Summary of the impact

Impact: Health and welfare; additional effective therapy for women with advanced, HER2+ breast cancer.

Significance: Allows approximately 10,000 patients a year, whose disease is no longer being controlled by trastuzumab, to receive a more effective therapy than chemotherapy with capecitabine alone.

Beneficiaries: Patients with incurable metastatic HER2+ subtype breast cancer; policy-makers; commerce.

Attribution: Cameron (UoE) was joint chief-investigator on the global pivotal registration trial that led to the marketing authorisation of the drug lapatinib in combination with capecitabine.

Reach: World-wide: the drug is approved in >100 countries and generated >£650M in sales for manufacturer GlaxoSmithKline.

Summary of the impact

Fears of recurrence (FoR) are the major concern for cancer patients. The Adjustment of Fear, Threat or Expectation of a Recurrence (AFTER) was initiated in Liverpool and developed significantly at the University of St Andrews by the originator (Prof. Humphris) and colleague Dr Ozakinci for general cancer patients, including an innovative validated Fear of Recurrence measure. The measure identifies patients with high FoR in NHS oncology services to enable psychological therapeutic treatments to be targeted. AFTER is being widely employed with cancer survivors successfully in UK cancer services and international oncology centres to reduce their FoR and depression.

Summary of the impact

Colorectal cancer is a common disease, which frequently causes death or morbidity, either because of failure to control the primary tumour or failure to prevent distant metastases. Leeds researchers have devised new treatment approaches using chemotherapy and radiotherapy and tested them in large randomised controlled trials which have led to major changes in clinical practice in the management of rectal cancer and advanced colorectal cancer (aCRC), driving clinical decision-making and improving outcomes for patients. This includes better-evidenced treatment for elderly patients and patient stratification on the basis of molecular biomarkers.

Summary of the impact

Research within the Northern Ireland Barrett's oesophagus Register demonstrated that cancer risk in this disease was substantially lower than previously thought. It identified clinico-pathological characteristics and potential biomarkers that allow Barrett's patients to be stratified into those with higher and lower cancer risk. This research has influenced recommendations from Gastroenterological Associations in the UK and USA and resulted in altered clinical practice nationally and internationally, in which costly routine endoscopic surveillance is now targeted to Barrett's oesophagus patients with the highest cancer risk.

Summary of the impact

Researchers at the University of Leeds have designed and developed new approaches and technologies for cancer patients to self-assess their symptoms and quality of life. The work focused on electronic methods for collecting patient-reported outcome measures (PROMs), developing PROMs for neglected areas of patient care, and running trials of these techniques. These approaches produced sizeable patient benefits including improved symptom control and better quality-of-life. These findings have influenced clinical guidelines in the UK and Canada, NHS policy and the endorsement of PROMs in the Health and Social Care Act (2012). Electronic PROMs systems based on the Leeds research have been implemented locally, nationally and internationally, making measurable improvements to patient welfare and health, such as a reported significant increase in completion of chemotherapy treatment.

Summary of the impact

UCL has conducted a series of national lung cancer trials, which have led to wide-scale changes in clinical practice. Two trials compared different platinum based therapies, which led to centres switching from using chemotherapy with cisplatin to carboplatin-based chemotherapy instead. Carboplatin can be given as an outpatient, and has fewer side effects, and has been (and still is) recommended as an alternative to cisplatin in the UK and US.

Summary of the impact

Collaborative research conducted by the Biological Sciences Research Group (BSRG) has brought considerable benefits for the treatment of cancer patients. Experimental research has shown that the shelf-life of the biological cancer drug Herceptin can be greatly extended thereby bringing significant economic benefit through cost savings. A clinical trial has demonstrated that yoga benefits the health and well-being of patients with gynaecological cancer leading to prospects of improved cancer survivorship. Sowter provides research-informed oncology training for NHS clinical trials staff throughout the National Institute of Cancer Research UK network (NCRN), and has supervised two senior registrars through their MD qualifications.

Summary of the impact

Work led by researchers at UCL has had a national and international impact on the way that patients with symptoms suggestive of colorectal cancer are investigated. Specifically, investigation of the role of CT colonography (a relatively novel and non-invasive method of investigating the large bowel using an X-ray scanner) has led to this examination replacing the standard alternative of barium enema in the UK National Bowel Cancer Screening Programme and for symptomatic patients in the NHS. The research has also led to easing of pressure on over-subscribed endoscopy services in the NHS because patients can be safely diverted towards CT colonography as an alternative.

Summary of the impact

Impact: Health and welfare; evidence-based palliative care for patients with non-malignant disease beyond cancer patients and in low-income countries; influencing policy; public engagement.

Significance: Care quality-standard changes and targeted interventions: for example, up to 50% fewer unplanned hospital admissions from nursing homes. Palliative care service development/redesign internationally; clinical tools deployed internationally.

Beneficiaries: Patients and their families/carers; NHS and healthcare providers; policymakers including UK and international governments; medical charities.

Attribution: The work was performed by an international team led by S. Murray at UoE.

Reach: International; policy changes and new guidelines/service structures in 11 countries (UK, Europe, N. America, Asia, sub-Saharan Africa); applicable to all those at end of life.

Summary of the impact

Bangor University staff (Neal & Wilkinson) are core members of a collaboration whose research since 2003 has had significant policy relevance and impact in the field of primary care oncology. Impact has been made in three areas:

• The role of primary care in the earlier diagnosis of symptomatic cancer; for example by determining the predictive value of symptoms and translating this into Risk Assessment Tools for clinical practice
• The contribution of primary care to cancer follow-up and the management of survivorship; for example by changing practice by illuminating poor care in prostate cancer
• Empowering patients through communication of new cancer-related science in primary care; for example by developing core messages for use in communication about HPV.