RCR Clinical Oncology: Inspiring Future Academics in ...€¦ · Inspiring Future Academics in...
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RCR Clinical Oncology: Inspiring Future Academics
in Clinical Oncology
The National Radiotherapy Research Strategy
David Sebag-Montefiore Professor of Clinical Oncology and Health Research
Honorary Consultant Clinical Oncologist
Deputy Chair CTRad
@MontefioreD
And an excellent partner for a career in Clinical Oncology
https://quotefancy.com/quote/1399506/Frederick-Sanger-Scientific-research -is-one-of-the-most-exciting-and-rewarding-of https://quotefancy.com/quote/1399506/Frederick-Sanger-Scientific-research-is-one-of-the-most-exciting-and-rewarding-of
Radiotherapy is a crucial, effective and cost–effective cancer treatment
• >50% of cancer patients require RT • 60% treated with curative intent
• >100,000 UK patients receive RT with curative intent every year • Across all tumour sites and different technology platforms
Curative treatment by modality
2003 – NCRI Review
2006 Oxford Institute
2008 – NCRI Rapid Review
2009 – CTRad
2016 CTRad: ‘NCRI flagship’
2017 CRUK Radiotherapy Review
2015 Centres of Excellence
CTRad Mission Statement
To maximise the quantity and quality of life for
patients receiving radiotherapy by optimising
tumour control and minimising toxicity
CTRad Executive Group Chair
Deputy Chair Workstream co-chairs
Consumer representative Ex-officio members
NCRI Executive
Workstream 1 Science base
• Preclinical studies • Radiation-drug interactions
• Radiobiology • Biomarkers & imaging
•Physics & imaging
Workstream 2 Phase I/II trials
• Phase I/II studies • Experimental Cancer Medicine
• Biomarkers & imaging
• Systemic therapies and RT
Workstream 3 Phase III trials and
methodology
• Phase III trials • Linking with CSGs • Trials methodology development for evaluating novel RT approaches
Workstream 4 New Technology,
Physics, QA
• New technologies (e.g. proton therapy, SABR, functional imaging)
• Quality assurance • Radiotherapy Physics • Databases
General Membership
Membership Refresh and Launch New Strategy July 18
• WS1 (Basic Science) • 2 Co-chairs • 9 members + 1 PPI
• WS2 (Phase I/II) • 2 Co-chairs • 8 members + 1 PPI
• WS3 (Phase III and methodology) • 2 Co-chairs • 11 members + 2 PPI
• WS4 (New technology, physics and QA) • 2 co-chairs • 9 members + 1 PPI
• New General Membership Category n=80
Trainees very welcome Email - [email protected]
TOTAL = >130!
RADCAS
SABR
RaDCom
Biomarker Support Network
Preclinical RTQA
RTTQA
Protons
Molecular RT
Database development
Academic work force development
Trials proposals meetings
CTRad Executive Group
WS1 (science base)
WS2 (phase I/II)
WS3 (phase III/
methodology)
WS4 (new technology,
physics, QA) Consumers
Proton Beam Clinical Trial Strategy Group
CTRad General Membership
Consumers (Patient and Public Involvement –PPI)
CTRad Strategic Vision 2018-21 http://ctrad.ncri.org.uk
Any sufficiently advanced technology is indistinguishable from magic.
Arthur C Clarke
https://www.telegraph.co.uk/news/obituaries/1582125/Sir-Arthur-C-Clarke.html
Current CT scan
MR Sim CT Scan
New Radiotherapy Technology – MR Linac
Elekta View Ray
New Radiotherapy Technology – Protons
Slides courtesy of Dr David Thompson Manchester
Stereotactic ABlative Radiotherapy
• Highly targeted • High ablative doses • 5-8 treatments • 90% local local control
Early stage Lung Cancer Leeds 2009-May 18 n=1531 pts
New Indications – CtE
NHS England >1200 patients treated (Feb 18)
CTRad Strategic Vision 2018-21 http://ctrad.ncri.org.uk
Practice Changing Radiation Therapy Trials for the Treatment of Cancer : where are we 150 years after the birth of Marie Curie? In Press BJC 2018
• Born 4th July 1867
• First woman to win a Nobel Prize
• First woman to win two Nobel Prizes and in two different scientific domains
• First female professor University of Paris
• Discovered Radium
• Founded Institute Curie
Authors • Marieke Thompson • Philip Poortmans • Anthony Chalmers • Corrine Faivre-Finn • Emma Hall • Robert Huddart • Yolande Lievens • David Sebag-Montefiore • Charlotte Coles
Practice Changing Trials – four disease “sites” n=47 trials; 47,890 patients
0 2 4 6 8 10 12
Breast
Lung
Prostate
Bladder
Rectal
Anal
UKNon UK
Last two decades
Development of clinical trial research proposals
• CTRad supports clinical trial research proposals development at all steps
• 184 trials reviewed at proposals guidance meetings up till June 16
Network of CTRad members within CSGs Consumers
CTRad provides reviews, feedback and guidance
Provision of expert reviewers for RT applications to CTAAC, NAC
184
Proposals submitted
Funded
58
CTRad Rated
48 87 22 27
Idea generation
Proposal development
Funding application
Funder peer review FUNDED
Lancet Oncology 2018 epub
Sharma et al Nature Reviews Clinical Oncology 2016
Alastair Greystoke, Gerry Hanna, Sarah Brown , on behalf of the CONCORDE study team
The proposed CONCORDE Study
Platform study of novel agents in COmbinatioN with COnventional RaDiothErapy in locally advanced disease
Leeds David Sebag-Montefiore
Sarah Brown Kevin Franks
Manchester Corrine Faivre Finn
James O’Connor Matthew Krebs
Oxford Ester Hammond Anderson Ryan
Glasgow Anthony Chalmers Stephen Harrow
Belfast Gerry Hanna
Richard Kennedy David G de Castro
Newcastle Alastair Greystoke
Chris Plummer
Cardiff Paul Shaw
Cambridge Susan Harden
11 ECMCs with RTTQA lung radiotherapy approval.
Primary endpoint: • DLTs within 3
months of RT
53.2Gy 28F
58.8Gy 28F
61.6Gy 28F
Ph II
Ph III
Pilot
T3/4 Nany,T2N1-3
Pilot/Ph II/PhIII
N=640
Leads – Hawkins and Sebag-Montefiore
ACT5
Primary end point :- 3yr locoregional failure
ACT3
Obsn
Margin ≤1mm
41.4Gy 23F
T1 N0/X Anal margin
Local excision
Phase II trial N=90
Lead – Renehan and Muirhead
50.4Gy 28F
41.4Gy 23F
ACT4
T1,T2<4cm N0/X
Randomised 2:1 Phase II trial
N=162
Leads – Adams and Harrison
PLATO - PersonaLising RadioTherapy dOse for Anal Cancer
CTRad Strategic Vision 2018-21 http://ctrad.ncri.org.uk
The Northern Oncology Trainees Collaborative for Healthcare Research NOTCH
@onctrainees
Dr Chris Jones @DrCMJones
Aims & objectives
THE NORTHERN ONCOLOGY TRAINEES COLLABORATIVE FOR HEALTHCARE RESEARCH
Aim: Promote high-impact collaborative trainee-led research Objectives: 1. Establish a network of research-interested trainees
2. Facilitate trainees to present & publish research
3. Enable learning & sharing of academic skills
4. Enhance networking opportunities
5. Promote leadership & teamwork
6. Undertake meaningful, practice-changing research
Sustainability: developing future academic leaders University of Leeds / Yorkshire Cancer Research University Academic Fellowships (UAF) – Examplar
• Consumable
Dr Louise Murray • Clinical Oncologist • CRUK PhD Leeds • Fellowship Toronto
Dr Ane Appelt • Physicist • CRUK PhD
Copenhagen • Post doc Denmark
• MRC Confidence in Concept –Reirradiation - STRIDER
• EPSRC – ePROMS SABR toxicity
• Co-lead YCR funded Aphrodite dose escalation trial in rectal cancer
• Big data distributed learning anal cancer
• Academic PA’s • 5 year tenure track to Associate Professor • 3 year probation review • Non Clinical PhD • Consumables budget
@cancerphysicist
Supporting academic training pathways Examplar - NIHR
Alex Gilbert
NIHR Academic Clinical Fellow
Royal College Radiologists Part 1 FRCR
Royal College Radiologists P art 2 FRCR
NIHR Lecturer 50% research
NIHR Clinician Scientist (pending)
NIHR PhD
@DeeGeeee
Current Clinical Oncology Trainees PhD and MD students - Leeds
Dr Chris Jones
Dr Katie Spencer
Dr Fin Slevin
Dr Fei Sun
Early mortality outcomes and cost-effectiveness of palliative radiotherapy for bone metastases in the English NHS
Optimising pelvic SABR (ART NET)
Cardiovascular outcomes in lung cancer
Unravelling non-genetic oncogenesis in oesophageal adeno-carcinoma: characterising the stress-inducible FGFR2-Grb2-
miRNA axis @DrCMJones
@Katiespencer72
The Twittersphere: A few suggestions
@gerryhanna @finn_corrine
@MontefioreD @ProfAJChalmers
@alison_tree
@achoud72
Conclusions
• Very exciting time to work in radiotherapy research!
• Crucial that we help development of our future academic workforce
• CTRad will drive the national strategy and we welcome trainees as members