Title: Evaluating new healthcare technologies in cancer
Funder: Medical Research Council

Abstract: Our aim is to improve cancer survival and decrease cancer morbidity by designing and implementing innovative late phase studies that have a major impact on clinical practice. We focus on adaptive trials that test more than one primary research hypothesis to increase efficiency including multi-arm multi-stage platforms, umbrella, and basket trial designs, primarily in the phase III setting. In this programme we focus on the opportunities that discovery science and new technologies bring to improve cancer outcomes. Over the last 10 years, there has been a transformed understanding of cancer biology and a new paradigm in relation to molecularly targeted therapies, as well as the development of immuno-oncology. We are at the forefront of the design and conduct of potentially practice-changing trials in these areas. We also evaluate a broader range of new technologies including the role of artificial intelligence (AI) to improve health outcomes. We have evaluated anti-angiogenics, monoclonal antibodies that target the epidermal growth factor receptor and tyrosine kinase inhibitors in ovarian, colorectal, renal and gastric cancer. Our metastatic colorectal cancer platform was one of the first oncology initiatives globally that stratified patients to participate in an evaluation of one of several new specifically targeted drugs based on the molecular characteristics of their tumour. Our evaluation of abiraterone for the treatment of locally advanced and castrate-sensitive prostate cancer has changed clinical practice and been incorporated into clinical guidelines internationally. We are extending our strategic approach to both molecular and imaging-based stratification by developing and facilitating national and international collaborations to improve recruitment to stratified trials. In our renal cancer adjuvant platform we will evaluate 2 different immune-oncology approaches, and the trial design permits an additional trial arm be added as new information and drugs become available. We will evaluate the ability of AI to speed up radiotherapy planning procedures in 2 common cancers globally cervical, and head and neck cancers. We will also evaluate AI as a tool to provide response evaluation criteria in solid tumours measurements as part of our future proofing strategy for academic trials. Integrated working with methodology colleagues enhances trial design, conduct and analysis, and facilitates the implementation of results. This programme links strongly with our translational science goals. All major trial platforms have associated correlative translational programmes where we aim to maximise the scientific value of the trials and where possible results from laboratory findings are fed back into the design of subsequent studies. This is exemplified by the UK Clinical Trial of Ovarian Cancer Screening (UKCTOCS) trial designed to delineate a screening strategy for ovarian cancer but has also developed an extensive biobank and network of industry collaborators for the discovery and validation of early detection and risk stratification biomarkers for cancer, cardiovascular and other chronic diseases.


Research activity codes: 6.1 PHARMACEUTICALS;6.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: CANCER AND NEOPLASMS