The study led by scientists at The University of Manchester and The Institute of Cancer Research, London, could potentially benefit patients by using a technique called Oxygen-enhanced magnetic resonance imaging (OE-MRI).

Using the non-invasive technique, the scientists were able to map parts of tumours that had oxygen deficiency - known as hypoxia - in patients with head and neck cancer. Patients with hypoxia in their tumours respond less well to treatment.

This will enable future work to use the MRI technique to target and fine tune treatment more precisely, reducing damage to healthy tissue in some patients.

Funded by Medical Research Council, Cancer Research UK, The National Institute for Health and Care Research, the study is published in a journal of the American Association for Cancer Research, today (15/08/24).

The study was supported by the NIHR 91ֱ�� Biomedical Research Centre (BRC) and the NIHR BRC at The Royal Marsden and The Institute of Cancer Research.

Though the study was performed on patients with head and neck cancer, it raises the prospect that OE-MRI could be useful in patients with other cancers.

The oxygen enhanced imaging provides detail similar to an expensive PET scan, but can be performed on standard - and much cheaper - MRI systems.

The researchers enrolled 27 patients who were given OE-MRI scans of their primary and nodal tumours before they began their standard chemotherapy or radiotherapy treatments.

Additional scans were then performed during their treatment.

Using sophisticated mathematical modelling, the method was found to have the potential to help patients whose tumours had reduced levels of hypoxia by the second week.

Michael Dubec, principal clinical scientist at The University of Manchester and The Christie NHS Foundation Trust said: “Cancers can be destroyed by radiation and chemotherapy, but the problem is healthy tissues and organs can be destroyed as well. So our aim is to destroy the tumour while preserving healthy tissue thus reducing toxicity.

“So our aim is to destroy the tumour while preserving healthy tissue thus reducing toxicity.

“Using Oxygen-enhanced magnetic resonance imaging to map hypoxia in patients’ tumours, may improve the accuracy of their treatment.

“Now we have proved the principle, we hope to move on to clinical trials so it can be validated on greater numbers of patients.”

Professor James O’Connor of The Institute of Cancer Research, London and The University of Manchester led the study. He added: “Few studies have compared the hypoxia modification observed in both primary tumour and nodal metastases following treatment, or the timing of these changes.

“So our findings amount to a potentially important way to determine optimum radiotherapy planning for patients with locally advanced disease.”

The study “Oxygen-enhanced MRI detects incidence, onset and heterogeneity of radiation-induced hypoxia modification in HPV-associated oropharyngeal cancer” is published in

Cancers develop partly through genetic abnormalities within cells of the body. Colorectal cancer is a major cause of death worldwide, but we don’t yet have a full understanding of the genetic changes that cause it to grow. New research – published today in Nature – delivers an unprecedented view of the genetic landscape of CRC and its responses to treatment.

Utilising data from 2,023 bowel cancers from the 100,000 Genomes Project led by Genomics England and NHS England**, the research team has identified new gene faults that lead to CRC. They’ve also uncovered new CRC cancer sub-groups (categories of cancer with specific genetic characteristics that affect how cancer behaves and responds to treatment). These findings offer profound insights into the disease's development and potential treatment strategies.

Key Findings of the 91ֱ��:

• Identification of Over 250 Key Genes: The study has pinpointed more than 250 genes that play a crucial role in CRC, the great majority of which have not been previously linked to CRC or other cancers, expanding our understanding of how CRC develops.
• New Sub-Groups of CRC: Four novel, common sub-groups of CRC have been discovered based on genetic features. In addition, several rare CRC sub-groups have been identified and characterised. These groups have different patient outcomes and may respond differently to therapy.
• Genetic Mutation Causes: The research reveals a variety of genetic changes across different regions of the colorectum, highlighting differences in CRC causes between individuals. For example, a process has been found that is more active in younger CRC patients’ cancers; the cause is unknown, but might be linked to diet and smoking.
• New Treatment Pathways: Many identified mutations could potentially be targeted with existing treatments currently used across other cancers.

Commenting on the findings, co-lead researcher, Ian Tomlinson, Professor of Cancer Genetics at the University of Oxford, said:

"Our findings represent a significant advancement in understanding colorectal cancer. By better understanding the genetic changes in CRC, we can better predict patient outcomes and identify new treatment strategies, quite possibly including the use of anti-cancer drugs that are not currently used for CRC."

The research provides a vital resource for the scientific community and a promising foundation for future studies. The results from the study are available to other researchers, who are invited to build on the data by undertaking more focussed projects based on the CRC genome.

Co-lead researcher, Professor Richard Houlston, Professor of Cancer Genomics at The Institute of Cancer Research, London, said:

“This research is a great insight into the biology of colorectal cancer, uncovering the clues as to how it develops, grows, and responds to treatments. I look forward to seeing future studies use these findings to develop tailored treatments for people with colorectal cancer, based on their genetics.”

Co-lead researcher, Professor David Wedge, Professor of Cancer Genomics and Data Science at the University of Manchester, said:

“This is the first really large study to come out of the 100,000 Genomes Project led by Genomics England and NHS England. In the coming months and years, I expect it to be followed by many more studies of different types of cancer as well as combined studies across all types of cancer, fuelled by the fantastic data resource provided by Genomics England.”

Dr Henry Wood, Lecturer in Translational Bioinformatics from Pathology in the University of Leeds’ School of Medicine, said:

“This study is the first to provide in-depth, whole-genome sequencing and characterisation of the microbiome - the community of bacteria and viruses that live in the gut - in a large number of cases of bowel cancer. This means that we are now in a position to investigate the importance of the microbiome in the development of these cancers, and whether we can change it to influence the tumour and improve patient outcomes.”

*The research team spanned the Universities of Oxford, 91ֱ��, Birmingham, Edinburgh and Leeds, as well as The Institute of Cancer Research, London and the Centro de Investigación Biomédica en Red Cáncer, Barcelona. 

** The 100,000 Genomes Project is an ambitious initiative that sequenced 100,000 genomes from NHS patients affected by rare conditions or cancer, providing both diagnoses and access to treatment for thousands of patients with research and analysis still ongoing. The Project laid the foundations for the NHS to become the first national health system to offer whole genome sequencing as part of routine care via the NHS Genomic Medicine Service. 

MFT researchers say it is likely this is because of the platinum-based chemotherapy that is widely used to treat ovarian cancer.

This is the largest study of breast cancer after ovarian cancer diagnosis to date and was supported by the National Institute for Health and Care Research (NIHR) 91ֱ�� Biomedical Research Centre (BRC).

BRCA1 and BRCA2 are genes that greatly raise the risk of developing cancer if they become altered (or mutate).

estimates there is a 72% risk of developing breast cancer by age 80 for people with BRCA1 and a 69% risk for people with BRCA2 gene mutations. However, this did not specifically assess the risk of breast cancer following ovarian cancer diagnosis.

Two studies* that have addressed this had follow up largely limited to 10 years and had no breakdown by gene. These studies estimated risk of breast cancer after ovarian cancer diagnosis to be 11% in 79 women and 7.8% in 509 women.

In this latest study, MFT researchers reviewed the history of breast cancer in 701 women with ovarian cancer who had the faulty BRCA1 or BRCA2 gene.

Women included in the study had attended specialist genetics clinics at MFT, East Cheshire NHS Trust, Mid Cheshire Hospitals NHS Foundation Trust, and Lancashire Teaching Hospitals NHS Foundation Trust.

Incidence of breast cancer was assessed annually by age group and for up to 15 years following ovarian cancer diagnosis.

Their analysis has shown for those with the faulty gene, the likelihood of developing breast cancer in the first five years after an ovarian cancer diagnosis is significantly lower than for those without ovarian cancer.

The study was led by Professor Gareth Evans, Consultant in Medical Genetics and Cancer Epidemiology at MFT and The University of Manchester and NIHR 91ֱ�� BRC Cancer Prevention and Early Detection Co-Theme Lead. He said: “Many women we speak to who have a new diagnosis of ovarian cancer immediately ask about bilateral mastectomy (removal of both breasts) as an option to manage their cancer risk. Many are upset to hear they need to delay this to the required two-year point of disease-free survival from ovarian cancer.

“Our findings mean we can reassure women that their risk of breast cancer in the first two years (short term) after diagnosis is relatively low at around 2% to 2.5%. This is likely because of the effects of platinum-based chemotherapy, which is widely used to treat ovarian cancer, resulting in control and potentially complete eradication of breast cancers that otherwise could have occurred in the first five years.”

The results, published in , show that for those with ovarian cancer and the BRCA2 gene, the low rate of breast cancer continues until 10 years of follow up. Their breast cancer risk after ovarian cancer diagnosis was 3.3% at 2 years, 6.2% at 5 years, 10.4% at 10 years, and 20.3% at 15 years.

For those with the faulty BRCA1 gene, incidence of breast cancer was lower between 0 and 5 years after ovarian cancer diagnosis, but risk increased between 5 and 10 and after 10 years of follow up. Their breast cancer risk after ovarian cancer diagnosis was 2.1% at 2 years, 5.0% at 5 years, 15.0% at 10 years and 29.1% at 15 years.

The researchers say women need to be aware of these increases, especially after 10 years.

Professor Evans said: “For those with BRCA2, lower rates of breast cancer continue until 10 years of follow up as this gene is more sensitive to chemotherapy than BRCA1.

“In women with good long-term life expectancy the higher risks of breast cancer after 10 years, particularly in BRCA1, should be discussed with their clinicians. This includes presenting all the available options such as MRI screening and risk reducing mastectomy.”

The experts from Prostate Cancer UK, The University of Manchester and other institutions argue changing the NHS guidelines will allow GPs to proactively speak to men who are most at risk of getting the disease.

They today publish a paper in the supporting changes that would see healthcare professionals telling at men about their risk and giving them the choice of a free PSA blood test, a potentially life-saving conversation.

Prostate cancer often has no symptoms in its earlier, more treatable stages, so it’s crucial men know about their risk of getting the disease and think about the option of getting a PSA blood test, even if they feel healthy.

However, in the current system the men who are the most likely to get prostate cancer — including Black men and men with a family history of the disease — aren’t told about their higher risk by GPs.

Current data shows only half (53%) of men with prostate cancer get an earlier diagnosis, which falls significantly short of the NHS’s target of 75%.

Black men have double the risk of both getting prostate cancer and dying from the disease, while men living in deprived areas of the UK are 29% more likely to be diagnosed with incurable disease.

Black men and men with a family history of prostate cancer also tend to develop the disease at a younger age – from 45 – potentially losing decades of healthy life and leaving them and their families to deal with economic hardship and emotional trauma.

Prostate Cancer UK estimates that updating the NHS guidance, and implementing plans for raising awareness about the changes, could be delivered in just twelve months.

Amy Rylance, Assistant Director of Health Improvement at Prostate Cancer UK, said: “Leaving men in the dark about their risk means too many men are getting diagnosed with incurable prostate cancer, and this disproportionately affects Black men and men living in deprived areas.

“Prostate Cancer UK welcomes the new Government’s promises to increase earlier cancer diagnoses and to address gross health inequalities. Our message to the Government and MPs in the Commons is that we’re here to help you deliver those promises. Updating NHS prostate cancer guidelines could drive forward significant progress in just a year and, crucially, would give men a fairer chance of living longer.”

In the PSA Consensus paper the panel of clinicians and experts have agreed for the first time that the PSA blood test is a cheap, safe, and effective way of identifying which men would benefit from having further tests – in the first instance an MRI scan.

Dr Sam Merriel, one of the authors of the paper, is a GP and Academic Clinical lecturer at The University of Manchester.

He said: "As a GP, it's frustrating that current Department of Health and Social Care guidelines on PSA testing in men without symptoms provide very limited detail for us and our patients. It is unclear what should be done for men at higher risk of prostate cancer, how often men who choose to have the PSA blood test should have one, and when it would be in a man’s best interest to stop testing.

"There has long been disagreement about the benefits and harms of the PSA blood test. However, with the publication of this new paper, we've shown there's broad agreement among the top minds in urology and prostate cancer care that the PSA blood test is simple and safe – and that GPs should consider proactively discussing the test with Black men and men with a family history from the age of 45. 

“Increases in PSA testing are likely to pose a substantial challenge to primary care resources which are already overstretched. The Government should provide NHS primary care with the necessary resources for men to be able to access PSA blood tests if they choose to do so, according to the current PSA testing guidelines for men without symptoms."

The state-of-the-art facility has been made possible through fundraising, philanthropic donations, and partnership between Cancer Research UK, the University of Manchester and the Christie NHS Foundation Trust.

This new National Biomarker Centre will help experts detect cancer at an earlier stage – when there are usually more treatment options available. It will also help to provide clues on how aggressive a patient’s tumour is, predict which treatments are likely to work best and monitor responses to personalised treatment.

Cancer Research UK will invest £2.5m into the National Biomarker Centre each year as part of a £26m investment in 91ֱ�� – putting the city at the heart of its mission to beat cancer.

The Cancer Research UK National Biomarker Centre is a significant milestone in the mission to develop earlier and highly personalised treatments for cancer. It is fitting that this revolutionary approach will be based in 91ֱ��, one of the world’s leading cities for cancer research.

Professor Graham Lord, Vice-President and Dean of the Faculty of Biology, Medicine and Health at The University of Manchester said: “The Cancer Research UK National Biomarker Centre is a significant milestone in our mission to develop earlier and highly personalised treatments for cancer. It is fitting that this revolutionary approach will be based in 91ֱ��, one of the world’s leading cities for cancer research.”

The news of the centre opening has been welcomed by three individuals from Greater 91ֱ��, each of whom owes their life to the power of cancer research. They were invited to the centre for a special preview before the official opening today.

Asia, who lives in 91ֱ�� city centre, has recently been given the all-clear after being diagnosed with stage 4 Hodgkin lymphoma last year.  

Last year was gruelling and I’m now delighted to be recovering and getting my life back on track. Being able to see direct the work which will help future patients is fascinating and inspiring,” said Asia.

Carolyn, from Whitefield, had just celebrated her 40th birthday and her youngest child was aged four when she was diagnosed with breast cancer. She had a mastectomy and reconstructive surgery and also underwent chemotherapy at The Christie. 

“As a patient treated at The Christie who has gone on to support Cancer Research UK for many years, I am delighted to have a sneak preview of the work at the National Biomarker Centre and find out what the future of research holds,” said Carolyn.

Sharon, from Chadderton in Oldham, also welcomed the news. She was diagnosed with breast cancer at the age of 36 after noticing a lump on her left breast. She underwent surgery followed by 12 weeks of chemotherapy treatment.  

“I am always humbled to hear about the amazing research work happening in 91ֱ��,” said Sharon. “Having a look at the National Biomarker Centre before the official opening is so exciting.”

Now 60, she will celebrate a quarter of a century free of cancer next year.

Showcasing biomarker research in 91ֱ�� 

Another person who knows all too well the impact of cancer is Professor Caroline Dive, Director of the National Biomarker Centre. Her grandfather died from brain cancer before she was born. Her mother has undergone surgery on an endometrial tumour, and her father was treated for colon cancer. He passed away aged 95, following a further diagnosis of cancer.

“The impact biomarkers will have on patients’ care can’t be underestimated,” said Professor Dive.

“Doctors will be able to get more information, faster, to determine the best treatment plan for each individual. And it will stop some patients from undergoing unnecessary interventions or treatments that could cause pain or discomfort without providing benefit.

“W�� are learning how to manage cancer. And that will mean we can give patients longer with their loved ones and a good quality of life.”

The launch event today brings together key stakeholders, philanthropists, political leaders, key researchers and Cancer Research UK staff, including Michelle Mitchell, CRUK chief executive. The event will showcase the new research facilities and bring attention to growing biomarker research in 91ֱ�� and the UK.

“As a former student of The University of Manchester, I’m delighted that such an exciting and revolutionary facility will be housed in the city,” said Michelle Mitchell.  

“Research at the Cancer Research UK National Biomarker Centre will help to transform cancer treatment in the future.”

Detecting cancer earlier 

Cancer survival is three times higher on average if diagnosed early. That’s why the National Biomarker Centre’s work in early detection is a key priority for Cancer Research UK’s More Research, Less Cancer campaign.

Images:

• Asia at the National Biomarker Centre
• Carolyn at the National Biomarker Centre
• Sharon at the National Biomarker Centre
• Professor Caroline Dive speaking to visitors at the new National Biomarker Centre

describe a force-controlled release system that harnesses natural forces to trigger targeted release of molecules, which could significantly advance medical treatment and smart materials.

The discovery, published today in the journal , uses a novel technique using a type of interlocked molecule known as rotaxane. Under the influence of mechanical force - such as that observed at an injured or damaged site - this component triggers the release of functional molecules, like medicines or healing agents, to precisely target the area in need. For example, the site of a tumour.

It also holds promise for self-healing materials that can repair themselves in situ when damaged, prolonging the lifespan of these materials. For example, a scratch on a phone screen.

Traditionally, the controlled release of molecules with force has presented challenges in releasing more than one molecule at once, usually operating through a molecular "tug of war" game where two polymers pull at either side to release a single molecule.

The new approach involves two polymer chains attached to a central ring-like structure that slide along an axle supporting the cargo, effectively releasing multiple cargo molecules in response to force application. The scientists demonstrated the release of up to five molecules simultaneously with the possibility of releasing more, overcoming previous limitations.

The breakthrough marks the first time scientists have been able to demonstrate the ability to release more than one component, making it one of the most efficient release systems to date.

The researchers also show versatility of the model by using different types of molecules, including drug compounds, fluorescent markers, catalyst and monomers, revealing the potential for a wealth of future applications.

Looking ahead, the researchers aim to delve deeper into self-healing applications, exploring whether two different types of molecules can be released at the same time. For example, the integration of monomers and catalysts could enable polymerization at the site of damage, creating an integrated self-healing system within materials.

They will also look to expand the sort of molecules that can be released.

said: "We've barely scratched the surface of what this technology can achieve. The possibilities are limitless, and we're excited to explore further."

The Clinical Academic Training Programme will invest £58.7m at nine research centres including the Cancer Research UK 91ֱ�� Centre in partnership with the Christie NHS Foundation and The University of Manchester and The University of Leeds.  

Clinician scientists play an essential role in translating cancer research, helping to bridge the gap between scientific research carried out in laboratories and clinical research involving patients. Working across both research settings, their contributions to new knowledge and its translation to clinical practice are critical for cancer research.

Cancer Research UK’s Clinical Academic Training Programme Award will continue to transform clinical research training at nine of its research centres over the next five years. It builds on the 5-year £50.7 million investment awarded by the charity in 2019. In total, the Cancer Research UK will have invested more than £109 million in this programme over ten years, signalling the critical role the charity plays in supporting the UK’s life sciences ecosystem.

Michelle Mitchell, Cancer Research UK’s Chief Executive, said:  “Clinician scientists have a very important role to play by bringing their knowledge and experience of treating people with cancer to scientific research.

“W�� need all our doctors and scientists to be able to reach their full potential, no matter their background. That’s why we are continuing to provide flexible training options for early-career clinician scientists. After the success of the first five years of this programme, we want to encourage even more clinicians to get involved in cancer research to help us get closer to a world where everybody lives longer, better lives free from the fear of cancer.”

Becoming a clinician scientist usually involves doctors taking time out of their medical training to undertake a PhD, before returning to train in their chosen specialisation, but many clinicians don’t come back to research after qualifying as consultants.

To address this problem, Cancer Research UK awarded funding to provide flexible training options alongside mentorship and networking opportunities to better support clinicians who want to get involved and stay in cancer research, through building stronger clinician scientist networks within and across research institutes.

In particular, the funding allows universities to offer combined Bachelor of Medicine-Doctor of Philosophy (MB-PhD) qualifications to early career clinicians – which allows medical students to complete a PhD earlier in their medical training.

Data from the Medical Schools Council Clinical Academic Survey reports a decline in the number of clinical academic positions between 2011–2020. US data also suggests that offering combined qualifications retains more women in clinical research roles.

Welcoming Cancer Research UK’s renewing of clinical training funding in Scotland, the Director of the Cancer Research UK Scotland Centre, Professor Charlie Gourley, said:  “W�� are delighted to gain further Cancer Research UK funding and to work with colleagues across Scotland to offer doctors new and flexible training opportunities so that they can become the clinical cancer researcher leaders of the future.

“It is vital for our laboratory scientists to be able to work with clinicians at all levels and specialities to find new and better treatments for cancer. This will undoubtedly lead to benefits for cancer patients in the longer term.”

The Cancer Research UK 91ֱ�� Centre is one of eight centres in England receiving further CATP funding The Director of the Cancer Research UK 91ֱ�� Centre and Professor of Cancer Studies at The University of Manchester, said: “Renewing funding for this programme of training and support for clinician scientists is another step forward.  The increased flexibility offered, and additional funding and support after doing a PhD will allow more time for doctors to do research, no matter their background and personal circumstances.

“This continued investment by Cancer Research UK will deliver a highly enthusiastic, educated, and diverse workforce in the UK who will help bring new cancer treatments and diagnostic tests to those who need it most.”

Medical student, transferred to a CRUK-funded MB-PhD course in 2020. Under the supervision of , her PhD focussed on using a new way of measuring obesity-related factors in individuals, called “overweight years”, similar to how “pack-years” is used to measure an individual smoker’s tobacco use.

She completed her PhD studies in 2023 and should complete her medical degree next year, with her gained research experience informing her studies and medical practice.

Reflecting on her MB-PhD studies, Dr Nadin Hawwash said: “The MB-PhD pathway to become a clinical scientist stood out for me, because it helps medical graduates to stay in research following undergraduate training.

“The course allowed me to: undertake data science-focused cancer research; create international collaborations; assemble and analyse a consortium with over 1.4 million individuals from 10 countries; and present my research globally.

“I am thrilled that more aspiring researchers will be able to train as clinician scientists in 91ֱ�� and elsewhere, to contribute to cutting-edge cancer research projects that will ultimately benefit patients.”

The ‘Team Womb’ collective, headed by Professor Emma Crosbie, Honorary Consultant in Gynaecological Oncology at MFT have been given the prestigious Team Science Award for their pioneering work on Lynch-syndrome associated endometrial cancer.

The team from Saint Mary’s Hospital (pictured below), part of MFT, will receive this award at the on Sunday 7 April in San Diego, California. The 10 researchers are from MFT, The University of Manchester, 91ֱ�� Cancer Research Centre, and NIHR 91ֱ�� BRC.

, who is Cancer Prevention and Early Detection Co-Theme Lead at NIHR 91ֱ�� BRC and Professor of Gynaecological Oncology at The University of Manchester said: “I am thrilled that our research means that everyone diagnosed with endometrial cancer in the UK is now offered testing for Lynch syndrome. The recognition of this work through the prestigious 2024 AACR Team Science Award is a tremendous honour and I would like to thank everyone who supported us along the way. This was a true multidisciplinary effort involving clinicians, allied healthcare professionals, researchers, patients and charities without whom none of this would have been possible.”

91ֱ��’s ‘Team Womb’ led a research programme that identified a link between womb cancer and Lynch syndrome, changing clinical practice across the UK.

Lynch syndrome is a genetic condition that can significantly increase the risk of developing cancer. It affects around 1 in 300 people, with most unaware that they have it. This condition runs in families and means anyone with the faulty gene carries a high risk of developing womb, bowel and other cancers.

Through unselected and comprehensive testing all womb cancer patients attending MFT between 2016-18, the team showed that 3% had Lynch syndrome and defined the best strategy for identifying them.

Following this study, the National Institute for Health and Care Excellence (NICE) commissioned an expert advisory group to assess the evidence, and resulted in a change in guidance which recommends universal testing of all endometrial cancer patients for Lynch syndrome. This guideline means around 1,000 new people per year in the UK alone can benefit from cancer prevention strategies.

The AACR founded the prestigious Team Science award in 2006 to recognise the growing importance of interdisciplinary teams in understanding cancer and for translating research through to clinical care.

Annually, this award recognises ‘outstanding interdisciplinary research’ teams for their ‘innovative and meritorious science’ that has ‘advanced or may advance our fundamental knowledge of cancer, or has applied existing knowledge to advancing the detection, diagnosis, prevention, or treatment of cancer’.

2024-25 AACR President, Dr Patricia M. LoRusso said; “I believe that this team exemplify true team science, bring together an interdisciplinary team of academics, clinicians and healthcare staff from across medicine, oncology, pathology, health economics and behavioural science. Within this nomination I highlight their exceptional and practice changing work within detection, alongside several outstanding current and future projects they have in their portfolio.”

Picture captions:

Photo 1 – Team Womb (from left to right): Prof Ray McMahon, Ms Nadira Narine, Prof Katherine Payne, Dr Louise Gorman, Prof Emma Crosbie, Dr Neil Ryan, Dr Rhona McVey, Dr James Bolton. Also Prof Gareth Evans and Dr Durgesh Rana (not in photo)

Photo 2 – Team Womb (from left to right): Dr Rhona McVey, Dr James Bolton, Dr Louise Gorman, Ms Nadira Narine, Prof Emma Crosbie, Prof Katherine Payne, Dr Neil Ryan, Prof Ray McMahon. Also Prof Gareth Evans and Dr Durgesh Rana (not in photo)

The research, published in the Ebiomedicine, part of the Lancet Discovery Science, reports that the test has over 95% accuracy in identifying post-menopausal women with cancer as the cause of their bleeding, and is more accurate than current methods.

The scientists hope the new test could improve the diagnosis of womb cancer and reduce the need for more invasive, painful and anxiety-provoking tests currently used in hospitals, such as hysteroscopy.

The study was led by , academic clinical lecturer and senior clinical oncology speciality registrar at The University of  91ֱ�� and , Honorary Consultant in Gynaecological Oncology at 91ֱ�� University NHS Foundation Trust (MFT) and Professor of Gynaecological Oncology at The University of Manchester and Principal Investigator.

Working with collaborators including Professor Anthony Whetton from the University of Surrey, they identified a five-marker panel of proteins in the vaginal fluid that accurately discriminates those with womb cancer from those that do not have cancer.

Samples were taken from symptomatic post-menopausal women recruited from Saint Mary’s Hospital, part of MFT, 53 with and 65 without endometrial cancer.

Samples were taken from symptomatic post-menopausal women, 53 with and 65 without endometrial cancer.

The scientists used a high tech method called SWATH-MS, a technique used in mass spectrometry, which measures the masses of molecules, providing information about their composition and structure.

SWATH-MS  helped them to analyze molecules, and create digital maps of proteins from the samples.

Then, they used machine learning to find the proteins that were most different between samples, creating a simple and accurate diagnostic model based on proteins.

The research was funded by Cancer Research UK 91ֱ�� Centre

Womb cancer is the fourth most common cancer in women in the UK with around 9,700 new cases every year.

Abnormal bleeding, especially after the menopause, is the main symptom. However, only 5-10% of women with bleeding have womb cancer as several other benign (non-cancerous) conditions such as polyps and fibroids can also cause bleeding.

Currently in the UK, women with suspected womb cancer undergo a transvaginal ultrasound scan, where a probe is inserted into the vagina to measure the thickness of the lining of the womb.

Those with a thickened womb lining then have their womb visually inspected by hysteroscopy, in which a narrow telescope with a light and camera is passed into the womb through the vagina and cervix.

Where needed, a biopsy will also be taken. The investigations are invasive and can be painful, and for most, unnecessary, since only 5-10% of symptomatic women have a sinister underlying condition.

Lead author, Dr Kelechi Njoku who has also recently been awarded the inaugural Eve Appeal/ Northwest Cancer Research Fellowship said: “The implications of this study are significant. If translated into clinical practice, a non-invasive, cost-effective, and accurate detection tool could improve patient care by swiftly identifying those with womb cancer while sparing many healthy women from unnecessary invasive tests.

“Building on this work and with funding support from the Eve Appeal and Northwest Cancer Research, we will be looking at developing clinically feasible assays based on established technologies like ELISA or Lumipulse®, or even newer platforms like lateral flow tests for point-of-care testing.”

Dr Helena O’Flynn, a General Practitioner and Trustee at Peaches Womb Cancer Trust, said: “This new test has the potential to better streamline the diagnostic process and may be used in primary care as a triage tool for women with suspected womb cancer.”

Detection of endometrial cancer in cervico-vaginal fluid and blood plasma: leveraging proteomics and machine learning for biomarker discovery - published in eBioMedicine (thelancet.com) is available

First awarded in 2002, The Wiley Prize in Biomedical Sciences is presented annually to recognise contributions that have opened new fields of research or have advanced concepts in a particular biomedical discipline.

Raymond proposed the concept of a stem cell niche back in 1978.  Recognition for this seminal work comes over 45 years later as he approaches his 99^th birthday. At that grand age it is quite remarkable that he is still around to receive this accolade.

The Paterson Laboratories as they were known then assembled a pioneering group of notable haematology researchers and the Paterson Institute became part of The University of Manchester in 2006. Working alongside Ray was Mike Dexter – at the time a postgraduate student – who later became the Director of the Institute and subsequently Director of Wellcome, and Brian Lord, who published over 130 papers and made many scientific break throughs in the of field stem cell biology and haematopoiesis. 

The photo features Ray on the left with colleague and friend Brian, who sadly passed away in 2021. Brian was the father of the current Vice-President and Dean of the Faculty of Biology, Medicine and Health, Professor Graham Lord. 

Ray worked at the Holt Radium Institute, later renamed the Paterson Laboratories after the first Director, Professor Ralston Paterson, until 1985 when he ‘retired’ to become a farmer in West Wales, where he still lives.

The new Paterson Building is on the same site as the original Paterson Laboratories, next to the Christie NHS Foundation Trust.

“I am thrilled that Drs. Schofield, Kimble, and Spradling have been selected to receive the Wiley Prize for their discovery of the stem cell niche. This niche is a cellular microenvironment that maintains stem cells in their naive state and prevents them from differentiating. Their pioneering discovery, made by studying bone marrow stem cells and stem cells in the reproductive organs of C. elegans and Drosophila, has revealed how stem cells are regulated during human development and tissue maintenance,” said Professor Titia de Lange of Rockefeller University and Chair of the Wiley Prize awards jury.

Among the many distinguished recipients of the Wiley Prize in Biomedical Sciences, thirteen have gone on to be awarded the Nobel Prize in Physiology or Medicine, and two have been awarded the Nobel Prize in Chemistry.

“The Wiley Foundation honors research that not only offers breakthrough solutions to existing problems in biomedical sciences, but also fuels future discoveries,” said Deborah Wiley, Chair of the Wiley Foundation. “The work of the 2024 Wiley Prize recipients truly upholds this mission, laying the foundation for today’s life-changing discoveries in the field of stem cell biology.”

This year’s award will be presented at the Wiley Prize lecture on 5 April 2024, although Ray will not be able to attend given his age.

Article credited to Gill Campbell, CRUK MI

A new Cancer Research UK-funded study has revealed that prostate cancer, which affects one in eight men in their lifetime, includes two different subtypes termed evotypes.

The discovery was made by an international team led by the , and The University of Manchester, who applied AI (artificial intelligence) on data from DNA to identify two different subtypes affecting the prostate.

The team hope their findings could save thousands of lives in future and revolutionise how prostate cancer is diagnosed and treated. Ultimately, it could provide tailored treatments to each individual patient according to a genetic test which will also be delivered using AI.

According to , prostate cancer is the most common cancer affecting men in the UK with around 52,000 cases a year. Dr Rupal Mistry, the charity’s senior Science Engagement Manager, said:

“The work published today by this global consortium of researchers has the potential to make a real difference to people affected by prostate cancer. The more we understand about cancer the better chance we have of developing treatments to beat it. We are proud to have helped fund this cutting-edge work, which has laid the foundations for personalised treatments for people with prostate cancer, allowing more people to beat their disease.”

The ground-breaking research, which involved additional funding from Prostate Cancer Research and involved scientists from the University of Oxford the University of Manchester, the University of East Anglia and the Institute of Cancer Research, London, highlights how a prostate cancer diagnosis can affect physical, emotional and mental wellbeing.

Lead researcher Dr Dan Woodcock, of the Nuffield Department of Surgical Sciences at the University of Oxford, said: “Our research demonstrates that prostate tumours evolve along multiple pathways, leading to two distinct disease types. 

“This understanding is pivotal as it allows us to classify tumours based on how the cancer evolves rather than solely on individual gene mutations or expression patterns.” 

The researchers worked together as part of international consortium, called The Pan Prostate Cancer Group, set up by scientists at The Institute of Cancer Research (ICR) and The University of East Anglia to analyse genetic data from thousands of prostate cancer samples across nine countries. 

Crucially, the team's collaboration with Cancer Research UK (CRUK) aims to develop a genetic test that, when combined with conventional staging and grading, can provide a more precise prognosis for each patient, allowing tailored treatment decisions. 

The researchers used AI to study changes in the DNA of prostate cancer samples (using whole genome sequencing) from 159 patients. 

They identified two distinct cancer groups among these patients using an AI technique called neural networks. These two groups were confirmed by using two other mathematical approaches applied to different aspects of the data. This finding was validated in other independent datasets from Canada and Australia. 

They went on to integrate all the information to generate an evolutionary tree showing how the two subtypes of prostate cancer develop, ultimately converging into two distinct disease types termed ‘evotypes’. 

of Manchester Cancer Research Centre, who led the study, explained: “This realisation is what enables us to distinguish the disease types. This hasn’t been done before because it’s more complicated than HER2+ in breast cancer, for instance. 

"This understanding is pivotal as it allows us to classify tumours based on their evolutionary trajectory rather than solely on individual gene mutations or expression patterns." 

Researcher Prof Colin Cooper, from UEA’s Norwich Medical School, highlighted that while prostate cancer is responsible for a large proportion of all male cancer deaths, it is more commonly a disease men die with rather than from. This means that unnecessary treatment can often be avoided, sparing men from side-effects such as incontinence and impotence. 

He added: “This study is really important because until now, we thought that prostate cancer was just one type of disease. But it is only now, with advancements in artificial intelligence, that we have been able to show that there are actually two different subtypes at play. 

“W�� hope that the findings will not only save lives through better diagnosis and tailored treatments in the future, but they may help researchers working in other cancer fields better understand other types of cancer too.” 

Dr Naomi Elster, Director of Research at Prostate Cancer Research, said: “W�� simply don’t know enough about what a prostate cancer diagnosis means at present – there are many men who have disease which is or may become aggressive and being able to treat aggressive disease more effectively is critical. But on the other side of the coin are the too many men who live with side effects of cancer treatment they may never have needed. 

“These results could be the beginning of us being able to take the same ‘divide and conquer’ approach to prostate cancer that has worked in other diseases, such as breast cancer.” 

Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, and Honorary Consultant in Clinical Oncology and Cancer Genetics at The Royal Marsden NHS Foundation Trust, said: “This study has utilised the enormous genomic dataset from The Pan Prostate Cancer Group – a powerhouse of information about prostate cancer from around the world. These results will hopefully lead to better treatments for patients, demonstrating the importance of data sharing and team science.”

The study - ‘’ is published online in the journal Cell Genomics.

The international guideline for ‘Idiopathic Inflammatory Myopathy-Associated Cancer Screening: an International Myositis Assessment and Clinical Studies Group (IMACS) Initiative’ was published at the beginning of November 2023 and led by .

Dr Oldroyd is an NIHR Academic Clinical Lecturer within the Rheumatic and Musculoskeletal Diseases Theme (RMD) of the NIHR 91ֱ�� BRC and his research focuses on improving cancer screening in myositis.

The guideline provides a personalised roadmap for people with adult-onset myositis, a rare condition that can cause weak muscles, and offers 18 recommendations. Their main aim is to empower clinicians to detect cancer early, especially those at high risk, contributing to better overall outcomes.

He said; “The guidelines help categorise individuals into standard, moderate, or high-risk groups based on their myositis subtype, autoantibody status, and certain clinical features.

“The guideline details 2 screening panels: a ‘basic’ one with tests like chest radiography, and an ‘enhanced’ option with advanced techniques like CT scans and tumour markers.

“Guidance on timing and frequency of screening is also provided and tailored to individual risk levels. Additional procedures, like gastrointestinal endoscopy and PET–CT scans, are recommended in specific cases.”

Myositis is an auto-immune muscle disease affecting approximately 10,000 people in the UK and evidence suggests up to 1 in 4 people with myositis will develop cancer within 3 years of diagnosis. Various cancers have been reported, including lung, ovarian, colorectal, lymphoma, breast and nasopharyngeal cancers among the most common. Myositis itself is currently treatable, not curable.

Dr Oldroyd, NIHR Academic Clinical Lecturer at The University of Manchester within the Division of Musculoskeletal and Dermatological Sciences, presented the recommendations at the American College of Rheumatology conference and a paper on the evidence-based guideline has been published in .

The process to develop the guideline began in 2019, and the first part of the project involved conducting a . The expert group included 75 co-authors across 22 different countries.

Dr Oldroyd, who is also a Rheumatologist at Salford Royal Hospital, part of Northern Care Alliance NHS Foundation Trust, added;

“I am really proud that we now have an evidence and consensus base for cancer screening to improve outcomes, enabling earlier diagnosis and stimulating further research in this area.

“This global guideline will help clinicians risk-stratify a patient’s individual characteristics using their disease sub type and enable a standardised approach across health systems to ascertain whether people will be at high, moderate or standard risk of cancer.

“Early detection of cancer is key to improving outcomes. Importantly we hope this will enable clinicians to plan how to screen for cancer in those patients and how often.

“Several 91ֱ�� BRC members are co-authors which highlights the capability of Manchester BRC in bringing together experts in musculoskeletal disease, cancer and rare conditions. Thank you to everyone who has contributed to and supported this work.”

The recommendations have been scientifically reviewed by the International Myositis Assessment and Clinical Studies Group Scientific Committee and endorsed by the International Myositis Society.

The RMD Theme is part of Manchester BRC’s Inflammation Cluster along with 3 other research Themes; Respiratory Medicine, Dermatology and Integrative Cardiovascular Medicine.

These conditions – which include arthritis and related conditions, chest diseases, skin disorders and heart disease – are all underpinned by chronic inflammation.

Watch the BRC’s Spotlight On film to find out how 91ֱ�� BRC’s inclusive and proactive research is driving health improvements in rheumatic and musculoskeletal diseases and other health conditions.

We know that to realise a future where gynae cancers are diseases of the past, we need to invest in the next generation of researchers and support them in becoming leaders in the field.

The Eve appeal has been working with North West Cancer Research, an independent charity committed to improving outcomes of people with cancer in their region. They will be funding Dr Kelechi Njoku, a senior clinical oncology specialty registrar and academic clinical lecturer from the University of Manchester, to develop a new, kinder, test to diagnose womb cancer. We will be funding Dr Njoku’s work with up to £120,000 each year for the next three years.

Professor Ian Jacobs, Chair of The Eve Appeal’s Research Advisory Committee thinks this new research programme has the potential to benefit many women, he says: “Kelechi is a talented clinical specialist working at a leading centre in gynaecological cancer. His research plans address an important issue - the application of powerful research technologies to achieve rapid, accurate and safe diagnosis of cancer of the womb.”

Womb cancer is the most common type of gynaecological cancer and the fourth most common cancer in women, and it is on the rise. Currently in the UK, when someone has the ‘red flag’ symptom of womb cancer, abnormal bleeding, they are faced with a series of uncomfortable and invasive tests. These include transvaginal ultrasounds (where a scanner probe is inserted into the vagina to visualise the inside of the womb), hysteroscopy (where a thin camera is put into the womb through the vagina and cervix to see inside the womb), and biopsies. But, Dr Njoku and his team have found that they can use proteins in vaginal fluid to test for womb cancer- without any invasive techniques or discomfort- using a small device that is put into the vagina.

Dr Kelechi believes this Fellowship represents a significant step forward in the collective efforts to improving outcomes for women affected by womb cancer, he says: “I have been working on developing simple, non-invasive and accurate tests for the early detection of womb cancer over the past few years and I am delighted to receive this funding from The Eve Appeal and the Northwest Cancer Research to continue the work”. His research found that when someone has womb cancer, cancer cells can be found in the vagina. They have been working on using the proteins in the vaginal fluid (an area of research called proteomics), to detect certain proteins that are signs of womb cancer. So far in their studies this has worked really well, especially in postmenopausal women, detecting 95% of cancers!

Now their plan, with thanks to the Fellowship funding, is to really put this technology to the test and try it on 500 women who are either known to have womb cancer or are at a high risk of developing it. They want to find out from these women whether the test works as well as they hope, how the women find the test and if it will be cost effective to the NHS to use instead of the current methods.

Eve CEO, Athena Lamnisos, is delighted by Dr Njoku joining Team Eve as a research Fellow, especially as womb cancer research is underfunded in the UK, she says: “with so little funding focused in this area, it is increasingly difficult for committed researchers to pursue their work; we know that this fellowship scheme has the potential to support the research workforce necessary to drive transformational change in gynae cancers. Dr Njoku is an exceptional candidate, and he will join a long line of early career researchers that The Eve Appeal have supported, who have gone on to make a world-wide impact in gynae cancer research.”

North West Cancer Research CEO, Alastair Richards, added: “W�� are delighted to be working in partnership with The Eve Appeal to jointly fund their first Fellowship. Gynaecological cancer remains a significant issue for the North West as well as the rest of the country and we hope that Kelechi’s work will be an important step forward in our knowledge of the diagnosis of womb cancer.”  

As the Chair of the Research Committee who confirmed Dr Njoku selection, Professor Ian Jacobs says: “Through a rigorous and competitive selection process Dr Njoku emerged as an ideal recipient of The Eve Appeal Fellowship. The Eve Appeal has a wonderful track record of supporting emerging talented researchers and Kelechi’s Fellowship award continues that trajectory.”

We had many really strong applications and hope to see more fantastic researchers joining Dr Njoku as Eve Fellows in the future. Athena comments: “With such a strong pool of applicants, we know that there’s an exciting range of research that requires support and driving forward. Eve and North West Cancer Research Fellowships will provide a step-change in transformative research in these areas and achieve our shared vision of a future where the five gynaecological cancers are either prevented or diagnosed at the earliest stage.”

The review, published in and funded by the National Cancer Research Institute, found that 61% of all SPED trials focused on just three cancer types – colorectal, breast, and cervical cancer. This compares with 6.4% in lung cancer and 1.8% in liver cancer, which are responsible for 26.3% of global cancer deaths compared with 19.3% for colorectal, breast, and cervical cancer.

Researchers identified areas of unmet needs around the world to highlight where more research and funding is needed. 88% of all SPED trials were conducted in North America, Europe, or Asia, with a lack of trials conducted in Africa and South America and a very low number of trials per head of population In Asia.

Results also highlighted that significant disparities exist between the proportion of SPED trials for certain cancer types and their global burden of disease. For example, colorectal cancer accounted for 32.9% of all SPED trials and 9.4% of global cancer deaths, whilst gastric cancers accounted for 1.5% of SPED trials and 7.7% of global cancer deaths.

This study, led by researchers at the universities of Nottingham and 91ֱ��, involved researchers from seven different universities across England and Scotland.

Dr Emma O’Dowd, Consultant Respiratory Physician and Associate Professor at the University of Nottingham, says: “Cancer is the most common cause of death and disability in the UK and the second most common cause globally. Global annual cancer incidence is forecast to rise to 27.5 million by 2040, a 62% increase from 2018. For most cancers, prevention and early detection are the most effective ways of reducing mortality.

“W�� looked at all trials published between 2007 and 2020 covering cancer screening, prevention, and early diagnosis to map what research had been done by cancer type, trial focus and geographical area, and to highlight research gaps.

“Over 117,000 papers were identified, and 2888 trials were included. There were disparities in terms of geographical location, type of research conducted and a clear focus on a small number of cancer types. We hope that this important piece of work can be used to guide and prioritise future trial funding.”

Dr Samuel Merriel, GP and NIHR Academic Clinical Lecturer at the University of Manchester, added: “There are finite resources that governments can allocate for cancer healthcare and a limited amount of money available for cancer research. Until now there has not been a detailed summary of all the studies of cancer prevention, cancer screening, and earlier detection of cancer.

“W�� hope that these findings and the database of studies we have generated can be used by policymakers, healthcare commissioners, and cancer research funders to address the disparities in cancer screening, prevention, and early diagnosis trials.”

Dr Elizabeth Roundhill, Research Fellow in the School of Medicine, University of Leeds, comments: “Our research has revealed that even though lung and liver cancers together cause more than a quarter of cancer deaths worldwide, they are less likely to be examined in screening, prevention and early diagnosis (SPED) trials. We also found there was a distinct lack of trials in cancers common in children and young people including sarcomas, blood cancers and brain tumours.

“Importantly, only 12% of SPED cancer trials have taken place in the Global South, meaning that the benefits of implementing SPED interventions in some of the world’s most populous regions remain unknown. With almost half of all cancers in the UK having a potentially preventable cause, this work calls for a greater focus on SPED research, including in the UK. We hope that these findings will encourage funders, policy makers and researchers to target resources towards addressing these major health inequalities in the future.”

For further information, the full report can be found

Around 15%* of breast cancers are classed as triple negative and if this form of the disease becomes resistant to chemotherapy, there are few other treatments available.

Triple negative breast cancer is also more likely than most other breast cancers to return or spread within five years following diagnosis**.

When breast cancer cells spread from the first cancer in the breast to other parts of the body it’s called secondary or metastatic breast cancer and although treatable, it currently can’t be cured.

Dr Nagarajan and her team recently discovered that lower levels of a protein called ARID2 in triple negative breast cancer can help cancer cells spread. They also found that ARID2 works with proteins called nuclear receptors to control certain genes.

The scientists are now investigating the exact ways in which ARID2 and nuclear receptors work together. They will look at how these proteins influence the activity of different genes in triple negative breast cancer cells that have been grown in the lab, and samples donated by patients to the Breast Cancer Now Tissue Bank.

Finally, they will test clinically approved drugs that block certain nuclear receptors, to see if they can control the spread of triple negative breast cancer in mice.

This will include a drug called mifepristone, which works in this way and is used for medical abortions where pills are taken to end pregnancy.

Dr Sankari Nagarajan said: “Chemotherapy is highly effective for many women with triple negative breast cancer. However, in the cases when the cancer doesn’t respond, there are limited targeted treatments available.

���� we can understand what helps these tumours spread to other parts of the body, we can hopefully find new, better ways to treat the disease. This could include repurposing drugs that block nuclear receptors to improve breast cancer survival and people’s quality of life.”  

Dr Simon Vincent, Breast Cancer Now’s director of research, support and influencing said: “Each year around 8,000 UK women are diagnosed with triple negative breast cancer, which is usually a more aggressive form of breast cancer and more likely to return or spread soon after treatment.

“T�󲹳�’s why Breast Cancer Now is funding this important research that could lead to new, effective ways to treat people with triple negative breast cancer and stop them dying from this devastating disease.”

Breast Cancer Now is the research and support charity here for anyone affected by breast cancer. Call their free helpline on 0808 800 6000 to speak to their expert nurses or find out more and donate at

* Diana, A., Carlino, F., Franzese, E. et al (2020). Early Triple Negative Breast Cancer: Conventional Treatment and Emerging Therapeutic Landscapes. Cancers, 12(4), 819.

** Lee, A., & Djamgoz, M. (2018). Triple negative breast cancer: Emerging therapeutic modalities and novel combination therapies. Cancer treatment reviews, 62, 110–122 and Dent, R., Trudeau, M., Pritchard. et al. (2007). Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence. Clinical Cancer Research, 13(15), 4429-4434.

The move is part of a £2million funding package for hard to treat cancers, announced by Prime Minister Rishi Sunak last week.

The oesophagus is commonly known as the food pipe and carries food from the throat to the stomach. More than 9000 people are diagnosed with oesophageal cancers in the UK each year, and this disease is responsible for 5% of cancer related deaths.

New treatments are necessary because even when the most common form of the cancer (OAC – oesophageal adenocarcinoma) is discovered at an operable stage there is a 50% risk of it reoccurring after surgery and chemotherapy. Only 10%-15% of patients with OAC live beyond 5 years from diagnosis.

Immunotherapies that boost the immune system and help the body fight the cancer can prolong life for up to 20% of patients.

The interdisciplinary research team has learnt how, in some cases, the body’s immune system shuts down its own anti-cancer defences, so they want to find a way to stop this happening.

This lab-based work involves an ‘RNA therapeutic’, using a technology similar to the COVID19 mRNA vaccines. The RNA molecules that the team will study can switch immune cells on, and they will design a new strategy to focus the delivery of medicines to a specific cell. The team will then put the new RNA-based therapy inside the cancer, targeting the specific group of cells responsible for disrupting the anti-cancer immunity. 

Dr Sara Valpione, consultant oncologist at The Christie and honorary senior lecturer at The University of Manchester said: “W�� are so pleased to have received the funding to enable us to test our hypothesis in the lab. If we can create a new medicine that can precisely target a specific type of cell within the tumour, and restore anti-cancer immune responses, this will be a game-changer for oesophageal cancer patients, bringing new hope. If we discover the drug performs as we anticipate in a lab setting, we will plan to start a clinical trial and test is on patients, although this is some way off. The results of this project should be very exciting, and will contribute to our understanding of immune-oncology and oesophageal cancer. Not only could this be a useful weapon against OAC, but it could have wider benefit, as our theory could be applied to other forms of the disease.”

Dr Megan Dowie, the Medical Research Council’s head of molecular and cellular medicine said

“W��’re pleased to be supporting all the interdisciplinary teams that were brought together by our activity aiming to target technological innovation for understanding cancers of unmet need. Dr Valpione’s project has a great multidisciplinary approach to address important questions for oesophageal cancer. The collaboration of life and physical sciences researchers will help achieve the changes we need to address hard-to-treat cancers with potential for translation to other types of cancer too.”

Announcing the news on Linked In, the Prime Minister said: “Almost every one of us will know someone that's been affected by cancer. And cancer of the brain, lungs and oesophagus are some of the hardest to cure with the lowest survival rates. But we can turn the tide against this devastating disease if we continue to drive innovation in medical research. A part of that is exploring the most pioneering techniques to tackle cancer, including the use of artificial intelligence. we announced a £2 million funding boost to four research teams across the UK that will do just that. A huge congratulations to those project winners.

The project is a collaboration between The Christie, The University of Manchester,  University College London, Imperial College London and the University of Edinburgh

Early this year, Claudia Boardman, 22, received the devastating news she had Rhabdomyosarcoma – a less common type of soft tissue cancer, which can appear in any part of the body.

They  will join the Media City 5K ,  on 31 August from 7pm-9pm raising money for the charity Sarcoma UK.

The student, who was in her final year of the midwifery course, had to make the difficult decision to interrupt her studies to receive extensive treatment for the illness.

After having back pain for 6 months, one morning Claudia woke up and realised she had lost the feeling in most of her lower body.

A visit to A&E revealed a large tumour on her spine, which was pressing against her spinal cord and chest.

She was immediately transferred to a different hospital where she had emergency surgery to have part of the tumour removed.

The operation was successful, but a biopsy revealed the tumour was a rhabdomyosarcoma.

On average, only112 cases of rhabdomyosarcoma are diagnosed every year in England, and now, Claudia is having nine rounds of intense chemotherapy, more major surgery to remove the rest of the tumour and radiotherapy. She will eventually need more chemotherapy following the treatment.

Claudia said: “I chose midwifery because I always wanted to do a rewarding job supporting and empowering women, and what better way to do that than helping bring life into the world. 

Being diagnosed with cancer meant I had to interrupt from my university course and my world had been turned completely upside down.

“I started treatment in March and lost all of my hair just 2 weeks after starting treatment.

“Fast forward to June, and I am on my fifth round chemotherapy, with 4 to go.”

Her friend and fellow student Katie Needham said: “As Claudia’s peers, we were all shocked and upset that she was having to leave the course indefinitely.

“It has been difficult knowing that her and her family were faced with so many operations and appointments.

“But organising the race has given us something to focus on and do something positive both for Claudia and Sarcoma UK.”

She added: “Any donation, no matter how small would be appreciated as a show of support to Claudia and her amazing family.”

Louisa Morgan, Events Manager at Sarcoma UK, said: “W�� would like to say a huge thank you to Katie, Claudia and their peers at the University of Manchester for taking on this challenge.

“Around 5,300 people in the UK are diagnosed with sarcoma cancer each year, and sadly very few people recognise its signs and symptoms. Sarcoma UK relies on generous voluntary donations, and the energy and imagination of our tireless fundraisers and supporters.

“The money raised by Katie and the team will help us to fund vital research to improve outcomes for everyone affected by sarcoma.”

You can donate by visiting the page

New forms of genetic tests can tell women their personal risk of developing breast cancer. However, has shown they are not accurate for many Black, Asian or Ashkenazi Jewish women, or women with a mixed ethnic background.

A new study by researchers in the UK and Israel and funded by Cancer Research UK has investigated how to improve breast cancer genetic tests for Ashkenazi Jewish women. This research is part of a wider 91ֱ��-based project which aims to develop accurate tests for women of different ethnicities and reduce inequalities in testing.

The tests look for tiny genetic variations all humans carry – called Single Nucleotide Polymorphisms (SNPs) – which, depending on the unique combination of them, can increase or decrease the risk of breast cancer.

This information is used to produce a Polygenic Risk Score (PRS), which can inform women whether they are at low, average, or high risk of developing breast cancer in the next 10 years. PRS are becoming more widely available through commercial companies and research studies on the NHS breast screening programme.

Current PRS were developed from large-scale genome studies which predominantly collected genetic data from mainstream white European populations. As a result, the accuracy of a PRS for an individual will depend on how closely their genetic material resemble those of the people whose data was used to develop the risk score.

This means that while commercially available PRS can accurately predict breast cancer risk for mainstream white European women, they often exaggerate this risk for Black, Asian or Ashkenazi Jewish women, or women with a mixed ethnic background.

In this new study, researchers from 91ֱ�� University NHS Foundation Trust (MFT) and The University of Manchester, supported by the National Institute for Health and Care Research (NIHR) 91ֱ�� Biomedical Research Centre (BRC), compared two available PRS based on two SNPs – SNP142 and the commercial SNP78 – and analysed their accuracy for women of Ashkenazi Jewish ancestry.

The findings, published in , showed that these PRS tests inaccurately predicted Ashkenazi Jewish women to be at higher risk of developing breast cancer.

After adjusting the test for Ashkenazi Jewish ancestry, the researchers were able to generate a more accurate prediction of breast cancer risk for these women.

The research team used genetic information from Ashkenazi Jewish women in both 91ֱ�� and Israel, with data from the Predicting the Risk of Cancer at Screening (PROCAS) study conducted in Greater 91ֱ��, a 91ֱ�� regional genetics database, and the Breast Cancer in Northern Israel (BCINIS) study.

This research was led by Professor Gareth Evans, a  and NIHR 91ֱ�� BRC Cancer Prevention and Early Detection Theme Lead.

Professor Evans, who is also a Consultant in Medical Genetics and Cancer Epidemiology at MFT, Consultant at The Christie NHS Foundation Trust and Professor in Medical Genetics and Cancer Epidemiology at The University of Manchester, said: “Polygenic Risk Scores (PRS) are a major component of accurate breast cancer risk prediction and have great potential to improve personalised screening methods. However, it is clear from our findings that you cannot simply apply current PRS developed using genetic data from individuals of white European ancestry to those from Ashkenazi Jewish backgrounds.

“A test result which exaggerates a woman’s risk of the disease could lead to undue stress or concern and unnecessary screening and preventative measures that they don’t need. Future PRS for Ashkenazi Jewish women should be based on their genetic data to provide a more accurate risk prediction.

“This study is an important step forward in our continued research into breast cancer genetic testing for people of different ethnic backgrounds to improve equity. More accurate and personalised PRS are required to avoid further increasing health inequalities and so patients can receive high-quality screening, care, and treatments.”

Vicky Lee (pictured) , 56, from 91ֱ��, grew up with a strong family history of female cancers and lost her mum to ovarian cancer aged just 47. As genetic sequencing became available, she tested positive for the presence of the BRCA gene and opted for a preventative hysterectomy and later a bilateral mastectomy. Vicky has been a patient at Saint Mary’s, Withington and Wythenshawe Hospitals, which are part of MFT.

Vicky, who is Jewish, said: “Before I was tested I had already decided that I would have preventative surgery if I was a BRCA carrier. I’d watched my mum and other members of my family go through ovarian cancers and I knew I had to do everything in my power to prevent my own daughters from watching me fight the same disease. 

“The ability to accurately test for gene fragments that might be the cause of family cancers is so important for allowing women to make informed choices about their future health. One size never fits all in medicine and medical advancements that allow women in specific communities to understand their own health picture properly are massively important. 

“Preventative surgeries are significant procedures that no woman would undergo lightly. Accurate testing gives women the confidence to make these decisions based on precise insight and, conversely, allows other women to know with confidence that their risk score is low giving them freedom to go and live their lives.”

The PRIME-ROSE* consortium consists of 24 partners, including nine beneficiaries and fifteen associated partners who will come together over the course of five years and work with regulators, policymakers, healthcare providers and patient advocacy groups to implement evidence-based PCM in routine clinical practice.

Approved by the European Commission**, PRIME-ROSE aims to bring together a network of similar clinical trials which are being implemented to broaden patient access to a wider range of innovative PCM treatments.

Cancer Research UK’s Centre for Drug Development, alongside the University of Manchester, are associate partners in the PRIME-ROSE consortium and represent the UK as the lead organisations running the DETERMINE trial.

The DETERMINE trial*** is a PCM platform trial open to adult, young adult and paediatric patients with any rare cancer type. Its unique design means that any treatment which appears to be working for patients on the trial will be submitted for review by the Cancer Drugs Fund (CDF)**** The intention is that the CDF team, working with NHS England Clinical Policy team, will then decide whether a period of data collection in the CDF is appropriate to assess if the drug could be used as a routine treatment option on the NHS for patients with this cancer type.  

The cross-country collaboration provided by PRIME-ROSE will enable data aggregation and analysis from multiple trials which is important when working with rare cancers where amassing significant amounts of data is a challenge.

The Director of Cancer Research UK’s Centre for Drug Development, Dr Nigel Blackburn, said: “W�� are delighted to be joining a consortium of partners who share our drive to make potentially life-saving precision medicine drugs accessible to patients who need them.

“This provides an excellent opportunity to foster collaboration between our DETERMINE trial and similar trials across the EU, gathering vital data to support applications to make precision medicine drugs available to more patients in the UK.”

Dr Matthew Krebs, Chief Investigator for the DETERMINE trial at The University of Manchester and The Christie NHS Foundation Trust, said: “DETERMINE is an important new trial in the PCM space in the UK and provides crucial opportunity to explore the use of existing medicines in new cancer indications. Our collaboration with European colleagues within the PRIME-ROSE consortium will help speed up assessment of the role of these treatments across Europe and, together with regulating agencies, provide potential to bring new life -prolonging treatment options to patients with rare cancers

*Precision Cancer Medicine Repurposing System Using Pragmatic Clinical Trials

**The project is being funded by the (grant no. 101104269)

***DETERMINE is led by the University of Manchester and is sponsored and managed by Cancer Research UK's Centre for Drug Development. It is run in collaboration with the University of Birmingham, the Royal Marsden NHS Foundation Trust and the Christie NHS Foundation Trust. To date, 8 drugs from Roche and Novartis have been committed to the trial.

****https://www.england.nhs.uk/cancer/cdf/   

The team at 91ֱ�� University NHS Foundation Trust (MFT) and The University of Manchester (UoM) will implement the new technology across MFT hospitals. The test aims to improve early detection of hepatocellular carcinoma (HCC) – the most common cancer affecting the liver and the third most common cause of cancer death.

One of the risks for developing HCC is a pre-existing liver disease and scarring of the liver, known as cirrhosis. Around two in 100 patients with cirrhosis will develop HCC every year.

In early, curable stages, HCC can have no symptoms and so it is recommended that everyone with known cirrhosis is tested twice a year. Unfortunately, even with current recommended surveillance, more than half of these patients are diagnosed with HCC at a stage where it cannot be cured.

The project is supported by Roche Diagnostics who developed the test, called Elecsys®GAAD alongside researchers at MFT, UoM and not-for-profit organisation, Vocal who provided valuable input from people affected by liver cancer.

Elecsys®GAAD is being fast-tracked into the NHS at MFT, which provides specialist liver care to the Greater 91ֱ�� region. It will be used alongside routine surveillance tests to see how it can benefit patients, so they have the best chance of surviving this type of cancer.

The technology is a fully regulated, accurate test that combines blood tests with gender and age, which indicates the presence of HCC.

Project lead Dr Varinder Athwal, Consultant Hepatologist at MFT and Honorary Senior Lecturer at the University of Manchester, said: “91ֱ�� has some of the highest rates of liver disease and liver cancer in the UK and far too many people are diagnosed when curative treatment is not possible. We need better tools to identify liver cancer earlier, when it can be cured. This innovation is a non-invasive test that easily fits into our current pathway, and we hope that it will enable us to diagnose more people at early, curable stages of primary liver cancer. As one of the largest trusts in the country, MFT is uniquely placed to test the innovation.”

Professor Rick Body, Group Director of Research and Innovation at MFT, said: “W�� are delighted to receive this funding and very proud to deliver this important research at MFT. Early diagnosis of cancer provides the best chance for successful treatment, which is why implementing this innovative test is so important. We are hopeful that this research will have a huge impact on the future of diagnosis for HCC and will ultimately save lives.”

Professor Neil Hanley, Vice-Dean for Research and Innovation at UoM said: “This new innovative test is a really exciting development and further compelling evidence that if we pull on our strength working across university, NHS and commercial boundaries we will translate research into innovations that make a real difference to people's lives.”

Dr Annie Keane, Deputy Director of Vocal, hosted by MFT and UoM, said: “We're delighted to support this vital project to bring about better outcomes for people with liver cancer. We’ve worked with the public to develop the funding bid from an early stage. We’ll continue to work in partnership with patients and the public to ensure they are meaningfully involved throughout, including the implementation of the test, as members of the core project team.”

Chris Hudson, Director of Access and Innovation at Roche Diagnostics UK and Ireland said: “W�� are thrilled this funding award from NHS England gives us the opportunity to build on the trusted partnership we already have with colleagues in 91ֱ�� and the important work we are doing together to identify liver disease more accurately and sooner. By bringing together the collective knowledge and expertise of academic, medical and industry partners, this new project has the potential to streamline the diagnosis and treatment pathway for patients with liver cancer across the UK, to improve their experience and outcomes, and help alleviate pressure on the NHS.”

Work to rollout Elecsys®GAAD will be supported by Health Innovation 91ֱ��, in partnership with the Greater 91ֱ�� Cancer Alliance, The Christie NHS Foundation Trust and Macmillan Cancer Support.

Findings from the implementation of the test at MFT will be used to co-develop a plan for the national roll out of the technology. This is supported by National Institute for Health and Care Research London MedTech In Vitro Diagnostics Co-operative, Imperial College London - who are observing the impact of the new technology on the NHS and Unity Insights who are carrying out an independent evaluation of the findings across the project. 

This work was commissioned and funded by the NHS Cancer Programme, with the support of SBRI Healthcare and the NHS Accelerated Access Collaborative (Project Reference Number NCPC02013). The views expressed in the publication are those of the author and not necessarily those of the NHS Cancer Programme or its stakeholders. 

Using £2.47m of funding over five years from the National Institute for Health and Care Research (NIHR)  the team will investigate how to minimise the long term effects of cancer treatment which can significantly impact on some patients’ quality of life and life expectancy after cancer.

Earlier detection and better treatments mean more than three million people in the UK are now living with and beyond cancer, a figure estimated to rise to 5.3 million by 2040 (Macmillan, October 2022).  Although this is good news, some cancer treatments can increase the risk of second cancers, heart disease, bone and joint problems, hormone deficiencies and depression and anxiety.

Historically, patients who lived long term after cancer had up to a 40% chance of getting a serious side-effect* years later depending on the type of treatment received. With improvements in therapy introduced over the last 10-20 years these risks have lessened. This research will aim to minimise these risks even further.

Speaking on National Cancer Survivors Day 2023 (Sunday 4 June), Professor John Radford, Consultant Oncologist at The Christie, Professor of Medical Oncology at The University of Manchester, and BRC LWBC Theme Lead who is leading the research said: “With many more patients now being cured or living in long term remission than was the case years ago the impact of cancer treatment on future health is increasingly recognised as an important area for study. At The Christie we are sharply focused on reducing these long-term consequences of treatment that undermine the quality and length of our patients’ lives. Through patient focused, collaborative research our mission is to understand the mechanisms by which cancer treatments increase the risk of heart disease, second cancers, and weakened bones, and develop ways that can prevent or lessen these risks. We are very grateful for this substantial award from the NIHR to 91ֱ��’s Biomedical Research Centre that  will help us achieve our goal. Crucially, we couldn’t do any of this without the support of cancer patients who help us understand their perspectives and allow us to use their expertise and experience to guide and inform our research.”

One patient who the research team has worked closely with is Jack Richardson, 31, a father of three from Stockport in Greater 91ֱ��.  When he was 25 years old he became ill and thinking he had a chest infection, was prescribed antibiotics by his GP. When there was no improvement and he was struggling to breathe and in pain, he went back to his doctor and was referred for a scan and discovered he had a tumour the size of a grapefruit in his chest, as well as tumours either side of his neck and both armpits. He also had fluid round his heart and lung and in September 2017 was diagnosed with Stage 4 (advanced) Hodgkin lymphoma, a blood cancer and the most common cancer for teenagers and young people.

Jack was immediately referred to The Christie for treatment, including six cycles of chemotherapy followed by radiotherapy to the chest which he completed in May 2018.  The treatment was successful and he is now in remission with currently no signs of cancer.

Then in October 2019 Jack suffered a heart attack and was diagnosed with heart disease which may have been a result of the cancer treatment. He now suffers from shortness of breath, has angina, and takes aspirin, a statin and a beta blocker. Jack lives with his partner, and they have a two-year- old daughter Amelia Grace. He also has two children Oliver, 12, and Ava, 7, from a previous relationship.  

Talking about his cancer experience, Jack Richardson said: “I thought I was perfectly healthy so to discover I had a tumour the size of a grapefruit in my chest was a huge shock. I wasn’t aware of it at all and didn’t even feel that ill. The NHS were amazing, and once discovered, the response was rapid and I was fast tracked for treatment. I do get out of breath quickly now and will have to take medication for my heart for the rest of my life, but I feel fine and I’m back at work and enjoy spending time with my three children. I feel lucky to be alive and I make the most of every day. If my story can help others, that can only be a good thing. I’m very keen to support the work of Professor Radford and his team to help reduce the risk of serious side-effects from cancer treatment in the future.”

National Cancer Survivors Day is an international event to raise awareness of cancer, and cancer survivors, held on the first Sunday in June each year.

*van Nimwegen et al JAMA Intern Med. 175(6):1007-17 (published 2015 using data over the previous 25 years)

Image: Jack Richardson with his children

Together, a multidisciplinary team of over 300 scientists and researchers and 400 clinicians and operational staff, the largest concentration in Europe – practising what is known as ‘team science’ – will deliver clinical trials covering the full extent of the patient pathway, from prevention and novel treatments to living with and beyond cancer. 

The new research centre replaces a previous building that was severely damaged in a fire 6 years ago. It is unique in that it is directly connected to The Christie hospital, allowing cells and samples from patients to be taken to the research lab in a matter of minutes. The ambition is to foster collaboration, double the number of patients benefitting from clinical trials by 2030 and ultimately improve outcomes and survival rates. 

Researchers from the Cancer Research UK 91ֱ�� Institute were relocated to Alderley Park in Cheshire after the fire and are the first to move into the building. They will be followed shortly by colleagues from The Christie and The University of Manchester’s Division of Cancer Sciences. Research teams will be co-located in laboratories to allow for maximum scientific interactions. 

A central component of the building is the new Cancer Research UK Cancer Biomarker Centre which will be situated on the third floor. The Cancer Biomarker Centre’s focus will be on biomarkers* – genes, proteins and other cancer-associated molecules – to aid in early cancer detection and diagnosis, and biomarkers that enable personalised management of a patient’s cancer, to determine which therapy will bring the most benefit. 

Discovering and delivering robust, accurate biomarker tests is central to optimising future cancer treatments. The more biomarkers we develop and deliver, the more personalised treatment pathways can be developed, meaning improved outcomes for patients. The facility will be one of the leading biomarker centres in the world, analysing the patients’ samples from across the country and from global clinical trials to accelerate new medicines for patients. 

Understanding cancer from every angle will be a big focus for researchers. The centre will be 91ֱ��’s scientific headquarters for the Alliance for Early Cancer Detection and will also house a team focused on global genomics, or how cancer presents differently in people from different racial and ethnic backgrounds. 

The Christie is the largest provider of radiotherapy in the NHS, so it makes sense that the new research centre will be home to a Cancer Research UK RadNet-supported programme that’s looking at, among other things, how the immune system can be harnessed to improve radiotherapy cures. It will also house an Academy of Surgical Oncology, something very few cancer centres have. 

The centre complements the partnership’s team science in the neighbouring Oglesby Cancer Research Building (OCRB). It will help increase the critical mass of research activity on The Christie site, but it will also be home to the Cancer Research UK Cancer Biomarker Centre and the Cancer Research UK 91ֱ�� Institute.

Lee Young has cancer of the unknown primary (CUP) and is currently on a clinical trial at The Christie. He says: “It’s fantastic to have a new world-class cancer research centre here in 91ֱ��. The work that’s going to happen in the new building is so important to improving outcomes for people like me. My doctors said that if I’d been diagnosed with CUP a few years ago, there would have been no treatment options for me. Luckily, I was able to go on a clinical trial at The Christie and it’s working so well that I was able to do a half marathon during treatment. It’s purely thanks to research that I’ve got a second chance at life and I’m relishing every moment of it.”

Roger Spencer, chief executive at The Christie, comments: “The Christie has been at the forefront of cancer research for over 120 years. Standard treatments that were first trialled here have improved the outcomes for millions of cancer patients across the world. This new centre allows us to build on this legacy, so it’s exciting to see the vision become a reality. 

“W�� want to give every patient who walks through our doors the best possible treatment and care. Having so many different specialists collaborating together under one roof will help us deliver more trials, more effectively, leading to better outcomes for patients. Together, our ambition is to make the facility one of the top 5 cancer research centres in the world.” 

Michelle Mitchell, chief executive of Cancer Research UK, comments: “As the world’s largest charitable funder of cancer research, Cancer Research UK is at the forefront of the global fight against the disease, bringing together millions of people who share our determination to beat it. 

“Co-locating the Cancer Research UK 91ֱ�� Institute with The Christie fulfils our strategy of delivering scientific breakthroughs which translate into treatments for patients. I’m delighted to see teams moving in and look forward to seeing our researchers find faster routes to new prevention measures, tests and treatments.” 

Professor Dame Nancy Rothwell, president and vice-chancellor of The University of Manchester, comments: “The new research building will be a fantastic opportunity to accelerate cancer research in 91ֱ��, not just because it will provide state-of-the-art facilities, but because it will bring together a fantastic workforce comprised of scientists, clinicians and support staff, including trainees, early career researchers and world-renowned investigators. It will enable staff from The University’s Division of Cancer Sciences to work side-by-side with colleagues from the Cancer Research UK 91ֱ�� Institute and The Christie, generating new ideas, making new discoveries and devising next-generation therapies. 

“Together with the proton beam therapy centre and the Oglesby Cancer Research Building, the new facility will be the latest piece of the cancer campus jigsaw, generating a vibrant, high-quality environment for our highly motivated research teams, all seeking to improve the lives of cancer patients, not just in 91ֱ�� but worldwide.”

* Scientists can use biomarkers to do several things: to detect cancer early when there is more chance of cure, to identify a person’s tumour type, to predict what treatment might be best for a patient, to monitor the cancer to see whether a treatment is working, and to anticipate when a tumour might become resistant to a particular treatment, so they can change treatment.

You can see a timelapse video of the cancer research centre being built in the video.

* is a multi-drug precision medicine trial for adults, teenagers and children with rare cancers, sponsored and managed by Cancer Research UK’s Centre for Drug Development with commercial partners Roche and Novartis and led by the research team here in 91ֱ��. Also collaborating on the project are researchers from the Royal Marsden NHS Foundation Trust, The University of Birmingham, and the Christie NHS Foundation Trust with contribution from the adult and paediatric Experimental Cancer Medicine Centres (ECMC) network.

Rare cancers make up 22 out of every 100 (22%) cancers that are diagnosed globally each year, more than any single type of cancer. If all rare cancers were defined as a single type, they would top the list of the most prevalent cancers worldwide, above lung, breast and colorectal cancer.

The DETERMINE trial seeks to find out if existing licensed drugs – those that are already prescribed by doctors for more common types of cancer – could also benefit patients with rare cancer types that the drug isn’t currently licensed for.

If successful, the trial will provide new treatments for those who have run out of options and improve the survival for people with rare types of cancer.

 provides a platform for businesses to engage with the life sciences community, supporting business growth and innovation within the sector. The annual  celebrate scientific excellence within the life sciences industry across 13 categories/

The DETERMINE team was represented by colleagues from the University, Novartis, Roche, CRUK and The Christie who were among 350 guests from across the life sciences community, held this year at the Concorde Hangar at 91ֱ�� Airport.

*DETERMINE: Determining Extended Therapeutic indications for Existing drugs in Rare Molecularly-defined Indications using a National Evaluation platform trial

The study led by researchers from The University of Manchester, working with scientists at the Institute of Cancer Research, University College London and The University of Leeds, is published in the journal Radiotherapy and Oncology.

Funded mainly by the Medical Research Council, the breakthrough was achieved by combining two cutting edge technologies: the research team adapted an MRI scanner that also delivers radiotherapy - called MR-Linac - to be able to also measure oxygen levels in tumours.

Researchers have known since the 1950s that when tumours are starved of oxygen they are difficult to treat effectively, a problem which is particularly true when doctors give radiotherapy.

Despite this knowledge, patients with cancer do not get routine tests to evaluate tumour oxygen levels because no single test has been developed that is precise, accurate, cost effective and readily available.

The 11 patients with head and neck cancer in the study, treated at The ChristieNHS Foundation Trust in 91ֱ��, were successfully scanned on the MR-Linac machine and, for the first time, maps of oxygen levels were obtained. However, the technology is relevant to most cancers.

The patients first breathed room air through a mask and then pure oxygen to bathe the tumour with the gas.

Parts of the cancer that had good levels of oxygen responded differently to those that were oxygen depleted, so the technique - called 'oxygen-enhanced MRI' - revealed which parts of the tumour were oxygen starved and likely to be resistant to radiotherapy.

Lead author Professor James O’Connor is a clinician scientist at The University of Manchester, The Christie and The Institute of Cancer Research.

He said: “Though it’s clear more work needs to be done, we’re very excited about the potential this technology has to enable daily monitoring of tumour oxygen and we hope to be at a point soon when the technology will guide cancer doctors in how they can best deliver radiotherapy.

“This imaging lets us see inside tumours and helps us understand why some people with cancer need an extra boost to get effective treatment. This is an important step towards the goal of changing treatment based on imaging biology.”

First author Michael Dubec from The University of Manchester and The Christie said: “The MR-Linac is an exciting technology that combines highly precise imaging and radiotherapy delivery that allows for real-time imaging”. 

“W�� are tremendously excited about what is the first application in humans of 'oxygen-enhanced MRI', developed as a result of a multi-disciplinary team working across the country which has exciting implications on patient outcomes.”

The paper First-in-Human Technique Translation of Oxygen-Enhanced MRI to an MR Linac System in Patients with Head and Neck Cancer is available

Image shows hypoxic parts of tumours

91ֱ�� Experimental Cancer Medicine Centre (ECMC) will receive the funding over the next five years to help doctors and scientists find the cancer treatments of the future.

The funding has been made possible by a partnership between Cancer Research UK and the National Institute for Health and Care Research.

91ֱ�� is part of a network of 17 ECMCs across the UK, funded by Cancer Research UK, which deliver clinical trials of promising new treatments. Since 2007, when the network was first established, around 30,000 patients have taken part in 2,100 trials.

The funding will allow new, experimental treatments - including immunotherapies - for a wide variety of cancers to be developed, as well as improve existing treatments.

ECMCs work in conjunction with local NHS facilities to provide access to cutting-edge cancer treatments. Testing these treatments helps to establish new ways of detecting and monitoring the disease and to evaluate how it responds to the treatment.

91ֱ�� ECMC co-lead, Prof Caroline Dive said:

"We are delighted 91ֱ�� has secured this funding. Clinical trials driven by informative biomarker tests are crucial to new and improved treatments becoming adopted as standard treatments by the NHS and this funding will allow us to further advance how we can treat cancer effectively as we determine the right drugs for the right patients at the right dose.”

91ֱ�� ECMC co-lead, Dr Natalie Cook said:

“91ֱ�� is thrilled to continue as part of the ECMC network. Over the next five years we look forward to offering many more clinical trial opportunities to patients and translating new biomarker discoveries into the clinic.”

 The 91ֱ�� ECMC is a collaboration between Cancer Research UK, The Christie NHS Foundation Trust and The University of Manchester.

One in two people in the UK will be diagnosed with cancer within our lifetimes so finding new effective treatments is vital. *

Cancer Research UK has been integral in aiding the discovery of many new cancer treatments. 91ֱ��’s Cancer Research UK funded ECMC pioneered the use of blood testing to help select the most appropriate early clinical trials for patients and will be driving forward national clinical trials for adult and paediatric patients with rare cancers.

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said: 

“W�� are proud to be supporting an expansion of our successful ECMC network, bringing together vast medical and scientific expertise to translate the latest scientific discoveries from the lab into the clinic.  

"The ECMC network is delivering the cancer treatments of the future, bringing new hope to people affected by cancer. The trials taking place today will give the next generation the best possible chance of beating cancer.  

“The adult and paediatric ECMC networks will offer clinical trials for many different types of cancer. Researchers will be working to find new treatments and tackle the unique challenges presented by cancers in children and young people. Working with our partners, this new funding will bring hope for more effective, personalised therapies for everyone affected by cancer.” 

Chief Executive of the NIHR, Professor Lucy Chappell, said:  

“The ECMC Network is a vital strategic investment in the UK’s cancer research community, bringing together top scientists and clinicians to tackle some of the biggest scientific challenges in cancer and improve outcomes for patients. 

 
“Through this route, we enable more people to join trials that could help them. The ECMC Network will give access to brand new experimental treatments for patients, including children and young people, paving the way for these treatments to be used in the clinic one day. This is a crucial part of NIHR’s work, and enables more people to join trials that might help them. We are proud to be partnering with Cancer Research UK and the Little Princess Trust in funding this network. 

“The UK has considerable strengths in cancer research. We will continue to back life-saving research for the thousands of adult and children patients affected by cancer every year.” 

Minister of State for Health, Helen Whately, said: 

“A cancer diagnosis can be devastating but the earlier the diagnosis, the better the chance to treat it and beat it. We are already picking up more cancers early by screening but we can do even better. 

“This partnership between Cancer Research UK, the National Institute for Health and Care Research and the Little Princess Trust will fund innovative trials that could lead to new life-saving treatments.  

"Every life lost to cancer is devastating and I’m pleased that across the country, people will be given renewed hope – especially children and young people – that we can beat this awful disease.” 

This discovery, published today (5 January 2023) in Oncogene, is the first time scientists have identified that targeting RAC1B, a variant of the RAC1 protein, could be a potential way of improving treatment for breast cancer.  

RAC1 plays a vital role in maintaining the health of all organs so directing cancer treatment against it has rarely been a research focus. But the University of Manchester team led by Dr Ahmet Ucar, discovered that the less common RAC1B variant is particularly important in cancer.  

The researchers found that breast cancer stem cells - the cells that are thought to cause cancer’s resistance to treatment, its recurrence and spread - rely on RAC1B.  

As the absence of RAC1B doesn’t cause any harmful effects to organs, it makes it an attractive target for future breast cancer treatments. 

When the team transplanted breast cancer cells into mice, they also found the cancer cells lacking RAC1B formed no visible tumours, even after 100 days.  

Further investigations showed that breast cancer cells grown in the lab without RAC1B didn’t recover after being treated with the chemotherapy doxorubicin. But those cancer cells that retained it made a­ quick and robust return when the treatment was stopped. And the cancer cells with higher levels of RAC1B recovered faster. 

Looking at clinical data, the researchers also discovered that patients with breast cancer treated with doxorubicin chemotherapy had poorer outcomes if their tumours had higher levels of RAC1B. 

Dr Ahmet Ucar, Breast Cancer Now research fellow at the University of Manchester, said:  

“Developing cancer stem cell treatments to target tumours at their root has been a research aim for ­more than 20 years, but until now has proven elusive.  

“For the first time, our research has shown that without RAC1B, breast cancer stem cells can’t form tumours and become more vulnerable to chemotherapy, making the treatment even more effective. Positively RAC1B isn’t needed for healthy cells so targeting RAC1B with new cancer treatments is unlikely to have severe side effects.  

“W�� hope that further research will help translate these findings into targeted therapies for breast cancer patients.”  

Dr Simon Vincent, director of research, support and influencing at Breast Cancer Now, said: 

“It’s exciting that a variant of a previously overlooked common protein could hold the key to transforming the way we treat breast cancer. Early-stage discoveries like this can help provide the building blocks for the breakthroughs of the future, leading to new and effective treatments for the 55,000 women and 370 men who are diagnosed with breast cancer in the UK every year.”  

The research is published in Oncogene  , DOI: 10.1038/s41388-022-02574-6  

The trial is set up to recruit both paediatric and adult patients, with any rare cancer type and is one of very few precision medicine platform trials in the world targeting these populations.

The DETERMINE* trial aims to find out whether existing drugs, including those which are licensed for more common types of cancer, could also benefit patients with rare cancer types that the drug isn’t currently licensed for.

Worldwide, rare cancers make up 22 out of every 100 (22%) cancers that are diagnosed each year** which is more than any single type of cancer. If we were to define all rare cancers as a single type, they would top the list of the most prevalent cancers worldwide, above lung, breast and colorectal cancer.

But despite their prevalence, fewer treatment options exist for patients with rare cancers.

Patients eligible for the trial will have undergone genetic screening and found that they have one of the particular genetic mutations in their cancer that can be targeted by a drug on the trial***.

Its unique design means that any treatment which appears to be working for patients on the trial will be submitted for review by the Cancer Drug Fund (CDF)**** who will then decide whether to collect more data and assess if the drug could be used as a routine treatment option on the NHS for patients with this cancer type.

Cancer Research UK’s Centre for Drug Development is sponsoring and managing the trial, with the University of Manchester leading it. Roche is providing 7 of their targeted drugs to be evaluated in the first instance. Further pharmaceutical partners are encouraged to join and contribute their drugs as the trial progresses.

The first trial site has opened at the Christie NHS Foundation Trust with other sites to follow, including the University of Glasgow, the Royal Marsden NHS Foundation Trust and the University of Birmingham, as well as sites across the entire adult and paediatric Experimental Cancer Medicine Centres (ECMC) network*.

Iain Foulkes, Executive Director of Research and Innovation at Cancer Research UK, said:

“This platform trial is a significant milestone in Cancer Research UK’s commitment to finding better treatments for cancer patients who desperately need them. By looking at drugs which are already available, and working with the Cancer Drugs Fund, our trial has a direct route to provide long-term patient access to potentially life-saving drugs which weren’t previously available to patients with rare cancers.

“Cancer Research UK’s Centre for Drug Development is unique in the world and the partnerships they have built with pharmaceutical companies will enable this critical trial.”

Dr Matthew Krebs, Chief Investigator for the DETERMINE trial at The University of Manchester and The Christie NHS Foundation Trust, said: “Patients with rare cancer often have few treatment options available and it’s vitally important we increase our research efforts for these patients. With technological advances in genetic testing we’ve learned that some rare tumours contain genetic abnormalities which may benefit from targeted treatment currently only available for more common cancer types. We will undertake in-depth research to understand which patients with rare cancers could benefit from these treatments. With the potential to change outcomes for adults, teenagers and children with rare cancers, this trial will be ground-breaking for a patient population who often feel neglected by current cancer research."

Pete Burchill and Jacqui Gath, Patient Representatives on the Trial Steering Committee agree that “This project is an exemplar for co-creation. A large number of people affected by cancer have been involved from the very beginning of the trial. The result is a clinical trial that supports patients throughout all stages of their clinical trial experience and a protocol that is designed to answer the questions most important to patients, in a patient friendly way.”

*DETERMINE: Determining Extended Therapeutic indications for Existing drugs in Rare Molecularly-defined Indications using a National Evaluation platform trial  

A Cancer Research UK adaptive umbrella basket platform trial to evaluate the efficacy of targeted therapies in rare adult, paediatric and teenage and young adult (TYA) tumours with actionable genomic alterations, including common cancers with rare actionable alterations. 

**Cancer Research UK: 

***DETERMINE will set a new paradigm in precision medicine trials by incorporating a focused, real-time multi-omic translational research programme. The translational data will not only inform the real-time optimisation of patient selection into the study, but also be used to discover potential new targeted therapy options in rare and paediatric cancers.

****

Combination treatments Cotellic + Zelboraf and Herceptin + Perjeta. Plus, single agents Alecensa, Rozyltrek and Tecentriq.

*The Experimental Cancer Medicine Centres (ECMC) network is an initiative funded by Cancer Research UK in partnership with the four health departments of England, Scotland, Northern Ireland and Wales. Launched in 2007 with a total investment by the funders of over £100million, this infrastructure award supports a network of 18 adult centres (of excellence) and 11 paediatric locations throughout the UK.

The unique partnership between The University of Manchester, The Christie NHS Foundation Trust, and Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) will raise awareness of squamous cell carcinoma of the oesophagus (OSCC) in Kenya and increase engagement in public screening opportunities using mobile detection units that travel across the country.

It will link the early detection of cancer using a digital transformation in cancer detection and outcome data through a “hub and spoke” system linking cancer hospitals and local healthcare authorities.

The funding will help establish a central cancer specialist “hub” at KUTRRH in the capital Nairobi which will support local cancer care delivery ’spokes’ in five regional counties: Meru, Kiambu, Kisii, Nakuru, and Nyeri.

According to the International Agency for Research in Cancer, OSCC is the third most common cancer in Kenya and the most lethal: 99% of patients die from their disease within 5 years.

The poor prognosis is directly related to OSCC patients being diagnosed too late when they have advanced, incurable disease. Instead, this initiative will establish early detection as a part of the Kenyan healthcare system by training healthcare workers to recognise early symptoms of OSCC.

The NIHR Global Health Research award will co-train Kenyan clinicians and healthcare workers in NHS Trusts. It will provide continuous, bespoke training in state of the art cancer diagnosis and molecular pathology where the initial trainees from Kenya travel to 91ֱ�� and subsequently return to Kenya to become the trainers future cancer researchers and carers.

The award will also use molecular assays to help identify Kenyans at greatest risk of OSCC.

Using next generation genetic and cell biology approaches, tissue samples taken for patient diagnosis will undergo sophisticated molecular pathology studies to document the abnormal cancer genes and proteins which drives the initial growth, unique biology and aggression of Kenyan OSCC cancers.

The genetic results will be obtained from all 5 Kenyan counties and matched with clinical data and county level information to try to understand the differences which cause the variable rates of OSCC seen across Kenya.

Robert Bristow is the study’s UK Co-Lead, Professor of Cancer Studies at The University of Manchester, Chief Academic Officer at the Christie NHS Foundation Trust  and Director of the 91ֱ�� Cancer Research Centre (MCRC).

He said: “W�� are excited to be working side by side with our Kenyan partners to optimise a national Kenyan Cancer Early Detection network to diagnose and understand the biology squamous cell carcinoma of the oesophagus at an early stage and design new strategies to improve survival.

“Our joint study is designed to increase accuracy of data across the diverse geography of Kenya to use to develop early detection intervention strategies for Kenyans living in rural areas with very low incomes.

“Many are cut off from cancer care since around 80% of cancer treatment centres are in the capital city Nairobi and a hub and spoke model will benefit both rural and urban populations.

“The project also is an example of inclusive cancer research as the data from the molecular research in OSCC and other Kenyan cancers will improve our understanding and appropriate individualised treatment of cancers in Africa and UK patients who come from Africa. Despite Africa being between 15-20% of the world’s population, only 2% of the genetic sequencing and information have been completed on African cancers”

Professor Keith Brennan, Vice Dean for Internationalisation at The University of Manchester said: “This work is about helping to meet the UN Sustainable Development Goals by supporting the provision of Universal Health Coverage within Kenya.

“As the world’s number one university in the Times Higher Education (THE) Impact Rankings last year, we take this responsibility very seriously.”

Professor F. George Njoroge is study’s Kenyan  co-principal investigator,  Chief Scientific Officer at  Kenyatta University Teaching, Referral and Research Hospital (KUTRRH),  Board director at Kenya Medical Research Institute(KEMRI) and chairman of the council at Daystar University

 He commented: “The unique collaboration between  Kenya and  United Kingdom in this oesophageal cancer study will go a long way in establishing ways  that would tilt the balance whereby oesophageal cancer could be detected at the potentially curative stages 1 and 2 rather than the late stages 3 and 4. This will be a game changer in diagnosis and management of that disease”

Routine testing for mutations in homologous recombination (HR) and mismatch repair (MMR) genes in women with the disease who also have a family history of ovarian, breast and other cancers, would save lives, they say.

The study, funded by Cancer Research UK and published in the journal Genetics in Medicine, is the largest study of cancer causing genetic mutations in ovarian cancer to date.

The research team tested 277 women with ovarian cancer whose close relatives had been diagnosed with the disease over their lifetime. Of those who tested negative for BRCA1 and 2 gene mutations, 22% were positive for HR and MMR, twice as high as the equivalent detection rate in breast cancer.

Currently, doctors routinely test for cancer causing BRCA1 and BRCA2 genes which are associated with a lifetime risk of 20% to 60% and 10% to 25% respectively. However, though they do test for the other genes – it is not routine.

HR genes work in combination with BRCA genes  and MMR genes are associated with Lynch syndrome, a condition passed from parents to children which increases the risk of different  cancers.

One of the HR genes - known as BRIP1 – was the single gene responsible for most cancers after BRCA1 and BRCA2.

Identifying the mutations in people with advanced cancer could allow doctors to prescribe them personalised gene therapies which specifically target the tumour.

And spotting the defective genes in close relatives who are well, such as daughters, nieces, aunts or cousins, could give them the choice of mitigating risk with preventative surgery.

Dr Nicola Flaum, lead author on the study from The University of Manchester , said: “This project is the most detailed genetic study of familial ovarian cancer to date.

“And we show that two gene families with a lifetime epithelial ovarian cancer risk of between 5% and 20% are even more present in these families than we thought.

“T�󲹳� is why we think as a matter of routine, women who are BRCA1 and BRCA2 negative with a family history of ovarian, breast and other cancers should be tested for these other gene mutations.

“Wider genetic testing of women with familial ovarian cancer is essential to both optimise their treatment and enable prevention of disease in family members.

She added: “Ovarian cancer has a poor survival rate as it is usually diagnosed late. That is why it is important to test asymptomatic family members as well so they can be offered risk management strategies.

“W�� urge patients to tell the doctors about their familial history so they and their relatives can be tested.”

The paper High detection rate from genetic testing in BRCA-negative women with familial epithelial ovarian cancer is available

The Memorandum of Understanding (MoU) between , Healthineers and The University of Manchester (UoM), will formalise already close working relationships between the three organisations.

Indeed, in January 2021, – with a value of approximately £125 million.

The Value Partnership between Siemens Healthineers and the Trust ensures the provision and replacement of key radiology equipment across nine of MFT’s hospitals, and represents a strong investment in the future of the UK’s largest NHS trust and the 750,000 people it delivers care for.

Key priority areas encompassed within the new, tri-party MoU include:

• earlier detection and intervention for cancer patients
• data-driven approaches to early diagnosis – ensuring patients receive the right treatment sooner
• integrative diagnostic approaches (testing) for conditions which disproportionally affect the Greater 91ֱ�� (GM) population, such as heart disease and preventable cancers

Dr Katherine Boylan, Head of Innovation at MFT, said: “91ֱ�� University NHS Foundation Trust is delighted to sign this new agreement with our close partners Siemens Healthineers and The University of Manchester.

“It will provide a formal framework for joint working, bringing the power of industry, academia and the NHS together to deliver benefit for the populations we serve, enabling us to collaboratively deliver outputs at pace.

“It is widely recognised that there are deep-rooted health inequalities and high levels of long-term conditions across GM, and our three organisations are committed to working to address these persisting issues.”

Professor Neil Hanley, Vice-Dean covering Research and Innovation in the Faculty of Biology, Medicine and Health at The University of Manchester, said: “This new partnership is really exciting and further evidence of our strength in working across university, NHS and commercial boundaries to translate research into innovations that make a real difference not just locally, but also out in the wider world."

Dr Craig Buckley, Head of Research and Development at Siemens Healthineers GB&I, said: “91ֱ�� has recognised that it faces considerable population health challenges, highlighting the need for a healthcare system focussed on rapidly delivering improved patient outcomes.

“Pioneering breakthroughs in healthcare is at the heart of what we do. This partnership marks a joint commitment to tackling the burden of cancer and other prevalent diseases in the region, with the aim of delivering cutting-edge detection and diagnosis, as we seek new ways of delivering care.”

GM has one of the largest National Institute for Health and Care Research (NIHR) infrastructures in the country.

This includes the , which was during the next five years. 

The GM research portfolio also encompasses the , co-hosted by MFT and UoM, which translates scientific breakthroughs into diagnostic tests and life-saving treatments.

Photo shows Professor Neil Hanley; Vice-Dean covering Research and Innovation in the Faculty of Biology, Medicine and Health at The University of Manchester, Dr Katherine Boylan, Head of Innovation at MFT, and Dr Alexandra Olaru, Research Collaborations Lead at Siemens Healthineers.

The review, published today (21/9/22) in the British Medical Journal, shows that leaving more than 1mm of non-cancerous tissue from the edge of an excised tumour is associated with a lower risk of distant (spread elsewhere in the body) and local recurrence independent of the use of adjuvant systemic therapy.

However, a previous UK study has shown that 21% of women in the UK had surgical margins of less than 1 mm.

����  you remove a tumour but cancer cells remain present or close to the edges, the risk of disease returning is increased,” said lead author Professor Nigel Bundred from The University of Manchester

“T�󲹳� is why increased surgical focus on adequacy of margin excision would improve breast cancer survival worldwide.”

When a tumour is surgically removed its edges, also known as margins, can contain microscopic cancer cells.

When the distance from the edge of the excised tissue to the tumour is measured by the pathologist, a close margin occurs when cancer cells are not at the edge, but within a given number of millimetres, usually one or two.

But inconsistent international guidelines mean acceptable surgical margin widths for breast cancer vary widely, creating confusion about the correct approach.

According to the analysis, the rate of recurrence of a tumour elsewhere in the body was 25.4% in patients with cancerous tissue still remaining at the edge.

But the figure shrank to  8.4% with cancerous tissue at or less than 2mm from the edge, and 7.4% for patients whose had non-cancerous  tissue cancerous tissue 2mm or more from the edge.

Professor Nigel Bundred, a clinical scientist at The University of Manchester, said: “In many cancers, such as colorectal cancer, attention to ensuring meticulous removal of the cancer with an encompassing cuff of normal tissue results in improved outcomes.

“Most patients with early breast cancer are treated with breast conserving surgery and then adjuvant(extra) systemic therapy but until this analysis, the effects of margin involvement on distant recurrence and mortality were unclear.

“But our analysis leaves us confident that inadequate margin width is associated with higher risks of distant recurrence and breast cancer mortality even after adjuvant chemotherapy, as well as increased recurrence around the original surgical site.

“T�󲹳� has major clinical implications for the surgical management of breast cancer and current international guidelines need revision to account for these findings.”

The data used in the study was taken from tumour tissue excised between 1980 and 2021, and observing outcomes in the patients the tissue was excised from.

Globally, local recurrence rates after breast surgery – which increases the risk of mortality - have reduced from 20% before widespread adjuvant therapy use to 5% or lower currently.

However, the impact of adjuvant systemic therapy on reducing local and distant recurrence rates has probably influenced surgeons to argue  they do not need to remove all cancerous tissue to protect a patient’s body image, argues Professor Bundred.

However, the balance between reducing the risk of recurrence and protecting body image is a difficult balancing act for many surgeons.

He added: “These findings plausibly indicate that clearance of margins in invasive breast cancer should remain a priority to reduce both distant and local recurrence irrespective of the increased use of adjuvant therapies.

“This sort of discussion with patients can be difficult, but tackling the issue of margin clearance in a supportive environment should be an essential part of informed consent for surgery.

“Similarly, decisions about re-excision should be the product of an informed decision between clinicians and patients.

“But as we believe this study shows an increased surgical focus on the adequacy of margin excision may improve breast cancer survival worldwide, such practice will be worth it.

“T�󲹳� is why differences between the various international surgical guidelines on the best width for margin clearance need to be standardised with prevention of distant recurrence a primary aim.”

The paper Margin status and survival outcomes after breast cancer conservation surgery: prospectively registered systematic review and meta-analysis is published in the British Medical Journal

Professor Petra Hamerlik started at The University of Manchester within the 91ֱ�� Cancer Research Centre (MCRC) and Geoffrey Jefferson Brain Research Centre (GJBRC) on September 1 2022.

Professor Hamerlik takes on this role alongside her role at AstraZeneca where she is a Director and Bioscience Lead in Oncology R&D. Prior to her role in AstraZeneca, Professor Hamerlik was Group Leader for the Brain Tumour Biology laboratory within the Danish Cancer Research Centre with an affiliation as an associate professor at the University of Copenhagen.

Bringing her expertise in neuro-oncology, Professor Hamerlik will build a programme focussed on the development of pre-clinical patient-derived xenograft models and capabilities to inform on central nervous system (CNS) tumour biology and the discovery of novel targets for drug and immunotherapy treatment.

The newly-created Chair role has been made possible thanks to a grant worth around £1.35 million from The Brain Tumour Charity – the largest dedicated funder of research into the disease globally.

Speaking about her appointment, Professor Petra Hamerlik said: “I am very excited about this unique opportunity and hope to leverage both my academic and industrial experience to synergise with an outstanding network of scientific and clinical researchers in 91ֱ��. My ambition is to build a platform of evidence which would serve as a stepping stone to redefining the care and thereby improving the outcome of patients suffering from this deadly disease."

In the UK, on average more than 12,000 people are diagnosed with a brain or other CNS or intracranial tumour every year. Five-year survival for individuals is also low, with only 12% surviving the disease, underpinning the need for further research and treatments.*

Professor Rob Bristow, Director of the MCRC, which is a partnership formed in 2006 by The University of Manchester, Cancer Research UK and The Christie NHS Foundation Trust said: “I am thrilled that Professor Hamerlik is joining our cancer research ecosystem and catalysing brain cancer research in 91ֱ��. The new models and biomarker approaches that she brings for the detection and treatment of this devastating tumour will not doubt place 91ֱ�� as one of the leading research programmes in translational CNS research.”

Neuro-oncology is a growing area of research in 91ֱ��. In 2021, the GJBRC was established with specific themes to accelerate neuro-oncology. In the same year, The Christie and Salford Royal NHS Foundation Trust (now Northern Care Alliance) were named as a Tessa Jowell Centre of Excellence. Professor Hamerlik will work to leverage the teams and infrastructure across 91ֱ�� with the ultimate aim of identifying new treatments for patients with brain tumours.

Professor Stuart Allan, Co-Director of the GJBRC, said “Petra’s appointment comes at a very exciting time for translational neuroscience research in 91ֱ�� with the launch last year of the GJBRC. The ambition of the GJBRC is to improve the lives of patients affected by neurological disease, with brain tumours a primary focus. Attracting Petra to 91ֱ�� is an important step in realising this ambition’”.

Professor Graham Lord, Vice-President and Dean of the Faculty of Biology , Medicine and Health at The University of Manchester, said: “W�� are delighted to welcome Professor Petra Hamerlik, one of the world’s leading experts in neuro-oncology, to The University of Manchester. The low survival rates for people who have brain cancer emphasises the need for further research and treatment to combat this devastating disease. Professor Hamerlik’s world renowned expertise in this area will be a great asset to our work at 91ֱ�� which aims to bring us closer to doing just that.”

Dr David Jenkinson, Chief Scientific Officer at The Brain Tumour Charity, which funds world-class research and trusted support and information services, said: “W�� are incredibly excited that Professor Petra Hamerlik has been appointed as the inaugural The Brain Tumour Charity Chair of Neuro-Oncology, which will be a major boost to brain tumour research here in the UK.

“With over 5,400 people still losing their lives to this devastating disease every year in the UK, we urgently need to accelerate progress towards new and kinder treatment options. Professor Hamerlik’s appointment will be critical to establishing a world-leading research centre in 91ֱ��, helping attract the brightest minds to the field in this country and maximising opportunities to collaborate to help us find new therapies faster.

“Thanks to the amazing generosity of our supporters, we’re immensely proud to be able to invest £1.35m to support this transformational role for the next five years. With such a strong track-record in translating breakthroughs from the lab bench through to improved care in NHS hospitals, 91ֱ�� represents a really unique research environment to catalyse much-needed progress for thousands of families affected by brain tumours – and we’re delighted that Petra has joined to lead and drive this work forward. A cure can’t wait.”

The study focussed on a new sensitive blood test to detect, characterise and monitor Small Cell Lung Cancer (SCLC), the most aggressive form of lung cancer.

SCLC is a fast-growing type of cancer that can rapidly spread to other parts of the body through a process called metastasis. Most small SCLC patients, representing 10-15% of all lung cancer cases, are diagnosed late with advanced metastatic disease and few survive beyond 1 to 2 years.  However, of the minority of patients with SCLC who are diagnosed very early and have surgery, 6 out of 10 can live for 5 years or more.

The research team developed a new method to analyse blood samples and pick up specific DNA modifications called methylation that change early on in the growth of cancers. The team also developed a sophisticated computational method to assess which methylation modifications were present.

They focussed on making their method sensitive enough to find methylation modifications in the very low levels of DNA shed from a patient’s tumour into the blood stream, known as called circulating tumour DNA (ctDNA).  The test was sufficiently sensitive and accurate to detect methylation of ctDNA, even from patients whose tumours were diagnosed at the earliest stage.

The standard treatment for SCLC is chemotherapy, but there are multiple types of SCLC that, recent studies suggest, would respond differently to a range of therapies. The new blood test developed by the team could also classify which type of SCLC is affecting a patient, supporting the potential for more personalised treatment options.

Professor Caroline Dive who led the study, which was funded by which was funded by the USA National Cancer Institute (NCI)  and  Cancer Research UK, said: “SCLC is a terrible disease, causing so much anguish to patients and their families. We think this blood test could be really useful in future clinical trials of new therapies to predict and monitor treatment responses”.

Dr Dominic Rothwell, who led the laboratory work said “A key advantage of blood-based molecular subtyping is that blood is much easier to collect and is able to circumvent the challenges often encountered in analysing scant and often extensively necrotic tissue associated with tumour biopsies. Our study opens up the exciting possibility of detecting SCLC earlier and assigning patients to more personalised treatments.”

Prof Charles Rudin, Chief of Thoracic Oncology at Memorial Sloane Kettering Cancer Center who leads the global consortium that defined the different types of SCLC said, “To our knowledge, this is the first published study to show that DNA methylation analysis of a blood sample can identify the SCLC molecular subtypes. Though further validation is clearly now needed in a larger independent patient cohort, this blood test could one day assist clinicians in choosing better treatments for SCLC, which is currently notoriously difficult to manage.”

Dr Marianne Baker, Research Information Manager at Cancer Research UK said: “These promising early results show that the CRUK Cancer Biomarker Centre is leading the way in developing liquid biopsies. These could allow doctors to spot a person’s lung cancer earlier, and even track how a cancer changes over time, helping them to choose the best treatments.

Many people with small cell lung cancer are diagnosed too late to be eligible for surgery, and this reduces their chances of survival. We urgently need ways to detect it earlier and blood tests like this have the potential to help us achieve this goal.

While more research is needed to be sure these tests will work in practice, it’s exciting to see them moving closer to clinical trials and to helping people with SCLC.”

Dr Martin McCabe, study lead and a clinical senior lecturer in pediatric and adolescent oncology at The University of Manchester presented the results of the study into recurrent and primary refractory Ewing sarcoma at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting today (05/06/22).

The current five-year survival rate of recurrent and primary refractory Ewing sarcoma is about 15%. Ewing tumors are uncommon as only about 60 children and young people are diagnosed with the disease in the United Kingdom each year.

There is no standard treatment for recurrent Ewing sarcoma. The study evaluated four chemotherapy regimens commonly used in this disease to see which is best, though two were eliminated from the study in 2019 and 2020 because they were not as effective.

In an analysis comparing ifosfamide and topotecan plus cyclophosphamide, the investigators showed that the length of time patients remained free of progression or second malignancies after study registration, was 5.7 months for ifosfamide compared 3.7 months for topotecan plus cyclophosphamide.

Median overall survival for the children was 16.8 months for ifosfamide compared to 10.4 months for topotecan plus cyclophosphamide.

It is the first randomized trial – on  451 patients -  to compare different chemotherapy treatments for the disease.

Because previous  studies were single arm trials or case series, untilo now it has not been possible to say which treatment was most effective or most toxic.

A greater survival difference was observed for patients under 14 than those aged 14 and older.

However, ifosfamide led to more brain and kidney toxicity than topotecan plus cyclophosphamide.

Both ifosfamide and topotecan plus cyclophosphamide had similar rates of febrile neutropenia (fever and a lower-than-normal number of neutrophils, a type of white blood cell).

Quality-of-life scores favored ifosfamide over topotecan plus cyclophosphamide in children but not in adults.

Dr McCabe, said: “The rEECur study has, for the first time, accrued randomized data for four widely used chemotherapy regimens and is now accruing data for a fifth regimen.

“Before the rEECur study, the basis for choosing drugs for patients with relapsed or refractory Ewing sarcoma was weak and lacking randomized trials to inform clinicians or patients about which treatments were most effective and/or most toxic.”

Ifosfamide, first approved for use in the U.S. in 1987, works by adding an alkyl group to DNA, leading to an eventual breaking of DNA strands and affecting the ability of cancer cells to multiply.

About the 91ֱ��

The phase II/III rEECur trial randomly assigned patients, ages 4 to 50 (median age of 19) with recurrent and primary refractory Ewing sarcoma to either topotecan plus cyclophosphamide, irinotecan plus temolozomide, gemcitabine plus docetaxel, or high-dose ifosfamide. The primary outcome was event-free survival in the phase III comparison. Secondary outcomes included OS, toxicity, and quality of life. At the first and second interim assessments, patients receiving irinotecan plus temolozomide and gemcitabine plus docetaxel had worse objective responses and event-free survival than the other treatments, thereby halting recruitment to both groups. The final assessment was a phase III evaluation of topotecan plus cyclophosphamide vs. ifosfamide. Median follow-up was 40 months.

The regimens were chosen because they were the most widely used regimens for recurrent/refractory Ewing sarcoma in Europe at the time the trial was established. These choices were important as some regimens, notably irinotecan plus temolozomide and topotecan plus cyclophosphamide, were being used as the chemotherapy backbone in trials with molecularly targeted agents.

The rEECur trial was funded by the Cancer Research UK and European Commission with additional funding from the Aamu Pediatric Cancer Foundation, Australia and New Zealand Children's Hematology and Oncology Group, Australia and New Zealand Sarcoma Association, Canteen, German Cancer Aid, Swiss Pediatric Oncology Group and the Zoé4life Other Foundation.

For more information about survival rates for Ewings sarcoma, visit the American cancer Society

The study, published by researchers from King’s College London and Te University of Manchester and funded by Cancer Research UK, provides reassurance to women and people with a cervix aged 24-49 years who test negative for the human papillomavirus (HPV), that screening at five-year intervals prevents as many cancers as screening at three-year intervals, even if they are not vaccinated against HPV.

The study confirms that women in this age group are much less likely to develop clinically relevant cervical lesions (high-grade cervical intraepithelial neoplasia, which are abnormal changes of the cells that line the cervix and are otherwise known as CIN3+) and cervical cancer, three years after a negative HPV screen compared to a negative smear test. This risk is more than halved.

Lead author Dr Matejka Rebolj, Senior Epidemiologist at King’s College London said: “These results are very reassuring. They build on previous research that shows that following the introduction of HPV testing for cervical screening, a 5-year interval is at least as safe as the previous 3-year interval. Changing to 5-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.”

Almost all cervical cancers are caused by HPV infection. Usually, the immune system gets rid of the virus on its own, but if it doesn’t HPV can cause abnormal cells to develop in the cervix. If these abnormal cells are not treated, they can turn into cancer. This is a process that often takes 10-15 years, and sometimes even longer.

Before 2019, cytology tests, otherwise known as smear tests, checked cervical cells for abnormalities first. If found, some of the samples would then be tested for HPV. These tests were recommended every three years. In 2019, following expert scientific evidence, the NHS Cervical Screening Programme in England fully implemented primary high-risk HPV testing using cytology as a triage test, whilst keeping the same screening intervals (3 years for those aged 24-49 years). Now samples taken during cervical screening are tested for HPV first. As having HPV infection comes before having abnormal cells, HPV testing detects more women at risk of cervical cancer.

The study shows that the HPV test is more accurate than a cytology test. Researchers from King’s College London, the University of Manchester, and the NHS have analysed data the from the NHS Cervical Screening Programme in England. They followed those attending screening for two rounds, the first from 2013-2016 with a follow up by end of 2019.

Researchers found that people eligible for screening under fifty who had a negative HPV screen in the first round had a lower risk of detection of CIN3+ in the second round compared to cytology. 1.21 in 1000 people had a detection of CIN3+ after a negative HPV screen compared to 4.52 in 1000 people after a negative cytology.

Currently in the UK, where the HPV screen is negative, the NHS Cervical Screening Programme in England invites women and people with a cervix aged 25-49 years to test every three years and people aged 50-64 years to test every five years or three years if they test positive.  Scotland and Wales are the first to implement the new intervals. England has introduced HPV testing but continue to invite those eligible under fifty every three years and over fifty to test every five years. Northern Ireland currently use cytology tests but will switch to HPV primary screening in the future.

Dr Rebolj added: “This monumental study relied on a multidisciplinary team including those in the NHS Cervical Screening Programme in England, working with women undergoing screening and their samples, and our academic partners. This partnership provides evidence that will best serve the millions of women invited for screening throughout most of their adult lives. These promising results show most women and people with a cervix do not need to be screened as frequently as they are now.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “This large study shows that offering cervical screening using HPV testing effectively prevents cervical cancer, without having to be screened as often. This builds on findings from years of research showing HPV testing is more accurate at predicting who is at risk of developing cervical cancer compared to the previous way of testing. As with any change to a screening programme, this will be monitored to ensure that cervical screening is as effective as possible for all who take part.

“It’s important to remember, screening is for people without symptoms. So, if you notice any unusual changes for you, do not wait for a screening invitation - speak to your doctor.”

High-risk Human Papillomavirus (HPV) DNA is found in over 99% of all cervical cancers. Cervical screening now primarily tests for the presence of this high-risk HPV infection, which is a common virus that most people will get at some point. HPV primary screening is a more sensitive and accurate test than the previous method (cytology alone) and is the best way to find out who is at higher risk of developing the cervical cell changes that over time could potentially lead to cervical cancer.

While the risk for people with high-risk HPV of getting cervical cancer is low, any abnormal changes can be identified early. If HPV is detected, the sample is then checked for any changes in the cells of the cervix. Cell changes are easily treated if caught early, so they don’t get a chance to turn into cervical cancer. 

For further information about cervical screening, please visit .   

The study findings are being published to coincide with Melanoma Awareness Month.

By tracking the projected impact on the 618,000 18-year-olds living in England in 2019, the research team showed that  a ban on indoor tanning would result in 1,206 fewer cases of melanoma and  207 fewer melanoma deaths over their lifetimes . 

The study, funded by the 91ֱ�� Cancer Research Centre, brought together a multidisciplinary team needed to address the financial, social and clinical aspects of the skin cancer project.

In addition, it would result in 3,987 fewer cases of other more common types of skin cancer (squamous cell and basal cell carcinomas) which  impose a major  burden on both affected patients and the NHS. 

The study, published in the British Journal of Dermatology, also  examined the costs of a public  information campaign at the same time as the ban, and the potential savings to the NHS. 

 And the policy would also save the NHS £700,000 resulting in a Net Monetary Benefit of £10.6m with a  99% likelihood that the ban with the information campaign would be cost-effective. 

The actual impact of an indoor tanning ban, and the savings to the NHS that would accrue, would be far greater when benefits to individuals that started to use sunbeds  over the age of 18 years were also factored in.

The results build on previous studies of the effect of similar legislation on healthcare in North America, Europe and Australia and add to the growing body of evidence supporting a total ban on commercial sunbeds. 

Though the International Agency for Research in Cancer in 2009 declared that the ultraviolet radiation from commercial indoor tanning devices  causes cancer in humans , it is currently legal for anyone over the age of 18 to use indoor tanning devices  in the UK. 

Despite some evidence of decreasing use, the practice of indoor tanning is still widespread in many countries including the UK. 

In England, sunbed use is especially high in the north-west and in cities with greater social deprivation; its popularity is thought to partly explain the unusually high rates of melanoma seen among young women living in the north-west.. 

It is also estimated there are around 62,000 children under 18 currently using sunbeds in England. 

Paul Lorigan, a Professor of Oncology at The University of Manchester and Honorary Consultant Medical Oncologist at the Christie NHS Foundation Trust said: “If the NHS invested in a public health campaign to support the ban on sunbeds, we estimate that melanoma and other skin cancers would be significantly  reduced, NHS resources would be saved and deaths averted.

“It is quite clear that melanoma and keratinocyte skin cancers have a significant impact on population health and healthcare budgets, and that a proportion are attributable to indoor tanning. Anyone who has used a sunbed increases their risk of melanoma by almost 60% .

“W�� show quite conclusively for the first time that banning indoor tanning supported by a public health campaign would be an efficient use of healthcare resources to reduce melanoma and other skin cancers in England. 

“Our findings agree with calculations of future productivity losses that were caused by these diseases in the USA in mainly young people in 2015 after exposure to tanning devices. There the total economic losses amounted to over $US127 billion over the individuals’ lifetimes.” 

The team analysed the cost-effectiveness of the policy on the NHS using modelling to track the national cohort of 18-year-olds over their lifetimes. 

The mortality data specifically, was obtained from Office for National Statistics. They compared a nationwide ban on commercial indoor tanning combined with a public information campaign with the status quo of availability of commercial indoor tanning. 

And they calculated the expected costs, Quality Adjusted Life Years and the Net Monetary Benefit of a ban. 

Professor Adele Green from The University of Manchester and the CRUK 91ֱ�� Institute added: “W�� already know that indoor tanning devices are strongly linked to melanoma and other skin cancers with resulting morbidity, mortality and increased healthcare costs. 

“But policy-makers require robust economic evidence to inform decisions about a possible ban of such devices to mitigate these burdens. We feel we have succeeded in providing that evidence.” 

Susanna Daniels, CEO at Melanoma Focus said: "This research is further evidence of the negative public health impact of sunbeds. I am thrilled that Melanoma Focus are supporting this project by funding the validation of UK costs of the melanoma diagnostic and treatment pathway. 

"For individuals, sunbed use dramatically increases the risk of developing melanoma which is the deadliest form of skin cancer. The rates of melanoma skin cancer are increasing in the UK yet 86% of cases are preventable. We strongly advise the avoidance of sunbeds."

Sarah’s story

In 2018, Dr Sarah Carlick was diagnosed with a lump in her collarbone area which was diagnosed as stage three malignant melanoma, over 6 years after she had a cancerous freckle excised.

As someone who had previously enjoyed spending time in the sun, she grew up without knowing how dangerous  being in the sun – or using sunbeds could be, or what a devastating impact it would have on her health.

In the intervening years, she was able to run her training and consultancy business for safeguarding children and adults at risk and completed a doctorate degree in 2018 at Lancaster University.

But just a day after her graduation in 2018, the doctors told her the cancer  - which is one of the fastest growing  - had returned and was travelling up the right side of her neck.

“I was utterly heartbroken and absolutely terrified when I found out the cancer had returned after I had been so long in remission, “ she said.

She had a further operation in January 2019 at The Christie Hospital followed by 12 months of gruelling targeted therapy.

And the therapy took its toll:  of the many side effects she endured the extreme fatigue was probably the worst.

She was so tired that at times she was wheelchair bound and was forced to take long periods of time off from her work which in turn affected her physical and mental health.

She said: “The treatment completely put my life on hold; it was very tough. But it was worth it as the therapy was  a preventative measure to stop the melanoma returning.”

Sarah finished the treatment just before lockdown in 2020, but it took her over 2 years to return to normality, now describing herself as 99% recovered.

But because of what she had been through, she is now a passionate campaigner on the dangers of UV light, sunbathing and use of sunbeds.

She said: “I wasn’t aware of the seriousness of sun protection growing up and I regularly got sunburnt as a child, as well as being a user of sunbeds in the family home as a young adult.

“But now I find it hard to watch anyone going anywhere near a sunbed because I know just how dangerous it is.

“I appreciate tanning salons are small businesses and that people’s livelihoods depend on it. But there’s so much ignorance about what happens to your body when you literally fry yourself.

“The industry needs to take responsibility for the danger they are subjecting their clients to. Like the dangers of  smoking are now highly visible on cigarette packets, there also needs to be a highly visible warning in the salons themselves.”

She added: “There are lots of factors that can contribute to skin cancer, many of which are preventable, and I would encourage everyone to regularly use sun cream, cover up and stay out of the sun  especially between the hours of 11am and 3pm.

“By raising awareness of skin cancer, its symptoms and the associated risk factors of over exposure to UV rays, I hope I can encourage people to be sensible when spending time in the sun and not use  sunbeds  and reduce the number of skin cancer cases.”

The paper Cost-effectiveness of a policy-based intervention to reduce melanoma and other skin cancers associated with indoor tanning is published in  the

Image: Sarah Carlick

The study, undertaken by Dr Garth Funston, Dr Chloe Barr and Professor Emma Crosbie from the University of Manchester, Dr David Jeelvan and Professor Sudha Sundar from the University of Birmingham and Dr Luke Mounce from the University of Exeter, investigated whether a type of protein found in the blood, human epididymis protein 4 (HE4), could help identify ovarian cancer more accurately and save other women from unnecessary and often invasive tests and procedures, such as physical examinations and biopsies.

The study has been published in the peer-reviewed journal, Cancers.

Ovarian cancer is the sixth most common cancer in women in the UK with around 7,500 new cases every year [1]. Almost one in five new diagnoses (18 percent) are in women under the age of 50 [2]. Currently, women with suspected ovarian cancer undergo a blood test to analyse the level of a protein called CA125 in their body. A high amount of this protein can be a sign of cancer, but it can also be caused by other conditions, such as menstruation, pregnancy, uterine fibroids and endometriosis.

Nine in 10 women with raised levels of CA125 in their blood, who are then subject to further tests, do not have ovarian cancer. Meanwhile, some ovarian cancers may be missed if levels of CA125 are too low. This can result in diagnosis occurring when the cancer is more advanced.

Researchers studied blood samples collected from 1229 patients over a 12-month period. Samples were tested for HE4 and the team investigated the diagnostic accuracy of HE4 alone and in combination with CA125. The study concluded that HE4 levels, when analysed alongside the current CA125 test and within an algorithm, could improve the detection of ovarian cancer, particularly in women under the age of 50.

A larger-scale study is now recommended to confirm these findings.

Dr Funston, an Academic Clinical Fellow in General Practice at the University of Manchester, who was awarded the inaugural Transformational Research Award by The World Ovarian Cancer Coalition in 2021, said: “While our results require validation in a much larger sample, these findings are extremely promising. Ovarian cancer is notoriously difficult to diagnose at an early stage, as symptoms are often non-specific, including bloating, pain and feeling full quickly after eating. We also know that the current blood test we use to investigate symptomatic women for ovarian cancer in primary care – CA125 – is less accurate in younger women.

“W�� hope our research can contribute to a change in how quickly ovarian cancer is identified. This is especially exciting as there has been little progress over the years towards developing more accurate ovarian cancer testing approaches for use in primary care.”

Previous studies have highlighted HE4 as a promising cancer biomarker, but until now, tests have only been conducted in groups of women in hospital when a pelvic mass has already been detected. It is currently approved by the Food and Drug Administration (FDA) in the USA for monitoring remission.

Professor David Williams, Chair of the Research Advisory Committee at Wellbeing of Women, and based at The Institute for Women’s Health, University College London, said: “The potential impact of this research is significant. About 21 women in the UK are diagnosed with ovarian cancer every day and we know the earlier cancer is detected, the more likely treatment will be successful, so giving GPs the ability to detect potential cases more quickly is vital.

“This is the first time that HE4 has ever been evaluated in a primary care setting, so it will be exciting to see larger-scale studies implemented to further assess its effectiveness as a diagnostic aid. Earlier diagnosis will have important implications for women’s treatment, care and ultimately, survival.”

The full research paper is available to view

Dr. Na Yu (Cherry) Chia, who is working with the world’s best doctors to develop a ground breaking early detection test for lung cancer, beat off stiff competition to land the accolade.

She was presented with her award at a ceremony in Singapore earlier this month.

Dr. Chia has been supported by the on her enterprise journey after her studies at the University of Manchester. Her pioneering work on a blood-based test to pick up lung cancer in its early stages is now attracting attention from the global scientific community.

She is currently working on product development and clinical recruitment for the Mirlung Dx lung cancer detector and hopes to have a prototype available to UK lung cancer patients by 2023.

ErleaDx's goal is to develop a handheld device for lung cancer detection which works in a similar way to glucose testing meters for diabetics.

Dr. Chia was one of the winners of the 2021 Business Start-up Competition in the healthcare category for this early lung cancer detection project. is the flagship annual start-up competition for all current students and recent graduates across the University of Manchester.

The commercially-available health sensors and devices produce a digital fingerprint of vital signs that could allow doctors to assess the progress of their patients.

Called, EMBRaCE, (Enhanced Monitoring for Better Recovery and Cancer Experience), the trial is a collaboration between , and The University of Manchester.

The trial opens initially for blood cancer, lung, and colorectal cancer patients and will run across Greater 91ֱ��.

The technologies under investigation include:

• a smart ring, worn on any finger made by the company Oura
• the Withings ScanWatch, a hybrid smartwatch
• the Isansys system, which is worn on the chest.

The technologies can assess a range of vital signs, including electrocardiogram (ECG), heart rate, temperature, physical activity levels and sleep.

Dr Anthony Wilson, Consultant in Anaesthesia and Critical Care at , part of  MFT, is the clinical lead for the project.

He said: "Cancer places a huge burden on the lives of people everywhere. This study uses cutting-edge technology that can monitor people during their treatment, with devices that they can wear all the time.

“W�� hope that it will provide new insights into how people cope with cancer treatment and what we can do to improve their recovery.”

Dr Michael Merchant, Senior Lecturer in Proton Therapy Physics, at The University of Manchester, said: “This trial will assess if the latest wearable technology has a role in cancer care.

“It will help us to identify ways that clinical staff can individualise treatment before, during, and after therapy.

“W�� will find out if 24/7 data from these wearable sensors can be used to support patient recovery and provide accurate measurement outside clinic.

“It could even support the development of new cancer treatments by developing a digital platform for clinical trials in cancer involving wearable devices or fitness trackers.”

Thomas Westworth, 70, is from South Lakeland in the Lake District. Now retired, he was self-employed within the building trade for 40 years, and has been receiving care for lymphoma at 91ֱ�� Royal Infirmary, part of , for three months.

Mr Westworth will be taking part in the trial in the next couple of weeks when he receives his first infusion of – a personalised medicine used to treat patients with certain types of leukaemia and lymphoma.

Mr Westworth said he is ‘fascinated by technology’, and was happy to consent to taking part in EMBRaCE when he was approached by the study team.

“I said if could be of any help I’d be happy to take part,” said Mr Westworth.

“I think the actual idea behind the trial is fantastic, I think it should help people.

“All the staff here at 91ֱ�� Royal Infirmary and other hospitals where I have been cared for have been fantastic, everyone is absolutely brilliant.”

EMBRaCE is funded by the GM Cancer Digital Innovation Fund, and the in collaboration with and .

Steve McConchie, CEO of Aptus Clinical, a clinical contract research organisation based in Alderley Park, Cheshire, said: “W�� are delighted that the clinical data collection and curation infrastructure we initially created to support an important piece of exploratory research into COVID-19 is being expanded to assess the utility of patient wearables to improve the care of cancer patients across 91ֱ��.

“W�� look forward to continuing this collaboration with our partners at MFT , The Christie, and Zenzium and are pleased to be supporting research with the potential to make a real difference to patient’s care.”

EMBRaCE is partnered with the health and biomedical data science company Zenzium Ltd to harness the power of Artificial Intelligence (AI) to analyse and identify key patterns within patient data.

Anthony D. Bashall, Managing Director of Zenzium, said: “W�� firmly believe the future of healthcare will be driven by continuous rather than episodic measurements to improve patient outcomes on an individual basis.

“W�� are excited to be part of this ground-breaking collaboration with some of the best entities in the field, which gives us the opportunity to bring our technology, knowledge and expertise in wearable devices enabled by AI to potentially make a real difference in the lives of patients.”

Mr Steve Sweeney, cancer survivor and chair of the group of patients who have advised the project commented: "A cancer diagnosis is fraught with a variety of challenges for patients, way beyond the clinical treatment pathway itself.

“W�� know patients have anxiety around ongoing monitoring and the gap between GP and hospital cancer care, issues with fatigue and sleep disturbance, problems maintaining fitness and the need for greater psychological support.

“The EMBRaCE programme addresses these challenges head on, allowing participants to take more proactive control of their cancer journey through wearables and the data they provide clinicians. These patient pioneers will help shape the future of cancer care in the UK.”

Professor Dave Shackley, Director of Greater 91ֱ�� Cancer Alliance and the Senior Responsible Officer for Cancer in Greater 91ֱ�� said: "We are delighted in Greater 91ֱ�� to have such a fantastic study taking place. The smart use of digital technology is going to be pivotal for high quality, personalised cancer care for our patients. We look forward to hearing the outcomes of this exciting research project and in particular implementing any key findings."

Images:

1.      the smart ring and smart watch

2.      Thomas Westworth wearing the smart ring and watch

3.      Senior Clinical Research Nurse, Sindhu Sibin, with Thomas Westworth

The DETERMINE* trial will be one of the largest precision medicine platform trials targeting these populations and it will enrol patients who have an identifiable genetic alteration in their cancer that can be targeted by treatments that are already approved for use in other cancer types.

Its unique design means that any treatment shown to benefit patients on the trial could be fast-tracked towards approval on the NHS**.

The University of Manchester will lead the trial which will be run in collaboration with the Royal Marsden NHS Foundation Trust, The University of Birmingham, and the Christie NHS Foundation Trust***, with contribution from the adult and paediatric Experimental Cancer Medicine Centres (ECMC) network****.

Under the terms of the partnership, Cancer Research UK’s Centre for Drug Development will sponsor and manage the trial, with Roche providing 7 of their targeted therapies to be evaluated in the first instance. More pharmaceutical partners are expected to join and contribute their drugs as the trial progresses.

The trial is aiming to recruit patients with rare adult and paediatric cancers, as well as more common cancers with rare genetic alterations that could be targeted by the drugs being studied in the trial.

Worldwide, rare cancers make up 22 out of every 100 (22%) cancers that are diagnosed each year* which is more than any single type of cancer. If we were to define all rare cancers as a single type, they would top the list of the most prevalent cancers worldwide, above lung, breast and colorectal cancer.

But despite their prevalence, fewer treatment options exist for patients with rare cancers.

The DETERMINE trial aims to find out whether existing ‘licensed’ drugs, meaning those which are already prescribed by doctors for more common types of cancer, could also benefit patients with rare cancer types that the drug isn’t currently licensed for.

The medicines being used in the trial are targeted to specific genetic faults that occur in cancer. Genetic testing is increasingly being undertaken for cancer patients in the UK either on the NHS or as part of other research trials. The genetic testing will help assess whether a patient is eligible for the study and which drug is most likely to benefit the patient.

 Any drug in that is shown to benefit patients, even if only in a small group of patients with rare cancers, could be submitted for review by the Cancer Drug Fund (CDF)**. They would then decide whether to collect more data to assess if the drug could be used more routinely for patients with this cancer type as a treatment option potentially available in an NHS setting.

Ultimately the study will create a ‘roadmap’ to help establish new treatment options for patients with some types of rare cancer.

This precision medicine trial is set to open to recruitment nationwide in early summer 2022, with the entire length of the trial spanning 5 years.

Dr Matthew Krebs, Chief Investigator for the DETERMINE trial at The University of Manchester and The Christie NHS Foundation Trust, said:

“Patients with rare cancer often have few treatment options available and it’s vitally important we increase our research efforts for these patients.

“With technological advances in genetic testing we’ve learned that some rare tumours contain genetic abnormalities which may benefit from targeted treatment currently only available for more common cancer types. We will undertake in-depth research to understand which patients with rare cancers could benefit from these treatments”

“With the potential to change outcomes for adults, teenagers and children with rare cancers, this trial will be ground-breaking for a patient population who often feel neglected by current cancer research”.

Iain Foulkes, Executive Director of Research and Innovation at Cancer Research UK, said:

“With numerous researchers involved nationwide and potentially around 850 people with rare cancers taking part, this trial represents a significant undertaking by Cancer Research UK and our partners.

“But what makes this even more exciting is that we will be able to fast track the approval of any promising drugs, opening the ‘door’ to treatments for patients who have historically been left with limited options.”

Richard Erwin, General Manager, Roche Products Ltd, said:

“We are committed to helping find ways to identify the right treatment for the right person at the right time. This study will help in identifying novel treatments for adults and children living with rare cancers.”

*DETERMINE: Determining Extended Therapeutic indications for Existing drugs in Rare Molecularly-defined Indications using a National Evaluation platform trial:

A Cancer Research UK adaptive umbrella basket platform trial to evaluate the efficacy of targeted therapies in rare adult, paediatric and teenage and young adult (TYA) tumours with actionable genomic alterations, including common cancers with rare actionable alterations. 

**Only applicable to England but the teams are in discussions with the devolved nations around treatment access.

***Dr Matt Krebs, from the University of Manchester, is the Chief Investigator for the trial, Dr Lynley Marshall is the paediatric lead at the Royal Marsden Hospital with Gary Middleton and Professor Cindy Billingham from the University of Birmingham the Translational Lead and Statistics Lead, respectively.

****The Experimental Cancer Medicine Centres (ECMC) network is an initiative funded by Cancer Research UK in partnership with the four health departments of England, Scotland, Northern Ireland and Wales. Launched in 2007 with a total investment by the funders of over £100million, this infrastructure award supports a network of 18 adult centres (of excellence) and 11 paediatric locations throughout the UK.

Combination treatments Cotellic + Zelboraf and Herceptin + Perjeta. Plus, single agents Alecensa, Rozyltrek and Tecentrig.

*Cancer Research UK:

**

Dr. Na Yu (Cherry) Chia launched her medtech start-up , after her studies at the University of Manchester.

Her pioneering work on a blood-based test to pick up lung cancer in its early stages is now attracting attention from the global scientific community.

She said: “This test is a game changer for the millions of people around the world who hear the devastating words ‘you may have lung cancer’ every year. The current test for lung cancer is expensive, not 100% accurate and involves invasive procedures.

“Our vision at ErleaDx is to make picking up lung cancer, in its early stages, as easy as a finger prick test at home.”

Dr. Chia, founder and CEO of ErleaDx, is currently working on product development and clinical recruitment for the Mirlung Dx lung cancer detector and hopes to have a prototype available to UK lung cancer patients by 2023.

More than 75% of UK lung cancer patients are still being diagnosed at an advanced stage of the disease.

The pandemic has made the situation worse – with a significant increase in the number of patients having their lung cancer picked up at a late stage.

UK health experts predict that there will be an extra estimated 1,300-plus lung cancer deaths five years after diagnosis as a result of COVID-19.

ErleaDx's goal is to develop a handheld device for lung cancer detection which works in a similar way to glucose testing meters for diabetics.

The company has developed a proprietary technology to detect microRNA biomarkers at the early onset of lung cancer.

Dr. Chia was one of the winners of the 2021 Business Start-up Competition in the healthcare category for this early lung cancer detection project. Venture Further is the flagship annual start-up competition for all current students, researchers and recent graduates across the University of Manchester.

This project also landed the UK Wellcome Trust Grant to support the pilot clinical studies in 91ֱ�� and a prestigious A*STAR GAP $100,000 grant from the Singapore government to turn its research into a market-ready product.

ErleaDx is collaborating with Genome Institute of Singapore (GIS), 91ֱ�� University NHS Foundation Trust, Tan Tock Seng Hospital (TTSH) and the University of Manchester to co-develop the test kit for early lung cancer detection.

Dr. Na Yu (Cherry) Chia received her Ph.D. from Nanyang Technological University and MBA from The University of Manchester. Both her studies were funded by the Agency for Science and Technology (A*STAR), a statutory board under the Ministry of Trade and Industry of Singapore.

Dr. Chia has published in prestigious medical journals including Nature and Nature Genetics. She was also one of finalists for the prestigious L'Oréal-UNESCO For Women in Science National Fellowship. Dr. Chia did her post-doctoral studies on gastric oncology in the Duke-NUS Medical School and she was the recipient for the Dean’s Excellence Award for research. Subsequently, she transited from academia to industry, where she became an Investigator at the Novartis Institute for Tropical Diseases. She then embarked on her entrepreneurial journey with Antler, a global early stage VC accelerator before launching her own start-up called ErleaDx (pronounced as “early” Dx=Diagnostics). Her lung cancer project was awarded the Wellcome Trust grant in the UK and A*STAR GAP grant in Singapore.

The research shows that CA125, a simple blood test available in primary care, is useful for ovarian cancer detection in symptomatic women attending their GP and could help identify other types of cancer.

The study is the first to evaluate CA125 within primary care and has important implications for GPs and clinicians. It found that CA125 was abnormal in the majority of women tested in primary care prior to ovarian cancer diagnosis. The study also demonstrated that while 10% of women with a CA125 above the national cut-off had ovarian cancer, a further 12% had another type of cancer such as lung, bowel and pancreatic cancer. The figures were even higher in older women - a third of women aged 50 years or more with an abnormal CA125 level had some form of cancer. These findings indicate that as well as helping to identify women with ovarian cancer, an abnormal CA125 level in primary care may indicate another form of cancer.

The team calculated the risk of women having ovarian cancer based on age and CA125 level. This information could be used by GPs and patients in the future to guide discussions and to inform individual decisions on the need for further cancer investigation.

The paper “” won the Clinical Research category on 14 October 2021, and was ‘Highly Commended’ in the Overall Paper for the Year category by the RCGP panel of judges.

The research was conducted by the , a multi-University collaboration funded by Cancer Research UK. Dr Garth Funston, at the University of Cambridge’s Primary Care Unit, worked with other researchers at the Universities of Cambridge and QMUL (Professor Fiona Walter), Exeter (Professor Willie Hamilton, Dr Gary Abel) and 91ֱ�� (Professor Emma Crosbie), as well as the NCRAS (Dr Brian Rous).

The RCGP panel said: “The research highlights the contribution of primary care research to science and to the evidence-base which guides our practice, and can be of immediate benefit to patients.”

Dr Funston said:”I’m really grateful that this paper has been acknowledged with the RCGP award. I think it is vital that we understand how well cancer tests perform within primary care and that we utilise them in the best possible way to detect disease. This work shows that CA125 is not only helpful in identifying women with ovarian cancer, but that elevated levels could indicate that a woman has another cancer type. In women over 50 with an abnormal CA125 level but no ovarian cancer, I would encourage doctors to consider other types of cancer - it could help diagnose the disease earlier.”

“Knowledge of the risk of a woman having ovarian cancer could help inform clinical decisions around referrals and we are currently working to validate our CA125 and age based models and to make them available to GPs and patients.”

The Research Paper of the Year, awarded by the Royal College of General Practitioners (RCGP), gives recognition to an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care.

Read the winning paper

Funston G, Hamilton W, Abel G, Crosbie EJ, Rous B, Walter FM (2020)  (10): e1003295. October 28 2020. PLOS Medicine. https://doi.org/10.1371/journal.pmed.1003295

Video link (l)

Despite advances in radiation treatment for prostate cancer, an established technique, it can reoccur in some patients most often within the prostate gland itself.

Localised recurrence is treatable and in many cases curative, however there is no consensus on the best option.

According to the research, more patients who had low-dose-rate (LDR) brachytherapy had side effects compared to high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT).

In LDR brachytherapy, doctors implant permanent low dose radioactive seeds in the prostate which remain in place but can sometimes move.

HDR brachytherapy, uses high-activity radiation sources that are temporarily placed within applicators inserted within the prostate, typically over 1-3 treatment sessions. The applicators are removed after each treatment with nothing left inside the patient. Both types of brachytherapy require a general anaesthetic.

EBRT delivers a high dose of radiation, with the aid of high precision computers, to the tumour while sparing the healthy tissue around it.

It is the least invasive radiation treatment and the patient does not require a general anaesthetic. With advances in this type of radiation treatment, EBRT can now be delivered to men with prostate cancer in 5 treatment sessions usually over the course of 2 weeks.

Short term side effects of treatment may affect both the urinary system and gastrointestinal system including pain, bleeding, frequency and urgency.

In the longer term, treatment may cause urethral strictures, a narrowing of part, or all of the tube that carries urine outside the body from the bladder.

The review found that in both the short and long term, LDR brachytherapy was associated with a much higher frequency of urinary and gastrointestinal problems than HDR brachytherapy and EBRT.

Few if any patients in the review who received HDR brachytherapy experienced gastro-intestinal problems and the numbers for EBRT were similarly low.

Co-author Professor Ananya Choudhury, is Chair in Clinical Oncology at The University of Manchester and Honorary consultant Clinical Oncologist at The Christie NHS Foundation Trust.

She said: “In the UK, prostate cancer is the most common cancer in men. Although radiotherapy is very effective, it can recur in around 15% of cases within 5 years of the treatment. There is currently no consensus on how best to treat reoccurrence.

“However, we do know that another course of radiotherapy, called reirradiation, may be better than other options such as surgery as there are fewer side effects.

“But although it may be safer than surgery, radiotherapy can still cause bowel and urinary problems.

“Though much more work needs to be done, this study begins to show that side effects can be reduced if clinicians choose the right therapy based on the evidence.”

Dr Jim Zhong, a Clinical Research Fellow at the University of Leeds said: “Our systematic review found that HDR brachytherapy or external beam radiation appeared to best balance how well the cancer was controlled along with fewer side effects. This also mirrors what happens in first time diagnosis.

“But it also highlights the need for further high quality prospective and randomised research studies to measure the efficacy and side effects associated with prostate reirradiation.

“Studies will need to place more emphasis on the importance of looking at how such treatments impact the patient's self-reported quality of life.

“A major limitation of the existing literature is that it is based on what clinicians think not what patients report – only a third of the 39 studies included patient reported symptoms.

“And some studies in the review were carried out 20 years ago, when radiotherapy was not as effective.”

The paper Salvage Reirradiation Options for Locally Recurrent Prostate Cancer: A Systematic Review is published in Frontiers in Oncology.

MDC, the independent national centre for innovation in drug discovery, has a major focus in pre-clinical imaging and will now offer the design and production of radiotracers alongside its cutting-edge imaging and industrial drug discovery expertise based at nearby Alderley Park.

In recent years MDC and the WMIC have jointly delivered a pipeline of commercial and grant-funded PET imaging projects for UK drug discovery innovators. This new partnership with the University of Manchester builds upon that success and secures the future of the only major radiochemistry facility in the North West – maintaining the region as a UK leader in positron emission tomography (PET) radiochemistry and imaging.

The combination of MDC’s in vivo imaging and infrastructure, with WMIC’s heritage in radiochemistry, further strengthens the national PET Network, which has been established across the UK by MDC and leading academic centres of excellence.

It also creates an opportunity for theranostics – an area of potentially significant impact – to flourish within the UK. Theranostics combines therapeutics and diagnostics in one package for image-guided therapy and could be a step change in defining the outcome of treatment at an early stage.

Professor Peter Simpson, Chief Scientific Officer at Medicines Discovery Catapult, said:

“By reinvigorating this leading centre for radiochemistry, and combining it with MDC’s extensive drug discovery capabilities, we can transform preclinical science in the North West and across the nation. Exploiting MDC’s state of the art imaging suite, underpinned by our internationally recognised scientists, we intend to showcase, simplify and industrialise PET imaging in drug discovery so the UK can become a global leader in preclinical and clinical PET imaging within the next five years.”

Professor Peter Clayton, Deputy Vice-President & Deputy Dean, Faculty of Biology, Medicine & Health, University of Manchester, said:

"The University has had a very positive working relationship with MDC for a number of years, and we are looking forward to seeing the impact of this new development on pre-clinical research. The combination of MDC’s in vivo imaging expertise and infrastructure with the University of Manchester's expertise and heritage in radiochemistry creates a virtual centre-of-excellence and provides the only centralised radiochemistry facility in the region."

Find out more about MDCs PET Imaging expertise .

Preliminary results, from what’s believed to be the first monitored remote pre-habilitation programme in the UK, are promising and could improve recovery by a third.

The surgical research team at the leading cancer centre has just completed the fourth phase of the study to discover if, by using a Fitbit smartwatch, it can improve a patients’ fitness pre-surgery enabling better recovery and a shorter stay in hospital post-op.

The trial initially started in May 2019, and recruited 22 patients who were scheduled to have major abdominal surgery at The Christie for appendix cancer. Half the patients were given an exercise programme to suit their abilities and half were told to continue to just do their normal level of activity.

The cohort was constantly monitored remotely to ensure they were completing the daily activities they’d been set, and the research team also called them weekly over their 4-6 week pre-habilitation period. Having the FitBit increased compliance and reduced hospital visits, which benefited patients, particularly those that didn’t live locally.

Feedback from the participants found the Fitbit wearable devices encouraged them to complete their exercises as they could easily see their progress towards their activity goals.

Mr Omer Aziz, consultant surgeon at The Christie and Honorary Lecturer at The University of Manchester who is leading the study, said: “To the best of our knowledge this is the first research into using smartwatch technology to benefit patients’ outcomes post-surgery. This novel approach could mean more patients are fitter for surgery resulting in a shorter recovery time and therefore less days in hospital, which not only benefits the patient but saves the NHS money. Using this method is also more convenient and safer for patients as they can do their pre-habilitation at home, avoiding a trip to hospital. During the pandemic this has, of course, been even more beneficial.”

Julie Gray, 61, from Bacup in Rossendale, Lancashire, one of the patients on the trial, who had major abdominal surgery, said: “The Fitbit certainly made me go and do more exercise. I’m a convert and I’ve now bought my own Fitbit and given one to my husband and daughter. It keeps track of your general health and sleep patterns which is also really helpful. In 2019 I had an 11 hour operation but came out of it feeling better than before. I think it did help me with the recovery and I was up and about not long after the operation. I even joined a gym and did spin and step classes.”

Julie left hospital nine days after her operation which is three days earlier than the average length of stay, 12 days, for this kind of operation.

Seema Rahman, Senior Physiotherapist at The Christie who was involved with this trial, said: “We see patients as little as 12 hours after their operation. We noticed the patients that had used the Fitbits felt fitter and were more than happy to get out of bed and start rehab. They were in the right mindset as they had put in all the hard work beforehand and were keen to get back to fitness. They were more mentally prepared for the next part of their journey to recovery and it wasn’t a shock for them.

“We know exercise helps reduce the recurrence of cancer, so changing their mindset to exercise is extremely important for their long term health. It’s still too early to determine if the Fitbits are key to shorter post-op stays, as we need to study this further but anecdotally we observed that the patients using the Fitbits generally left hospital sooner than those that didn’t.”

Previously, prehabilition before major abdominal cancer surgery has ranged from unsupervised home-based techniques such as providing the patient with exercise booklets, CDs and computer programmes, to supervised hospital-based face-to-face sessions using cycle ergometers and exercise equipment.

Led by University of Manchester scientists at the Cancer Research UK 91ֱ�� Institute, the team publish their findings in Clinical Cancer Research.

The study is funded by The Wellcome Trust, Cancer Research UK and the Royal Society.

Men have more skin squamous cell carcinoma (cSCC) than females and their tumours are more aggressive. It is not clear if this is linked to more exposure to sunlight. This study used animals to explore this question.

The study found male mice developed more aggressive tumours than females, despite receiving identical treatments.

Immune cell infiltration and gene expression related to the anti-cancer immune system were increased in female mouse skin and tumours, suggesting a protective effect of the immune system.

In keeping with the animal study, 931 patient records collected from four hospitals in 91ֱ��, London and France, the researchers identified that while women commonly have a more mild form of cSCC compared to men, immunocompromised women develop cSCC in a way more similar to men

That suggests the protective effect of their immune system may have been compromised.

The results in human patients were confirmed in a further cohort of sun-damaged skin from the USA. In this cohort, human epidermal cells confirmed women’s skin activated immune-cancer fighting pathways and immune cells at sites damaged by sunlight.

Furthermore, the USA cohort showed two types of human T Cells - CD4 and CD8- which are important in our immune response to skin cancer- were twice as abundant in women as in men.

The differences in male and female immunosuppressed mice and human skin cells were studied by a technique called RNA sequencing.

“It has long been assumed that men are at higher risk of getting non-melanoma skin cancer than women” said Dr Amaya Viros, from The University of Manchester.

“Other life-style and behavioural differences between men, such as the type of work or exposure to the sun are likely to be significant.

“However, we also identify for the first time the possible biological reasons, rooted in the immune system, which explains why men may have more severe disease.

“Although this is early research, we believe the immune response is sex-biased in the most common form of skin cancer, and highlights that female immunity may offer greater protection than male immunity.”

Dr Viros added: “We can’t yet explain why women have a more nuanced immune system than men.

“But perhaps it’s reasonable to speculate that women’s evolutionary ability to carry an unborn child of foreign genetic material may require their immunological system to be very finely tuned and have unique skills.

“Very little is known about how sex differences affect incidence and outcome in infectious diseases, autoimmune disorders and cancer. More work needs to be done.

“But we feel this study has opened a window into this area, and could one day have important implications on other types of immunologically based diseases.

“And it suggests if doctors are to offer personalised treatment of cancer, then biological sex should be one of the factors they take into account.”

Dr Samuel Godfrey, Research Information Manager at Cancer Research UK said: “Research like this chips away at the huge question of why people respond to cancer differently. Knowing more about what drives immune responses to cancer could give rise to new treatment options and show us a different perspective on preventing skin cancer.”

An embargoed copy of the paper Female immunity protects from cutaneous squamous cell carcinoma, published in Clinical Cancer Research, is available .

DOI: 10.1158/1078-0432.CCR-20-4261

The University of Manchester led national study of 3,776 patients – treated for early breast cancer at 64 hospitals across the UK – between March and May 2020, is published in .

The team found that the majority of patients were delivered safe and effective treatment in line with normal practice, on time and to standard, in pre-operative, operative, and post-operative settings.

There were just 14 cases of patients testing positive for COVID-19 in the study, one per cent of the total. None of the patients involved the study died from the disease.

The success, say the team, can be partly explained by the adoption of multidisciplinary UK guidelines, which were published early in the pandemic, advising on the safe management of patients.

In addition, there was rapid adoption of the findings from a 10-year study – known as Fast Forward. Fast Forward was published in May 2020, although guidance arising from it was issued before publication.

Fast Forward recommended shortening radiotherapy course from 15 doses over three weeks to five doses in a week, having showed that five doses was as effective as 15 doses in terms of cancer recurrence.

Though the reduced number of doses are given at a higher intensity, side effects are no different.

Of the 64 hospitals in the study, 46 rapidly introduced the Fast Forward protocol during the period of the study.

Other measures included rigorous COVID-19 testing of patients, operations carried out in COVID-19 free surgical theatres known as ‘green zones’ both in the NHS and private sector, and rapid discharge of patients.

However, some patients did potentially miss out on breast reconstruction surgery which is likely to have implications on the breast service in the future, in terms of needing to offer more reconstructions at a later date.

And though the study only examined existing patients, breast cancer screening has been hit by the pandemic, with reduced numbers of women attending for screening.

However, screening services are now fully open and women can be reassured that safe, COVID-protective measures are in place.

Paper co-author, surgeon Professor Cliona Kirwan, is a Clinician Scientist at The University of Manchester.

She said: “Compromises to cancer care during the COVID-19 pandemic have the potential to impact on survival, as well as quality of life, service provision, and health economics.

“But this study definitively shows that for patients with breast cancer who are in the system, the NHS is able to deliver effective, timely and safe care.

“Outcomes are as good as they were before the pandemic took hold, and that’s a result of the fantastic work of everyone in multi-disciplinary teams across the UK.

“The message we want to get across is that it is perfectly safe to come to hospital if you have discovered a lump in your breast and want it checked out.”

Co-author Mr Rajiv Dave, a Consultant Oncoplastic Breast and Endocrine Surgeon, said: “The Fast Forward study pre-empted the pandemic, the timing of its publication was fortuitous, allowing new treatment guidelines to be based on it.

“Fast Forward fits well into the changed environment; patients do not need to visit hospital as many times, thus reducing their risk of exposure to COVID-19.

“But what is remarkable that it took many years for hospitals to transition from a regime of 25 doses to 15 doses, this change happened in a matter of months.

“The NHS reacted quickly to the evidence and there’s lots of evidence to suggest the pandemic triggered a permanent change in practice.”

The collaborative research team have published their findings in Nature’s journal, , and demonstrated that Very High Energy Electron (VHEE) beams can have a positive effect for treatment with damage to DNA at similar levels to those conventional X-Rays and proton therapy, whilst harnessing the unique technological qualities of electron beams.

Human cells are composed of DNA and this new result is a fundamental step forward for VHEE radiation as a treatment for a number of cancers. This new treatment has the potential to extend conventional treatment with electron beams used in hospital which only penetrate a few centimetres into the body and struggle to reliably reach deep seated tumours.

This new technology has the potential to extend the toolbox of radiotherapy techniques that can be used in hospitals to treat cancer, in particular an ability to treat deep seated tumours with electrons in a robust manner.

Earlier work from The University of Manchester group indicated this radiation is insensitive to intervening media – meaning if the dimension of the lung changes for example (the patient’s breathing) then the radiation will remain targeted to the tumour, limiting the damage to healthy tissue. The results in this new paper are a first to quantify damage to Double Strands of DNA with high energy electrons.

Following experiments carried out by The University of Manchester, at CLEAR 250 MeV facility and at , the findings show Very High Energy Electron (VHEE) beams are effective at causing DNA damage, important for killing cancer cells, for radiation given over the course of several minutes and for the rapidly evolving field of sub-second FLASH radiation.

In the newly published paper the research group focussed on experimentally determining the DNA Double-Strand Break yield and this was used to evaluate the Relative Biological Effectiveness (RBE) — a key value to evaluate the effectiveness of this type of radiation compared to existing radiation treatments. These results, a first in the field, were found to be consistent with established radiotherapy modalities.

Kristina Small, a PhD student, carried out the experiments, Kristina said: "Electron beam treatment has been identified as a candidate for treatment of lung cancer, a cancer which sadly still has a low survival rate. We have shown, through experiments at CERN and Daresbury Laboratory that VHEEs cause a similar level of damage to DNA compared to protons and X-rays.”

Similarities in physical damage between VHEE and conventional modalities gives confidence that biological effects of VHEE will also be similar – key for clinical implementation. The researchers also made detailed Monte-Carlo (statistically based) simulations — and these complicated simulations were consistent with previous experiments. 

Professor Roger Jones from The University of Manchester and said: "This paper represents a significant step in verifying the potential of Very High Energy Electron beams to treat cancer. It relies on a seamless collaboration of The University of Manchester's Department of Physics and Astronomy, The Division of Cancer Sciences, Daresbury Laboratory and CERN, and The Christie NHS Foundation Trust.

“It is the first to quantify both single strand breaks (SSB) and double strand breakage (DSB) in DNA using VHEE beams. To do this we used plasmids which effectively freeze the damage (as plasmids are not equipped with repair mechanisms that living cells possess) and hence enabled us to process the results obtained at CERN back at the 91ֱ�� Cancer Research Centre. These results compare well with detailed Monte Carlo simulations. It also explores the exciting regime of FLASH Radiotherapy - which entails delivering a high dose over a sub-second timescale and where early experiments worldwide show potential to spare healthy cells during treatment. This work points the way for a potential new paradigm in radiotherapy.

“Advantages of this technique over existing methods include – potentially more precise and rapid delivery to tumours with reduced fractionation (number of times the patient has to have a follow up radiation treatment) which result in fewer patient visits needed with a more conformal high dose delivered. Recent results in the area of ultra-high dose rate radiotherapy indicate considerable sparing of healthy tissue.”

The next step is to further demonstrate these exciting results in future experiments. In the long term, researchers hope that VHEE therapy will make a valuable addition to the radiotherapy toolkit in order to improve future cancer treatment.

Dr Michael Merchant (Division of Cancer Sciences, The University of Manchester) said: "This is an exciting first measurement of DNA damage for very high energy electrons. These measurements will help to build understanding of how to harness the medical applications of very high energy electrons.”

Professor Jim Clarke, Director of ASTeC at STFC Daresbury Laboratory said: “These exciting results have built upon earlier studies with lower electron energy using CLARA at Daresbury Laboratory. The planned energy upgrade of CLARA to 250MeV next year will make it an ideal test bed for further VHEE experiments that could lead to new radiotherapy treatments in the future.”