical techniques to improve clinical trial design and enable trials to be used to their greatest potential to influence clinical practice. As an example of innovative trial design, we are leading adaptive trials at the ICR and The Royal Marsden. These allow researchers to build greater flexibility into the study design to include different treatment types as different arms of the study, identify ineffective and nontolerable treatments earlier, and allow more patients to benefit from better-performing treatments. Any individual patient can also
be switched between different arms, depending on how well (or badly) they are responding to a particular treatment. Other examples are basket or umbrella trials, where patients are given treatments according to their specific tumour profile, rather than simply by their broad cancer type and stage of disease. Ultimately, of course, the aim of all this is to get new drugs as safely, effectively and quickly as possible to the patients for whom they can be life-changing.
“I am motivated by a desire to ensure that trials are utilised to their maximum potential”
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Top: The Royal Marsden and the ICR’s Oak Drug Development Unit runs Phase I trials of new treatments for rare cancers. Top right: Dr Liam Welsh. Right: the biobank in the Centre for Molecular Pathology stores brain tumour tissue samples for use in research. Above: Professor Louis Chesler
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UNCOMMON CANCERS
Rare talents There are more than 200 types of cancer that can be classed as uncommon – and experts at The Royal Marsden and the ICR are at the forefront of research into these diseases
Rare and less common cancers – those other than the four most common malignancies of breast, prostate, lung and colorectal – account for 46 per cent of all cases but 54 per cent of deaths. It is this disparity between diagnosis and mortality rates that makes the research into these 200 or so diseases at The Royal Marsden and the ICR so crucial. For example, in The Royal Marsden’s Neuro-oncology Unit, there are two main aspects to research. The first focus is on primary brain and central nervous system tumours. The second is on secondary cancer – where it has spread to the brain or central nervous system from another area in the body. “Compared with other types of cancer, these are rare and hugely varied,” explains Dr Liam Welsh, Consultant Clinical Oncologist in the Neuro-oncology Unit. “We aim to treat patients to maximise their quality of life and overall outcomes. With treatment, some can have a long life expectancy, and sometimes even a cure. “For primary brain and central nervous system tumours, we’ve seen improvements in diagnosis, thanks to better
tools for classification. If we are able to distinguish the microscopic differences between tumours, we are able to give patients more appropriate and personalised treatment. “Another improvement we’ve seen is that, thanks to advances made in imaging and radiotherapy technology, we can target tumours more precisely, which means fewer side effects for patients.” Dr Welsh is working with the ICR and St George’s University Hospitals to build a preclinical programme of research. “We’ve established a brain tumour tissue biobank in the NIHR Centre for Molecular Pathology,” he says. “Analysing these samples will enable further characterisation of tumours at a molecular level. With the ICR, we hope this could lead to new ideas for treatment – it really is an example of ‘bench to bedside’ and back again.
“It’s a unique scenario to have the NIHR BRC here at The Royal Marsden and the ICR. With the Oak Drug Development Unit, we are able to develop Phase I trials, which are so crucial with this specific tumour group.”
Paediatric focus All childhood cancers are considered rare, and some of these are a major area of research focus for the ICR. Most cancers occur in adults – particularly older people – as the genetic changes that cause the diseases are more likely to develop as we age. Because they affect such small numbers of children, childhood cancers are difficult to research, and developing treatments is a huge challenge. But the problem isn’t limited to finding new treatments. We know that sometimes the right treatments exist, but we need to use them more effectively.
“We’ve seen improvements in diagnosis of rare brain and central nervous system tumours”
Professor Louis Chesler, Professor of Paediatric Cancer Biology at the ICR and a consultant at The Royal Marsden, led a recent study that showed genetic testing is a powerful tool for picking out the best drugs for children with cancer that will extend and improve their lives. Using a gene panel test, researchers read the DNA sequence of 91 genes that drive the growth and spread of cancer from 223 children’s tumour biopsies to identify potentially ‘targetable’ mutations. The study found that half of these tumours had gene mutations that can be targeted using adult cancer drugs available either as standard treatments or via clinical trials. “Our study has demonstrated that we have the scientific knowledge and technology to get children access to state-ofthe-art testing and treatments,” says Professor Chesler. “And, because our testing currently only assesses a focused set of well-known and clinically meaningful mutations, it is more practical, more cost-effective and faster than looking at the whole genome.” This is ostensibly great news. However, regulatory and funding CANCERBRC.ORG 9
UNCOMMON CANCERS
barriers pose a challenge. Most children in the study could not access these drugs because there was no trial available in patients of their age, the treatments were unavailable to them on the NHS, or they were too ill to receive an experimental treatment by the time they were tested. In September, Professor Janet Shipley, who leads the Sarcoma Molecular Pathology Team at the ICR, also called for better repurposing of adult drugs at the Childhood Cancer Conference – the UK’s biggest annual gathering of the community of researchers and families searching for new treatments in childhood cancer. Professor Shipley’s research focuses on rhabdomyosarcoma, a type of cancer resembling muscle tissue that primarily affects children and teenagers. “We need better molecular markers and brand-new drugs for children with cancer,” Professor Shipley told her audience. “But, very importantly, we also need to be repurposing existing drugs.”
Better understanding It’s important to gain a thorough understanding of the genetic changes within childhood cancers. Professor Chris Jones, lead in Childhood Brain Tumour Biology at the ICR, is a worldleading expert in diffuse intrinsic pontine glioma (DIPG) – an essentially untreatable childhood brain cancer with an average survival of just nine months – and high-grade glioblastoma. Professor Jones led a study gathering genetic data from 910 cases in 20 previously published analyses, and 157 new cases – all of which focused 10 ADVANCE
on children or young adults up to the age of 30 with high-grade glioblastoma or DIPG. The results produced by this study are now considered the definitive dataset on these cancers, and the research community can access it via a public portal for use in designing new tests and treatments. “Our study uncovered a wealth of new information about children’s brain cancers,” says Professor Jones. “We found that tumours that have historically been lumped together under one diagnosis comprise many, remarkably different, diseases.” While some children’s tumours are driven by a single genetic error in which genes are fused together, there are others where tens of thousands of genetic errors are involved. Thinking about targeted therapies for these tumours is therefore a complex process, and each disease needs to be assessed individually to understand what treatment will be appropriate. “Treating cancer based only on what we see down
“Treating cancer based only on what we see down the microscope isn’t good enough any more”
Professor Chris Jones
the microscope simply isn’t good enough any more,” says Professor Jones. “We need to start thinking about these as completely different cancers and diagnosing and treating them based on their genetic faults. “It’s exciting that several types look like they could be clearly treatable using either existing drugs on the market or other treatments under development.” Rare cancers present huge challenges for research, drug development and access – and leading-edge science is just one part of the story. Knowing more about the biology and genetics of these cancers will be essential – but so will regulating drugs to ensure new treatments reach the patients who so need them. Further reading doi.org/10.1016/j.ejca. 2019.07.027 doi.org/10.1016/j.ccell. 2017.08.017 Find out more about the BRC’s work in uncommon cancers at cancerbrc.org/our-research
Q&A
“The precision of the MR Linac allows us to adapt the treatment each day to better target the cancer”
Q&A
Dr Helen McNair The Lead Research Therapeutic Radiographer at The Royal Marsden explains how the pioneering MR Linac is being used to treat patients as part of research into its capabilities
What does the MR Linac do? It combines two technologies – an MR scanner and a linear accelerator – to precisely locate tumours, tailor the shape of X-ray beams in real time and accurately deliver radiation to moving tumours. Together, The Royal Marsden and the ICR were the first centre in the UK to install the machine in November 2016 – thanks to a £10-million grant from the Medical Research Council, with additional support from The Royal Marsden Cancer Charity.
What is your role in the MR Linac team? Initially, I helped to co-design the MR Linac suite and develop the research protocols to investigate the benefits of the machine. Now it is in clinical use, I’m involved in developing the processes and workflow for patients. I was recently awarded a Senior Clinical Lectureship by the NIHR, enabling me to lead a new study to find out how we can train staff to deliver a technique known as real-time adaptive radiotherapy.
How does the MR Linac differ from a regular radiotherapy machine? At the moment, we use MRI scanners to help plan patients’ radiotherapy. This is done several days before treatment starts, and the resulting image helps us pinpoint where in the body we need to aim the beams. However, having a scanner as part of the MR Linac means we see the tumour in real time as the patient has treatment and can direct the radiation far more accurately.
How does this technology benefit patients? The locations of tumours and organs can change over time. For example, a tumour in the lung will move up and down as a person breathes, while a tumour in the rectum or prostate may move from day to day, depending on what the patient has eaten or how full their bladder or bowel is. The precision of the MR Linac allows us to adapt the treatment each day to better target these types of tumours so we can safely deliver higher
doses of radiation, making radiotherapy more effective, with fewer side effects.
How many patients have been treated on the MR Linac so far? We treated our first patient in September 2018 as part of the PRISM trial for prostate cancer. Since then, we have continued treating patients on this trial, as well as opening trials for rectal, bladder and cervical cancers. We have also tested the imaging technology on volunteer patients, including one with a paediatric brain tumour, in preparation for treating children with cancer in the future.
What does the future hold? Some cancers – prostate and breast, for example – respond most effectively to large doses of radiation delivered over a short period. The MR Linac’s precision could one day make it possible for us to cure many cancers in a single treatment. That’s incredibly exciting, and so positive for our patients and their families. CANCERBRC.ORG 11
Blood will tell Blood tests known as ‘liquid biopsies’ could represent a major step forward in our ability to detect and monitor breast and other cancers
12 ADVANCE
LIQUID BIOPSIES
Our liquid biopsy study in numbers More people are surviving breast cancer than ever before, thanks to progress in research and NHS treatment, but recurrences – which happen when breast cancer cells survive initial treatment and grow into new tumours – remain common. When the disease returns and spreads to form tumours in other parts of the body – known as metastatic breast cancer – it can be controlled for some time, but cannot be cured. Indeed, almost all of the 11,500 women and 80 men who lose their lives to breast cancer each year in the UK will have seen their cancer spread.
Detecting DNA However, ‘liquid biopsies’ could provide a way forward. Emerging as an exciting new field in cancer research in recent years, these blood tests could help us monitor how a patient’s cancer is responding to treatment in real time, detect emerging resistance to treatment, and spot any recurrences at the earliest possible stage. Previously, the only way to get detailed genetic information about tumours was to take a tissue biopsy, either during surgery or through the use of a needle. But because the process is invasive and uncomfortable for patients, there is a limit to how many times it can be done. By contrast, a liquid biopsy simply involves taking a blood sample from a patient before, during or after a course of cancer treatment, and then testing it to detect tumour cells or DNA in the bloodstream. A recent study – published by researchers at the ICR and The Royal Marsden in JAMA
Oncology, and funded by Breast Cancer Now and other collaborators including The Royal Marsden Cancer Charity and Le Cure – found that using liquid biopsies for women with early breast cancer could detect the return of the disease almost 11 months before patients developed symptoms, or secondary tumours became visible on hospital scans. The test was found to work in all major subtypes of breast cancer, and could detect the early signs of the spread of the disease around the body (outside of the brain). Further research is now needed to understand how the test could be used in the clinic to help guide treatment and improve patient outcomes, with UK trials now under way to assess new treatments alongside the test in triple-negative breast cancer. The authors suggest that upcoming trials could lead to “a new treatment paradigm for breast cancer”, in which therapy could be offered at the first signs of relapse at a molecular level, rather than at a later stage once symptoms have appeared.
“By identifying relapse much earlier, we hope to treat it more effectively, and perhaps even prevent it”
Early signs Professor Nicholas Turner, who led the study, says: “These new blood tests can work out which patients are at risk of relapse much more accurately than we have done before, identifying the earliest signs almost a year before the patient will clinically relapse. “We hope that by identifying relapse much earlier, we will be able to treat it much more effectively than we can do now, and perhaps even prevent some people from relapsing. But we will now need clinical trials to assess whether we can use these blood tests to improve patient outcomes. We have launched the first of these studies already, and hope to launch larger studies in the future.” With clinicians and researchers also working with liquid biopsies in prostate, lung and gastrointestinal cancers – and more recently, head and neck cancers and paediatrics – the goal is for the technique to benefit as many patients as possible. Further reading doi.org/10.1001/ jamaoncol.2019.1838
101 women diagnosed with early breast cancer had blood samples taken regularly for up to five years after treatment
165 different mutations were found that could distinguish cancer DNA in the blood and could be tracked over time
29 out of 144 women (101 in this group, plus others from a previous study) saw their breast cancer return after three years
23 of these women had cancer DNA detected in their blood prior to relapse
10.7 Professor Nicholas Turner
months – the average time before clinical diagnosis that liquid biopsies spotted the signs of recurrence
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M O L E C U L A R PAT H O LO G Y
“My lab experience has really opened doors to a research career”
Dr Ben Challoner completed the Molecular Pathology Starter Programme
Supporting specialists Through the Molecular Pathology Starter Programme, the NIHR BRC is training new scientists in the latest diagnostic techniques The NIHR BRC is committed to improving diagnostic medicine and is supporting the next generation of clinician scientists by training them in the latest techniques through the Molecular Pathology Starter Programme. As genetic technologies and personalised medicine advance at a rapid pace, it is essential that the methods we use to diagnose and monitor cancer can keep up. Histopathologists diagnose disease by studying the physical form and structure of tissues 14 ADVANCE
and cells. However, there is an increasing need for these specialists to also have a comprehensive knowledge of the molecular and genetic causes of cancer. The six-month Molecular Pathology Starter Programme has been designed to further the abilities of trainee histopathologists by enabling them to gain an understanding and practical experience of the molecular techniques used to diagnose cancer and monitor
progression. In addition to enhancing a career in traditional diagnostic histopathology, the course will equip trainees with the laboratory expertise required to pursue a career in research. Dr Ben Challoner recently completed the programme, during which he investigated whether the quantity of immune cells found in tumours of the upper gastrointestinal tract is linked to patient outcomes. “Before my medical degree, I studied biochemistry – so I
have always been driven to understand the causes of cancer and how genetics can influence the behaviour of our cells. The programme provided an excellent opportunity to develop my understanding of this field and gain expertise in new molecular techniques. “It can be difficult to transition into a research career from pathology, so my experience in the lab has really opened doors. As a result, I was able to successfully apply for a PhD studentship at the ICR, where I am now working under the supervision of Dr Marco Gerlinger, an academic medical oncologist who seeks to overcome drug resistance in gastrointestinal cancers. “As a future consultant, I will now be able to approach cancer diagnostics from two perspectives – traditional histopathology and aspects of molecular pathology – and hope to guide future histopathology trainees down a similar route to promote the integration of these two fields.” To date, the BRC has supported nine candidates through the programme, and applications for the 2020 intake are now open. Please contact cancerbrc@ rmh.nhs.uk for information on eligibility and how to apply
PROFILE
Professor Nandita deSouza Professor of Translational Imaging at the ICR
“Using MRI, we can see how tissues behave – gaining crucial insights into the nature of cancers”
Professor Nandita deSouza is Professor of Translational Imaging, Co-Director of the Cancer Research UK Clinical Magnetic Resonance Research Group and Deputy Dean of Clinical Science at the ICR, and a consultant at The Royal Marsden. She co-ordinates multidisciplinary research projects involving clinical medicine, physics, biochemistry and engineering that are aimed at improving patient care. Her research uses magnetic resonance imaging (MRI) to guide radiotherapy, aid early diagnosis, and identify biological indicators of a patient’s prognosis and likely response to treatment. She has been a key player in setting standards to enable
multicentre imaging trials nationally and internationally, and also chairs the European Imaging Biomarkers Alliance on behalf of the European Society of Radiology. Professor deSouza helped pioneer the use of endocavitary probes to provide high-quality pictures of cancer tissue and show chemical changes within tumours, with a focus on understanding how cervical and prostate cancers develop and progress. She says: “The diagnostic information obtained with MRI is unrivalled by other imaging methods. By using MRI, we can see how tissues function and behave – gaining crucial insights into the nature of cancers.” Along with a team of physicists led by the ICR’s Professor Gail ter Haar, Professor deSouza has worked to bring high-intensity focused ultrasound (HIFU) treatment to patients at The Royal Marsden. HIFU uses MRI to direct intense beams of ultrasound at areas inside the body affected by cancer. With funding from the EU, HIFU is being tested for patients with painful cancers that have spread to their bones. And through funding from the NIHR, it is also being tested for those with pelvic tumours that have returned after treatment. A keen interest of Professor deSouza’s is ensuring more women are represented at the highest levels of cancer research. She supports flexible training for academics, supervises several PhD and MD students, and oversees the MDres programme at the ICR. Additionally, she is an active member of the Athena SWAN steering group at the ICR, which promotes the careers of women in science, engineering, technology, maths and medicine in higher education.
CV 1991 Appointed as a Fellow of the Royal College of Radiologists 1993 Becomes an MRC Fellow in MRI at Hammersmith Hospital 2000 Appointed as a Reader in Imaging at Imperial College London 2004 Joins the ICR as a Reader 2005 Appointed as a Fellow of the Royal College of Physicians 2008 Appointed Professor of Translational Imaging at the ICR
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Patient and public engagement at the NIHR Biomedical Research Centre A summary of our 2019 events
6
22
50
medical research and support charities
presentations
total number of events
Prostate cancer
90%
rated event either excellent or very good
2%
other
Large granular lymphocytic leukaemia
3%
students and teachers
10%
representatives from medical research and support charities
Melanoma and urological cancers Hairy cell leukaemia Breast cancer
17%
professionals from The Royal Marsden and the ICR
710
people attended
68%
patients, carers, family and friends
Gynaecological cancers and sarcoma
“The event really helped me to feel I am not alone in this.”
“Great to be able to attend and hear from experts.”
“Gave me muchneeded background information and food for thought on any treatments I might need.”
Please visit cancerbrc.org for information about our patient and public engagement event programme for 2020.
“It is important for patients and families to be provided with facts and the opportunity to learn more about cancer research.”