NIHRDataInsights/HRCSData huggingface dataset:
Title: Using information to prepare cancer caregivers to cope: translating evidence to practice
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: A growing number of people are caring in the community for a family member or friend affected by cancer. This support is vital as they assist in managing medications, symptom management, personal care, social support and transportation. Providing informal care can have a negative impact on an adult cancer carers (ACC) physical and mental health and this may compromise their ability to carry out their role. ACC lack information about cancer and expectations of their role; they are rarely prepared as often this role is unexpectedly put upon them. Despite the integration of routine patient information in oncology, specific guidelines and supports to best help family and friends to provide care are non-existent. In an attempt to redress the balance, the applicants undertook a study which aimed to examine the impact of caring on ACC and their needs for support 1. Through a survey with 98 ACC and interviews with 24 cancer care professionals we found that ACC have poorer health compared to caregivers of other chronic conditions and many lack support and information. ACC require appropriate and specific information regarding medications, psychological issues, managing partners change in body image or sexual function, the financial impact of cancer and managing their role whilst continuing employment. This information needs concur with previous international research findings 2-3. The Knowledge Exchange project will involve the development and evaluation of an information DVD for ACC with content determined by our previous research findings. The user-friendly format, dialogue and presentation will be established through collaboration with clinical, voluntary and user representatives. It is proposed that this information DVD will be administered within the information package routinely given to all cancer patients by oncologists and Clinical Nurse Specialists (CNS). It is hypothesised that due to succinct mode of delivery i.e. During routine consultation, the resource will easily and rapidly be integrated into routine care in a cost effective and sustainable way. The impact of this project is multifaceted enabling the translation of research findings rapidly into the clinical setting, informing and shaping service delivery, building collaborations between academics, clinical staff and the voluntary sector and achieving planned policy initiatives by meeting the needs of caregivers.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: CANCER AND NEOPLASMS
Title: US-Ireland R&D Partnership - Systems Modeling of Tumor Heterogeneity and Therapy Response in Colorectal Cancer
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Colorectal cancer (CRC) has one of the highest worldwide incidence (>1.3 million new cases) and mortality rates (~610,000 deaths annually). Genotoxic chemotherapy in stage II and III confers minimal treatment benefit (improved survival in 3-4% stage II patients and 15-20% patients in stage III), and predictive markers for therapy response are lacking. CRC patients would strongly benefit from novel prognostic and predictive biomarkers that identify patients who will not benefit from 5-FU-based chemotherapy, redirecting them towards ‘targeted’ or novel interventions and intensified disease monitoring. One of the challenges in implementing such a biomarker approach is the CRC is a highly heterogeneous disease, with multiple subtypes emerging. The purported causes of chemotherapy resistance are complex and multi-factorial, including dysfunctional apoptosis pathways, immune cell cytotoxicity (in turn, negatively affecting apoptosis and reducing immune-competency) and presence of cancer stem cells (and expression of multidrug resistance proteins). The numbers, spatial distribution and pathway status of these cells in the tumor and stromal area (or their heterogeneity) is an important consideration, but the significance is not understood. The central hypothesis under investigation in this proposal is that modelling of apoptosis pathways at a cellular level and integration and tumor heterogeneity drivers in stage II and III CRC patient samples will better predict chemotherapy response, compared to standard biomarkers and treatment algorithms. We will use a novel single cell imaging technology to profile up to 40 proteins in a single tissue micro array sections from >1500 stage II and III CRC patients. These proteins will represent the apoptosis pathway, immune cells, stem cells, stroma and epithelial cells and be quantified at single cell level. Systems models will be used to integrate the apoptosis data with heterogeneity metrics and predict response to chemotherapy. In a subset of patients with available cell lines, we will experimentally investigate mechanisms of drug resistance and test whether novel apoptosis-inducing therapies could potentially provide an alternative to chemotherapy. Finally, we will validate significant predictive biomarkers in a randomised controlled trial with chemotherapy treated and untreated patients. Predictive biomarkers for stage II and III patients could potentially save hundreds of thousands of patients per year from treatments with limited benefit and provide oncologists with greater ability to direct patients towards other therapies.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: CANCER AND NEOPLASMS
Title: Enabling Research Award: A feasibility study of a pedometer based intervention for patients with Myeloproliferative neoplasms
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Fatigue is commonly associated with significant disease burden in cancer patients. Classic myeloproliferative neoplasms (MPNs) are a rare heterogenous group of haematological malignancies. It has been reported that “Fatigue is one of the most devastating side effects of this malignancy and its treatment”. MPN patients have lower physical activity levels than the general public with fatigue reported as an inhibiting factor. Pedometers have been shown to increase activity in some clinical populations but no assessment in patients’ with MPNs has been undertaken. To determine the acceptability and validity of either a waist (DigiWalker SW200) or wrist (Garmin Vivofit) pedometer 30 patients with another chronic haematological malignancy (Chronic Myeloid Leukaemia/Chronic lymphocytic leukaemia) will be recruited and asked to wear both devices and an activity belt (ActiGraph wGT3X-BT) for 1 week. Following this, sixty MPN patients will be recruited into the feasibility study with patients randomised to one of three groups (20 patients in each). All patients will wear the ActiGraph wGT3X-BT for one week preceding and subsequent to the intervention period. One group (control) will receive normal routine care. One intervention group will be provided with a pedometer and information on how to use the device. The other intervention group will receive a pedometer, initial assessment by a research nurse and motivational telephone discussions weekly in month 1, fortnightly in month 2 and once in month 3. We will measure change in the step counts over the intervention period, use questionnaires to assess changes in fatigue, other symptoms and quality of life and talk to patients about their experiences using focus groups. The goal is to identify the appropriate methodology and scale the study up to a full size RCT within the Clinical Trials Network in the UK recruiting patients from 20 sites to ensure adequate sample size attainment.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: CANCER AND NEOPLASMS
Title: A Framework to Study Radiotherapy-Induced Late Effects on Paediatric Patients
Funder: Royal Academy of Engineering

Abstract: Childhood cancer treatment has become relatively successful, and nowadays 75% of the patients survive for 10 years or more[1]. Radiotherapy had a fundamental role in improving outcomes, but with increasing survival the late treatment-induced side-effects also become more important. Namely, 1 in 5 survivors are expected to develop second cancers (i.e., new primary cancers) decades after the treatment, and this is their highest cause of mortality[2]. Existing population-based studies of second cancer risk are based on single-risk factors averaged over large volumes, namely mean planned dose to organs. However, there are multiple risk-factors of second cancer induction (namely, delivereddose, radiation effectiveness and radiosensitivity of tissues) and the spatial location is also important (i.e., within sub-volumes of tissues and organs). Children have been treated with state-of-the-art radiotherapy for over one decade now, so late follow-up data is becoming available. However, there is no infrastructure to properly study this data: studying in three-dimensions (i.e., spatially) a heterogeneous population such as paediatrics is still a challenging and unsolved problem, and the best physical and biological risk-factors to predict cancer induction are still underdeveloped.Hence, the goal of this multidisciplinary programme is to engineer the research infrastructure required to properly model the risk of radiotherapy-induced second cancers. This will be achieved by focusing on two complementary approaches. First, three-dimensional medical imaging-based techniques will be engineered to bettercharacterise patient-specific risk-factors, specifically the dose delivered and tissue radiosensitivity in the vicinity of the primary disease. In parallel, a three-dimensional image-based coordinate system that represents the paediatric population will be engineered, to which the information from each individual patient can be propagated. This multidisciplinary programme will enable three-dimensional modelling of second cancer risk and provide the basis for evidence-based radiotherapy. In the longer term it will contribute to cancer cures with fewer late side-effects.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;2.6 RESOURCES AND INFRASTRUCTURE (AETIOLOGY)
Health categories: CANCER AND NEOPLASMS
Title: The use of quantitative sonoelastography in the differentiation of benign and malignant extremity lipomatous soft tissue masses]
Funder: Royal College of Radiologists

Abstract: To investigate the role of quantitative sonoelastography in the differentiation of benign and malignant extremity lipomatous soft tissue masses. To investigate technique reliability between different shear wave technologies.


Research activity codes: 1.4 METHODOLOGIES AND MEASUREMENTS
Health categories: CANCER AND NEOPLASMS
Title: BIVISTA: multi-modality imaging for improving surgical intervention
Funder: Science and Technology Facilities Council

Abstract: Major cancers such as pancreatic and breast cancer (worldwide incidence of over 277,000 and 1,383,000 respectively) rely on surgical intervention. The challenge is to reduce the mortality rate for these and other types of cancer through interventional imaging techniques that can assist clinicians and surgeons at the time of operation. Clinical diagnosis forms the basis for improved patient management and we propose that high quality imaging at the point of care will contribute to better diagnosis and treatment outcomes for patients. Gamma cameras are used routinely in many areas of medicine to image different tissue types and processes using radioactive 'tracer' compounds injected into the patient. The resulting images are of great value to the clinician in the staging and treatment of a variety of conditions. The combination of multi-spectral imaging, inherent in the BIVISTA system, will improve diagnosis and hence treatment management in a wide variety of cancers and other diseases. A patent application has been filed on the BIVISTA concept. The advantages of the BIVISTA versus larger-field gamma cameras include: Uniquely combines gamma and optical imaging Much higher resolution which allows imaging of smaller areas of tissue or the study of other processes such as lymph drainage Compact and mobile device offering real time imaging that can be used in a variety of environments, for example at the bedside and in the operating theatre. Multi-modality imaging: simultaneous optical and gamma ray and the ability to map fluorescence markers; an emerging technology in surgical practice. High spatial resolution information of 3D distribution of activity within the patient BIVISTA will deliver significant healthcare benefits to a range of patients.


Research activity codes: 5.4 SURGERY
Health categories: CANCER AND NEOPLASMS
Title: Advanced femtosecond laser technology for particle detector characterisation and processing
Funder: Science and Technology Facilities Council

Abstract: The proposed programme of work will advance the femto-second laser process to (a) Develop a versatile detector characterisation instrument based on multi-photon absorption with micron resolution. (b) Develop direct laser writing for graphitic electrodes in diamond. The goals are to provide a low cost high precision characterisation method for detector developments and to establish 3D diamond detectors as a mature detector technology enabling particle detectors with unprecedented radiation hardness. Identified key projects benefiting from this technology development are e.g. in the area of Particle Physics for experiments at the energy frontier, and for diagnostic devices in the area of radiation therapy for cancer treatment.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS
Title: Developing a technique to measure levels of tumour hypoxia during proton beam therapy through gamma-ray spectroscopy
Funder: Science and Technology Facilities Council

Abstract: Around 50% of patients receive radiotherapy as part of their cancer treatment. One of the most important factors influencing clinical outcome, following radiotherapy, is tumour hypoxia. Low oxygen levels (hypoxia), is a characteristic of the tumour microenvironment which drives increased metastatic potential and confers resistance to radiotherapy, decreasing overall survival. However, even with advances in radiotherapy, including a move towards proton beam therapy (PBT), hypoxia-mediated radio-resistance is a complexity that remains. This project aims to develop a technique to measure oxygen levels, and consequently hypoxia, in tumours treated with PBT in real time. During PBT, dose is deposited in tissue by both the ionisation of atomic electrons and proton interactions with the atomic nuclei. This project takes a multidisciplinary approach to harness the naturally produced radiation during PBT to measure hypoxia. Real time measurement of hypoxia during treatment will inform adaptive therapy where radiation dose can be escalated to overcome hypoxic radio-resistance during fractionated treatment planning.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS
Title: RF Power Systems and Optimized RF structures for electron beam acceleration
Funder: Science and Technology Facilities Council

Abstract: The proposed work is driven by the ultimate goal to design a modular linear accelerator for cancer treatment with minimum subsystems making it robust, reliable and accessible to communities with lower and intermidiate incomes. The road map to achieve this goal was identified during the recent workshop hosted by STFC, CERN and ICEC in partnership with representatives from ODA countries. It is based on the idea to use the best available in accelerator science solutions and adapt them to specific problems linked to the challenging environments, financial situations and knowledge availability in the ODA countries. This project aims to design accelerating structures which can be affordable, robust, efficient and easy to look after, while keeping the design at the cutting edge of the technological solutions available. To achieve the goals the design of the RF accelerating structure will be based on the CLIC system and adapted to the 1.3GHz frequency enabling the use of either a low voltage solid state RF power supply or alternative sources like klystron or magnetron. To make it modular with minimum subsystems required the structure will be vacuum sealed i.e.no vacuum pumps will be needed to maintain the vacuum and LINAC operation. This will reduce the overall capital and maintenance cost. To reduce the manufacturing cost of the cavity a new technology of cavity manufacturing will be tested. The cavity will be machined from two aluminium blocks using CNC lathe. This will also reduce the weight of the cavity allowing the beam energy of 6MeV -8MeV to be achieved while RF cavity length is around 30cm. The Department of Physics workshop has experience of building a 1.3GHz RF cavity using CNC lathe and will be able to manufacture the cavity in the time scale of the project. It also has experience with vacuum testing of the structures and has the equipment required. The RF bead pull test facilities (JAI Oxford and Daresbury Laboratory) will be used to measure operating and high order modes. The cavity will be sealed and vacuum tested in JAI Oxford and transported to CERN for high power RF tests. The cavity will be kept sealed to observe whether any vacuum degradation will take place with time. To ensure that the system is suitable for ODA countries the partners from Nigeria and Tanzania will be invited to the workshop in Oxford to test the system and advise on ergonomics of the design. We plan to communicate regularly (every two weeks) with all partners via web-meetings during the project to ensure stable and continuous progress as well as securing the impact of the deliverables to the overall aim of the project.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS
Title: Cloud-based Electronic Infrastructure in Support of Linac-based Radiotherapy in Challenging Environments
Funder: Science and Technology Facilities Council

Abstract: This study aims to adapt an existing Cloud-based Electronic Platform (CEP) to facilitate remote treatment planning, research, education and multidisciplinary training partnerships between radiotherapy teams working in high-income countries and those in low and middle-income countries (LMICs) which operate in challenging environments. As part of the proposed 3-month work package, four radiotherapy centre visits will be planned in Nigeria and Ghana as part of this feasibility study.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES;5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT)
Health categories: CANCER AND NEOPLASMS
Title: Robust Permanent Magnet Beam Delivery Systems for Medical Radiotherapy Linacs
Funder: Science and Technology Facilities Council

Abstract: This proposal forms part of an initiative to design a linear electron accelerator for radiotherapy where all subsystems will be optimised to ensure it is robust, reliable, cost effective and appropriate for use in challenging environments including developing countries. This project aims to design a beam delivery system (magnetic focusing and steering) which uses modern capabilities in permanent magnets to ensure that a high-quality electron beam can be taken from the source to the x-ray generating target with minimal losses. Replacing some or all of the existing electromagnets with permanent magnets should enable a maintenance-free focusing system which requires very little electricity, which has been highlighted as a barrier to providing this technology in ODA countries. (A few smaller, cheaper and replaceable adjustable electromagnets will be included for fine tuning, which would have minimal power requirements.)


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS
Title: RTT Accelerator Technology Options Study
Funder: Science and Technology Facilities Council

Abstract: Conventional and commercially available Radiation Therapy (RT) treatment systems utilise S-band linac technologies coupled to magnetron or klystron RF power sources, which invariably entails incorporation of the linac structure inside the rotating gantry for circumferential patient treatment. The theme of this activity is to assess a variety of different linac and RF source configuration options, taking advantage of recent technology developments in frequency ranges outside of the conventional provision. Advances in both Standing Wave and Travelling Wave linac operational performance and solid state, magnetron and klystron RF power delivery capabilities, have the potential to be able to define a new RT system configuration which can not only outperform, but also may offer a simpler, more efficient and robust system integration platform which can be more appropriately applied for ODA country exploitation.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS
Title: A modular, integrated electron gun and RF cavity for radiotherapy treatment systems in developing countries
Funder: Science and Technology Facilities Council

Abstract: 4 in 10 patients with cancer in the UK receive radiotherapy treatment on a linear electron accelerator (linac) based radiotherapy treatment (RTT) system. In the lowest income counties within Africa only 4% of cancer patients that need radiotherapy receive RTT . There are currently 385 radiotherapy machines on the continent of 54 countries and 1 billion people. About 60% of the machines are found in just three countries: South Africa, Egypt and Morocco. The next 20% are also in just three countries: Tunisia, Nigeria and Algeria. Figure 1 shows the number of RTT machines per million people , as can be seen in Europe almost all counties have more than 1 machine for every 0.2 million people while in Africa many countries have less than 1 machine per 5 million people. Even though high cost of these machines is an issue, downtime is a major issue in African radiotherapy centres which can affect treatment outcomes and severely limits the number of RTT facilities. In 2016 Ghana's only RTT failed, having been in operation since 1995, while most RTT machines are only meant to last 10-15 years with proper maintenance by the manufacturer. In this project we aim to optimise a radiotherapy system to make maintenance easier while extending the life of an RTT system. One of the most common parts to fail is the electron source (gun) of the linear accelerator which can have a lifetime of 2-3 years . Typically, the electron gun is an integrated part of the linac, and in case of fault all of the linac needs to be replaced or returned to the manufacturer for repair which is expensive and takes a long time. Our aim is to make a modular electron gun that can be repaired seperately from the linear accelerator. We will also look at reducing the cost of the RF cavity and minimising beam losses inside the cavity to help reduce the cost as well.


Research activity codes: 5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES;5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT)
Health categories: CANCER AND NEOPLASMS