The National Radiotherapy Research Strategy

Transcription

1 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

2 And an excellent partner for a career in Clinical Oncology -is-one-of-the-most-exciting-and-rewarding-of

3 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

4 2017 CRUK Radiotherapy Review 2016 CTRad: NCRI flagship 2015 Centres of Excellence 2009 CTRad 2008 NCRI Rapid Review 2006 Oxford Institute 2003 NCRI Review

5 CTRad Mission Statement To maximise the quantity and quality of life for patients receiving radiotherapy by optimising tumour control and minimising toxicity

6 CTRad Executive Group Chair Deputy Chair Workstream co-chairs Consumer representative Ex-officio members NCRI Executive Workstream 1 Science base Workstream 2 Phase I/II trials Workstream 3 Phase III trials and methodology Workstream 4 New Technology, Physics, QA Preclinical studies Radiation-drug interactions Radiobiology Biomarkers & imaging Physics & imaging Phase I/II studies Experimental Cancer Medicine Biomarkers & imaging Systemic therapies and RT Phase III trials Linking with CSGs Trials methodology development for evaluating novel RT approaches New technologies (e.g. proton therapy, SABR, functional imaging) Quality assurance Radiotherapy Physics Databases General Membership

7 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 TOTAL = >130! Trainees very welcome - Carolyn.Chan@ncri.org.uk

8 CTRad Executive Group WS1 (science base) WS2 (phase I/II) WS3 (phase III/ methodology) WS4 (new technology, physics, QA) Consumers RaDCom Biomarker Support Network Preclinical RTQA RADCAS SABR Trials proposals meetings RTTQA Protons Molecular RT Database development Academic work force development Consumers (Patient and Public Involvement PPI) Proton Beam Clinical Trial Strategy Group CTRad General Membership

9 CTRad Strategic Vision

10 Arthur C Clarke Any sufficiently advanced technology is indistinguishable from magic.

11 CT scan Current CT Scan MR Sim

12 New Radiotherapy Technology MR Linac Elekta View Ray

13 New Radiotherapy Technology Protons Slides courtesy of Dr David Thompson Manchester

14 Stereotactic ABlative Radiotherapy Early stage Lung Cancer Leeds 2009-May 18 n=1531 pts New Indications CtE Highly targeted High ablative doses 5-8 treatments 90% local local control NHS England >1200 patients treated (Feb 18)

15 CTRad Strategic Vision

16 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 Authors Born 4 th 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 Marieke Thompson Philip Poortmans Anthony Chalmers Corrine Faivre-Finn Emma Hall Robert Huddart Yolande Lievens David Sebag-Montefiore Charlotte Coles Discovered Radium Founded Institute Curie

17 Practice Changing Trials four disease sites n=47 trials; 47,890 patients Anal Rectal Bladder Prostate UK Non UK Lung Breast Last two decades

18 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 Idea generation Proposal development Funding application Funder peer review FUNDED Network of CTRad members within CSGs Consumers 184 Proposals submitted CTRad provides reviews, feedback and guidance CTRad Rated Provision of expert reviewers for RT applications to CTAAC, NAC 58 Funded

19 Sharma et al Nature Reviews Clinical Oncology 2016 Lancet Oncology 2018 epub

20 The proposed CONCORDE Study Platform study of novel agents in COmbinatioN with COnventional RaDiothErapy in locally advanced disease Alastair Greystoke, Gerry Hanna, Sarah Brown, on behalf of the CONCORDE study team

21 Belfast Gerry Hanna Richard Kennedy David G de Castro Glasgow Anthony Chalmers Stephen Harrow Manchester Corrine Faivre Finn James O Connor Matthew Krebs Newcastle Alastair Greystoke Chris Plummer Leeds David Sebag-Montefiore Sarah Brown Kevin Franks Oxford Ester Hammond Anderson Ryan Cambridge Susan Harden Cardiff Paul Shaw 11 ECMCs with RTTQA lung radiotherapy approval.

22 Primary endpoint: DLTs within 3 months of RT

23 PLATO - PersonaLising RadioTherapy dose for Anal Cancer Lead Renehan and Muirhead T1 N0/X Anal margin Local excision ACT3 Leads Adams and Harrison T1,T2<4cm N0/X ACT4 Leads Hawkins and Sebag-Montefiore T3/4 Nany,T2N1-3 ACT5 Margin 1mm 53.2Gy 28F 58.8Gy 28F 61.6Gy 28F Obs n 41.4Gy 23F 41.4Gy 23F 50.4Gy 28F Pilot Phase II trial N=90 Randomised 2:1 Phase II trial N=162 Ph II Ph III Primary end point :- 3yr locoregional failure Pilot/Ph II/PhIII N=640

24 CTRad Strategic Vision

25 NOTCH The Northern Oncology Trainees Collaborative for Healthcare Dr Chris

26 Aims & objectives Aim: Objectives: Promote high-impact collaborative trainee-led research 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 THE NORTHERN ONCOLOGY TRAINEES COLLABORATIVE FOR HEALTHCARE RESEARCH

27 University of Leeds / Yorkshire Cancer Research University Academic Fellowships (UAF) Examplar Consumable Sustainability: developing future academic leaders Academic PA s 5 year tenure track to Associate Professor 3 year probation review Non Clinical PhD Consumables budget Dr Louise Murray Clinical Oncologist CRUK PhD Leeds Fellowship Toronto MRC Confidence in Concept Reirradiation - STRIDER EPSRC eproms SABR toxicity Dr Ane Appelt Physicist CRUK PhD Copenhagen Post doc Co-lead YCR funded Aphrodite dose escalation trial in rectal cancer Big data distributed learning anal cancer

28 Supporting academic training pathways Examplar - NIHR NIHR Academic Clinical Fellow Royal College Radiologists Part 1 FRCR NIHR PhD Royal College Radiologists P art 2 FRCR Alex NIHR Lecturer 50% research NIHR Clinician Scientist (pending)

29 Current Clinical Oncology Trainees PhD and MD students - Leeds Dr Chris Unravelling non-genetic oncogenesis in oesophageal adenocarcinoma: characterising the stress-inducible FGFR2-Grb2- mirna axis Dr Katie Early mortality outcomes and cost-effectiveness of palliative radiotherapy for bone metastases in the English NHS Dr Fin Slevin Optimising pelvic SABR (ART NET) Dr Fei Sun Cardiovascular outcomes in lung cancer

30 The Twittersphere: A

31 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