I am the Executive Medical Director for the Sarah Cannon Research Institute; the research arm of HCA UK. I focus on the clinical research of new drugs and new trials for patients with advanced cancers. I am also a gastrointestinal (GI) oncologist, focusing on innovation in the treatment of conditions such as bowel and stomach cancers using new drug treatments. I’m also part of the cancer service line structure and leadership team at HCA UK. In this role, I am responsibly for integrating the latest technologies and treatments into our service within our hospitals across London and Manchester.
The institute is the only independent-sector, phase-one, early drug-development unit in the UK. We focus on early development of new drugs, which often come from testing on mice and monkeys into patients for the first time, based on biology, cancer genetics or immune signatures. We take a personalised approach to our patients. We try to target treatments to ensure patients get the most effective treatment with as few side effects as possible. The unit has 40 team members, ranging from medical doctors and nurses to data-entry staff.
This unit forms part of HCA UK’s wider cancer network, ensuring that our patients can access the latest medications. This unit is also integrated into the global Sarah Cannon network, which is based in the US. Strategically, it is important that the Sarah Cannon Research Institute is based in London so that patients in the UK can access new drugs which are not yet available within the NHS or even in the private sector.
I am most excited about immunotherapies, which have been shown to be effective in treating cancers that were previously untreatable, such as melanoma and lung cancer. What we call ‘checkpoint inhibitors’ can target specific interactions between T cells and cancer cells. This is the first indication that some cancers that were previously considered as incurable are now becoming what we would call ‘chronic diseases’, meaning patients may now be able to live for longer with these new drugs.
Beyond this, another exciting development has been cellular therapies. For this form of therapy, we are able to manipulate the immune system to extract cells such as T cells, manipulate them genetically, re-infuse into our patients and let these manipulated T cells, and probably the manipulated immune system, fight cancer very effectively. This is what the media often refers to as C/ART cell therapy.
At HCA UK, we are in the process of offering this. We are already running studies of TIL therapies – effectively, extracted highly effective T cells that are re-infused into patients – and we are seeing very exciting results. This is a very complex procedure and can’t be performed in an outpatient unit, so these patients are treated in our inpatient facilities at the UCLH (University College London Hospitals) joint-venture facilities.
A further development is combining these immunotherapies with targeted drugs. Often cancers not only have signatures that respond to immunotherapies, but also contain genetic changes that are of relevance in driving cancer. We are currently running several trials that are very promising in combining immunotherapy which targets the genetic mutations alterations. For example, the Sarah Cannon Research Institute is currently running the world’s largest bladder cancer study. I am really interested in combining immunotherapy and targeted therapy to provide ‘smart’ and personalised therapies.
HCA UK has also made a significant investment in the understanding of cancer genetics. We have built a proctology lab, the only one of its kind in the country, where we screen our patients on a broad gene panel to understand cancer biology. This integrates pathology with day-to-day oncology care, which is very important in understanding cancer genetics.
Our unit also includes a genomic review board, which is comprised of a multidisciplinary team of specialists including oncologists and clinical geneticists. This review board is unique in Europe, which is very exciting. The review board’s aim is to understand what genetic alterations mean, put it into context for patients and aid oncologists in making the right decisions.
Unfortunately, cancer is often detected too late. At HCA UK, we know how important it is to put early detection systems in place and we offer our patients early screening for conditions such as prostate cancer, breast cancer and colon cancer. These cancers behave differently in these early stages, and with new technologies in place, we can detect cancers early to avoid them becoming metastatic and advanced.
We are developing a better and more complex understanding of cancer tumour biology, and how immunotherapy can prevent or reduce certain cancers, such as cervical cancer, which is often caused by a virus. I think that detecting cancers early to identify high-risk patient groups is the next step for HCA UK, because after identifying these groups, we can support them with vaccinations and reduce the rate of aggressive cancers developing.