Muscle invasive bladder cancer is the sixth most common cancer and
remains a major cause of
death and suffering worldwide. The standard treatment for advanced bladder
cancer has been
surgical removal of the bladder (cystectomy) which is associated with
Many (20%) patients are elderly, with significant co-morbidities and hence
are high risk for a major
operation. In the past patients who were not able to undergo surgery were
radiotherapy. Research at the University of Birmingham has shown that the
addition of low toxicity
chemotherapy to radiotherapy is as effective as cystectomy in controlling
disease progression and
has minimal impact on bladder function. This new approach is an excellent
cystectomy and has been adopted as a new standard of care thus
impact on clinical practice and patient outcome.
University of Glasgow research has led to the adoption of first-line
chemotherapy for ovarian cancer, which has improved patient survival by
11% and has been used to treat 66% of women with ovarian cancer since
January 2011 in the West of Scotland Cancer Care Network alone. These
therapies are recommended by guidelines for ovarian cancer treatment in
the USA, Europe and the UK. The USA guidelines are disseminated to 4.3
million people worldwide and the European guidelines reach 15,000 health
professionals. The UK guidelines are used to identify those drugs that are
funded by the NHS and used in NHS hospitals.
Bowel cancer is the third most frequently diagnosed cancer worldwide.
University of Glasgow researchers have established Xeloda (an oral
5-fluorouracil precursor) and XELOX (a chemotherapeutic regimen combining
Xeloda with oxaliplatin) as highly effective, targeted therapies for
patients with bowel cancer. Since 2008, European regulatory approval of
these therapies has been incorporated into major international clinical
guidelines. The research has transformed patient care by improving the
treatment experience, with more convenient dosing schedules and fewer side
effects compared with previous chemotherapy procedures. Xeloda and XELOX
have transformed chemotherapy for bowel cancer and decreased therapeutic
costs, potentially saving around £4,762 (Xeloda) and £947 (XELOX) per
patient for the NHS.
Impact: Health and welfare; additional effective therapy for women
with advanced, HER2+ breast
Significance: Allows approximately 10,000 patients a year, whose
disease is no longer being
controlled by trastuzumab, to receive a more effective therapy than
Beneficiaries: Patients with incurable metastatic HER2+ subtype
breast cancer; policy-makers;
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
Reach: World-wide: the drug is approved in >100 countries and
generated >£650M in sales for
Research within the Northern Ireland Barrett's oesophagus Register
demonstrated that cancer
risk in this disease was substantially lower than previously thought. It
characteristics and potential biomarkers that allow Barrett's patients to
into those with higher and lower cancer risk. This research has influenced
from Gastroenterological Associations in the UK and USA and resulted in
practice nationally and internationally, in which costly routine
endoscopic surveillance is now
targeted to Barrett's oesophagus patients with the highest cancer risk.
Locally advanced prostate cancer (where a tumour has extended outside the
prostate gland to
surrounding tissues) will affect around 20,000 men per year in the US, and
4,000 men per year in
the UK. Prior to the underpinning research, there was no consensus on the
standard of care, with
hormone therapy often being given alone. The International randomised
clinical trial, led by Cardiff
researchers showed that treating locally advanced disease with a
combination of radiotherapy and
hormone therapy halved the risks of dying of prostate cancer.
Consequently, it is now a standard of
care, enshrined in European and North American guidelines, that all such
patients who are fit
enough to receive it, should now be offered combined modality radiotherapy
plus hormone therapy.
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.
Impact: Improved depression care for people with cancer.
Significance: Assessment of emotional distress and evidence-based
intervention to manage
depression has a direct effect on quality of life of cancer patients. It
may also reduce suicide
attempts among them.
Beneficiaries: Cancer patients, NHS and healthcare delivery
Attribution: The work was led by Sharpe (UoE), with UoE Cancer
Research Centre colleagues
and collaborators in Manchester and London.
Reach: International; this work directly affected NHS practices
and clinical guidelines in Europe
and North America. It also stimulated international debate and new
research into psychological
aspects of living with cancer.
Research from UCL Division of Surgery has transformed the breast cancer
treatment paradigm so
women can complete their local treatment intraoperatively (~30 min), with
reduced toxicity. Our
work has challenged the dogma of giving several weeks of whole breast
radiotherapy (EBRT) after
lumpectomy for breast cancer with our idea of irradiating only the tumour
bed in selected cases; we
have developed and evaluated new technology called TARGeted Intraoperative
(TARGIT) within the novel approach of risk-adapted radiotherapy. To date,
TARGIT has saved
180,000 hospital visits and could save £60M(UK)/ $280M(USA)/year.
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.