5 minute read
How Discovery Drives Clinical Progress
by RCSI
Beaumont RCSI Cancer Centre is dedicated to strengthening links between clinical and research teams and training future clinicians
Clinical trials are research studies involving people that help to discover new ways of diagnosing, treating and preventing disease. Cancer clinical trials aim to discover better ways of detecting and diagnosing cancer, treating cancer, preventing cancer and cancer recurrence, and improving quality of life for people with cancer.
Beaumont RCSI Cancer Centre is focused on conducting high-quality clinical research across the Cancer Centre with the aim of understanding more about the scientific changes of cancer and new therapies that can be delivered to improve quality of life and cancer survival. Significant funding for clinical research has been awarded to the Centre from both international and national funding bodies, including the EU and Health Research Board, over the past 18 months.
Immunotherapy
Researchers at Beaumont RCSI Cancer Centre are involved in research for many different types of cancer and for patients with different stages of the disease. For patients with early stage (curable) cancer, recent trials have focused on novel approaches such as immunotherapy, which aims to harness the normal immune system to fight cancer cells. Immunotherapy is often much easier for patients than older chemotherapy drugs. Hence, this research has focused on increasing long-term survival and cure by maximising new treatments and minimising chemotherapy. For patients who benefit from immunotherapy, but develop toxicities, Professor Jarushka Naidoo is leading research into novel immune side-effects, to identify those at risk and develop new treatment algorithms.
Individualised Treatment
The partnership between clinicians and scientists is central to our understanding of how cancers develop, grow and spread. This knowledge is being used to try and identify patients with very low-risk cancer, who can safely avoid older, more toxic, chemotherapy. This research has led to more individualised, personalised treatment approaches. Many patients now receive systemic anti-cancer therapy
(chemotherapy, targeted therapy and immunotherapy) before surgery. Following the operation, pathologists conduct a rigorous review of the tissue removed by surgeons, to determine how well cancers have responded to treatment. This information is now routinely used to determine how much treatment to give patients after surgery.
Radiotherapy
RCSI Professors Orla McArdle and Colm Power have been running a trial of novel radiotherapy in patients undergoing breast surgery. This approach has focused on low-risk cancers and delivering radiotherapy during surgery, with the aim of offering patients a more convenient, less toxic therapy with a quicker recovery. This has required a close working relationship between members of the multidisciplinary team and speaks to the great collaborative strength of the group.
Rare Cancers
Beaumont RCSI Cancer Centre is harnessing the capacity of the cancer genomics laboratory to attract novel clinical trials for rare cancers. The ability to perform novel tests on tumours has allowed the team to conduct clinical trials for rare cancers and rare subtypes of common cancers. T his expertise is now being used to develop investigator-initiated trials, where scientific discoveries are translated into the clinic. Patient samples from these trials are then used to further scientific discoveries back in the laboratory. RCSI Professors Siobhá n Glavey, Bryan Hennessy and Jarushka Naidoo are all involved in these types of research across an array of different cancers.
Colorectal Cancer Clinical Trial
Scientists at the Cancer Centre have shown that common cancers vary quite a bit from one person to the next. This cancer heterogeneity has led to the design of clinical trials based on the key drivers that make them grow and spread, rather than an older view based on the organ where cancers begin. For example, KRAS mutations on cancer cells cause cancers that originate in the bowel, lung and other sites to grow and spread. Investigators at the Cancer Centre are now involved in clinical trials using an oral therapy, which targets a particular KRAS mutation. Professor Liam Grogan is leading a trial to examine an oral therapy in advanced KRAS mutated colorectal cancer – a cancer where there have been very few recent advances for patients and clinical research opportunities have been limited. Professor Jarushka Naidoo is leading similar trials with this drug in lung cancer.
Haematology
Consultant Haematologist Dr Karl Ewins has recently opened two clinical trials, which are examining new blood-thinning medications in patients with cancer who develop blood clots. This is a common problem in patients with cancer and it is hoped that in the future better treatments for the complications of cancer and cancer therapy will lead to further improvements in patients’ quality of life.
Surgical Clinical Trial
Not all cancer clinical trials involve new drugs or novel radiotherapy. Professor Arnold Hill has recently led a trial examining a new surgical technique in women undergoing breast surgery. It is hoped that new approaches to surgery can result in fewer complications and quicker recovery for patients.
Cancer Trials in the National Context
Cancer Trials Ireland, the national cancer trials network, is a key partner of Beaumont RCSI Cancer Centre and is located on RCSI’s St Stephen’s Green campus. The clinical trials network works closely with leading researchers, medical and radiation oncologists, surgeons and haematologists in the cancer centre to increase availability of new clinical trials for patients on the island of Ireland. “Our goal in Cancer Trials Ireland is to open new cancer clinical trials in Beaumont RCSI Cancer Centre and in many other centres so that patients in Ireland can avail of the most up-to-date treatments, at no cost to themselves or the state,” comments Cancer Trials Ireland CEO, Eibhlín Mulroe.
