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research.oncology@mbht.nhs.ukLast Updated: 2026-06-02 07:03:26
All
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Specialty: All |
PI: Prof Alison Birtle |
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CPMS No: 66335 |
Estimated Opening: 31/05/2026 |
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Description: Cancers that are hypoxic (have a high percentage of regions of low local O2 concentration) are refractory to radiotherapy but benefit from hypoxia modification. However, there are no biomarkers to identify patients with hypoxic tumours. The gold standard for determining tissue O2 concentration is the O2-electrode which takes measurements at several sites within the tumour. However, this necessitates insertion of a needle into multiple regions of the tumour so is invasive and provides only a localised hypoxia status. Other hypoxia biomarkers that identify hypoxia have been derived from cell surface protein expression, gene expression or imaging outputs. Proteins expressed on the tumour cell surface of hypoxic cells include CA9 and glut1 but the expression of these proteins is not specific to hypoxia and is highly heterogeneous within tumours. Whilst expression of HIF1 by hypoxic tumours has been shown not to predict benefit from hypoxia-modification (Swartz et al 2022). Gene signatures are a set of genes in which the collective changed expression has been validated to demonstrate diagnosis, prognosis or predict therapeutic response. Gene expression is consistently altered across tumours with high hypoxic fractions meaning that they are robust indicators of hypoxia status. Using RNA extracted from archived material (Formalin fixed paraffin embedded tumour tissue) our gene-expression signature-based biomarkers for bladder, head and neck, prostate, sarcoma, cervical and lung cancers have been validated by demonstrated prognosis in each of the cancer groups. Further the 24 gene bladder cancer hypoxia signature has been shown to be predictive of benefit from hypoxia modification for patients with hypoxic tumours receiving radiotherapy. A recent review of predictive biomarkers in cancer treatment has shown that this is the only predictive biomarker for hypoxia-modification during radiotherapy (Batis et al 2021). Hypoxic regions in tumours can also be identified using MRI techniques including O2-senstive MRI (OE-MRI) and Intravoxel incoherent motion imaging. Combining imaging with gene expression data results in more accurate assessment of hypoxic status and identify tumour subtype which further contributes to personalised clinical decisions. MRI-based techniques also facilitate localized personalization approaches, e.g. for hypoxia-directed focal radiotherapy dose escalation. |
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Breast
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Specialty: Breast |
PI: Dr Shaziya Ali |
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CPMS No: 58409 |
Estimated Opening: 23/07/2026 |
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Description: Breast cancer affects 55,000 patients each year in the UK, and in ~20% of cases, the cancer will have spread to the armpit (axillary) lymph nodes. The current standard treatment for these patients is to remove all the axillary lymph nodes (axillary node clearance), even if only one or two are affected. However, one in three patients will experience life changing complications as a result of this treatment, including permanent swelling of the arm (lymphoedema), long-term pain, and problems with shoulder function. These complications dramatically affect quality of life and are costly to the NHS. Axillary node clearance (ANC) was believed to give patients the best chance of surviving their breast cancer, but there is no evidence to show that this is true if the spread to the axillary lymph nodes is limited. More targeted surgery to the armpit, called a targeted axillary dissection (TAD), in which just the lymph nodes containing cancer and the first draining (sentinel) lymph nodes are removed may be just as safe and reduce the risk of life-changing complications. The TADPOLE study aims to determine whether targeted armpit surgery (TAD) reduces the risk of lymphoedema at 12 months after the operation without increasing the risk of the cancer returning, compared to ANC. 861 patients will be recruited from 40 UK NHS Breast Units. One group will receive ANC (standard care), while the other group will receive TAD. Patients will be assigned to a group by randomisation to ensure that the groups are similar. TADPOLE will compare how many patients have lymphoedema 12 months after surgery, and patients will be followed up for five years to ensure that the risk of the cancer returning after receiving TAD is acceptable. We will also collect information on surgical complications, shoulder function, pain, quality of life and financial costs. |
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Colorectal
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Specialty: Colorectal |
PI: Dr Chan Ton |
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CPMS No: 71028 |
Estimated Opening: 31/05/2026 |
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Description: Colorectal cancer is 37% higher in the North-West than the national average and is treated by chemotherapy, including fluorouracil, capecitabine, and oxaliplatin. A side effect of these drugs is loss of memory, forgetfulness, and general brain fog, which can persist for months after the end of treatment, collectively known as “chemo-brain”. We will use an existing prehabilitation intervention we have developed, which increases fitness and reduces hospital length of stay in colorectal cancer surgery patients, to try and improve chemo-brain symptoms in those undergoing chemotherapy and improve quality of life. The study aims to: Aim 1: To determine if prehabilitation promotes an improvement in brain health in colorectal cancer patients before starting chemotherapy. Aim 2: To determine if prehabilitation protects against cognitive and neural dysfunction, to establish if prehabilitation can reduce the negative effects on the brain following chemotherapy. Aim 3: To determine if brain health changes following prehabilitation lead to improvements in quality of life three months after cessation of chemotherapy in colorectal cancer patients. We will use a range of physiological tests (cardiopulmonary exercise testing, blood panels), neuroscientific (electroencephalography) and psychological (cognitive test battery, well-being questionnaires) to determine if our prehabilitation intervention improves chemo-brain and quality of life in colorectal cancer patients. Our intervention will be delivered across Lancashire, aimed at reducing health inequalities and negative health outcomes associated with cancer treatment in our region. |
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Prostate
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Specialty: Prostate |
PI: - |
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CPMS No: 63997 |
Estimated Opening: 31/05/2026 |
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Description: Prostate cancer is incurable when it has spread to other parts of the body (called metastatic prostate cancer). Metastatic prostate cancer is initially managed with hormonal treatments. The most common first treatment option used for men in the UK is hormonal injections (androgen deprivation therapy, ADT) combined with hormonal tablets (an androgen receptor targeted agent, ARTA), known as a doublet therapy. A blood test for a protein called prostate specific antigen (PSA) is routinely used for monitoring patients to check whether their prostate cancer is responding treatment. Almost all men have a reduction in their PSA result after starting their treatment. However, how far the PSA falls after treatment starts is a strong indicator of longer term outcomes. Multiple studies have shown that if the PSA falls, but still remains above 0.2 ng/ml, after about 6 months of treatment with hormones, then the outcomes (such as survival) tend to be worse. This clinical trial, called INTENSIFY, is for men with metastatic hormone sensitive prostate cancer who have a PSA that remains above 0.2 ng/ml after 6 months of hormonal treatment. We will test if they survive longer if we add chemotherapy to their treatment earlier than otherwise planned. INTENSIFY will recruit 518 patients with prostate cancer, where the PSA falls but still remains above 0.2 ng/ml, after 6 months of doublet hormonal therapy. Patients who choose to take part will be randomly selected to receive one of two possible treatment options:1. Standard of care treatment - continue doublet hormonal therapy (ADT +ARTA);2.Experimental treatment - continue doublet hormonal therapy plus chemotherapy. Chemotherapy will be with a drug called docetaxel given through a drip at the hospital outpatient treatment unit every 3 weeks for up to 6 treatments. This is a chemotherapy drug that has been used to treat different cancers for many years, including prostate cancer. |
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