Bwrdd Iechyd Addysgu Powys
Iechyd Cyhoeddus Cymru
Powys Teaching Health Board
Public Health Wales
Ymddiriedolaeth GIG Felindre Velindre NHS Tust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust
Transforming care for patients with incurable breast cancer A trial led from Wales has produced significant results in the treatment of incurable breast cancer. This work won the MediWales award for Health and Social Care Research Partnership Award with Industry, which recognises NHS personnel who have partnered with industry to deliver a project with a particular focus on health and/or social care research.
Breast cancer is the most common type of cancer in the UK, with around 55,000 new cases each year and around 11,400 breast cancer deaths. The most common form is estrogen receptor positive breast cancer, accounting for 70-75 per cent of cases. The FAKTION trial was designed to help improve outcomes in patients with incurable estrogen receptor positive breast cancer. Such patients often respond to hormone therapy, but they eventually become resistant to it. One mechanism known to cause treatment resistance involves the
activation of a protein called AKT. The trial tested whether the addition of a novel AKT inhibitor (recently developed by Astra Zeneca) to standard hormone therapy could improve treatment outcomes in breast cancer patients. The trial was led from Cardiff by Rob Jones (Speciality Lead for Cancer in Wales, Lead for Phase 1 trials in Wales and Clinical Research Director at the Velindre NHS Trust) and coordinated by the Cardiff University Trials Unit (CTR), with Velindre NHS Trust acting as sponsor and Astra Zeneca as an industry collaborator. The trial involved 140 patients from 20 hospitals across the UK. Half of the patients received hormone therapy with the AKT inhibitor (Capivasertib) while half received hormone therapy with a
placebo, and results showed significant improvements in cancer shrinkage and control. It was found that 41 per cent of patients who received the AKT inhibitor with hormone treatment had a significant shrinkage of their cancer, compared to 12 per cent who received the hormone plus placebo. The cancer was also controlled for over twice as long if patients received the capivasertib drug with hormone treatment, compared to the hormone and placebo (10.3 months vs 4.8 months). These results have now prompted a global phase 3 trial involving around 700 patients, which could lead to a future change in the standard of care for patients around the world. Another benefit of the FAKTION trial is that the patients in Wales who participated have had access to a brand new drug ahead of time. All drugs given in the trial (including the standard hormone therapy) were supplied for free by Astra Zeneca, which has saved the NHS the equivalent cost. This Wales-led trial is a significant piece of breast cancer research and was selected for oral presentation at the ASCO oncology conference in Chicago in 2019 and was a full publication in Lancet Oncology 2020. It is also a highly successful example of a cancer trial led from Wales which has followed this model of close collaboration with industry, with the IP remaining within academia. The trial’s results could have a huge impact for millions of patients with incurable breast cancer and is a flagship example of what collaboration with industry can achieve.
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