1 in 2 people develop some form of cancer during their lifetime. The BRC has identified cancer as a major strategic priority.

Our Cancer Theme’s aim is to optimise and develop precision cancer medicine. The Theme focuses on areas where recent developments in basic science can be translated into clinical practice. This capitalises on the unified ambition of UCL, a world leading university which has a strong focus on biological and medical sciences, and UCLH a ‘research hospital’ where cancer medicine is a major strength.

We support NHS clinicians to deliver first class clinical trials and run a large, dynamic early phase cancer trials programme which is facilitated by our Clinical Research Facility.

Doctor and patient in front of machine

A second clinical research facility for inpatients has been built in the new UCLH cancer development which also includes the Proton Beam Centre, and an extended Haematological Cancer Centre with its own intensive care unit.

Our research is supported by considerable expertise and strength in basic/discovery science and is enabled by access to state-of-the-art facilities and equipment. We have also well-established national and international collaborations which support our ultimate goal to improve tumour related outcomes (e.g. response and survival) whilst minimising treatment side-effects.

We deliver research aligned to four subthemes:

1. Translating the genetic understanding of cancer into better treatment 

Cancer is a dynamic disease and during its course, cells become more heterogeneous or diverse. A tumour may contain several sub-populations of cells and not all of these populations may be responsive to matching targeted therapy which makes delivery of precision cancer treatment problematic. With this challenge in mind, we are focusing on: 

  • understanding the mechanisms of cancer genome instability (genetic mutations) which drive tumour heterogeneity 
  • exploiting the diversity of tumour cells in an attempt to determine their response to therapy, thereby enhancing individualised treatment options 
  • investigating the development of resistance to targeted therapy 

For example, TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy [Rx] is a prospective study of patients with primary non-small cell lung cancer. It aims to define the evolutionary trajectories of lung cancer in both space and time through multiregion and longitudinal tumour sampling and genetic analysis. TRACERx has already led to two FDA approved breakthrough device biomarkers for Minimal Residual Disease (MRD) detection. 

 

2. Innovating cancer immunotherapy  

Immunotherapy is heralded as the biggest cancer breakthrough in decades. The ability of T-cells, which are present in many tumours, will be exploited to destroy tumour cells. Boosting patients’ immune responses to tumours and the application of genetically engineered T cells in trials are some of the strategies employed. 

  • We are focusing on CAR-T cell therapy to reprogramme T cells to recognise and kill tumour cells; checkpoint inhibitor therapy to help the body recognise and attack cancer cells; and neo-antigen T-cell therapy to generate anti-tumour immune responses by manufacturing individual patient tumour-specific T-cells. 
  • Achilles therapeutics (“Achilles”) is a clinical stage biopharmaceutical company launched as a spin-out from UCL/UCLH in 2016. Achilles is developing novel cancer immunotherapies targeting clonal neoantigens T cells (cNET therapy). These are protein markers, unique to each individual, that are expressed on the surface of every cancer cell. Achilles uses DNA sequencing data from each patient, together with a proprietary bioinformatics platform, to identify clonal neoantigens specific to that patient and enable the development of personalised cell therapies. 

 

3. Revolutionising early diagnosis of cancer and relapse/progression 

UCLH holds a number of well documented cancer patient cohorts. The ongoing application of artificial intelligence to imaging in collaboration with the UCL Departments of Computer Science and Engineering has led to our membership of the International Cancer Early Detection (ACED) Alliance, a major collaboration between UK and US centres to inform the integration of advanced imaging techniques and non-imaging biomarkers for early cancer detection.  

An example of our work includes the SUMMIT study, the largest UK screening study for detecting lung cancer early among at-risk Londoners, when cancers are curable surgically. The study aims to clinically validate a blood test for the early detection of multiple types of cancer, and to deliver low dose CT screening for lung cancer to an at-risk population.  

 

4. Integrating radiotherapy into precision oncology  

Proton Beam Therapy (PBT) is a type of radiation therapy that delivers accelerated proton beams rather than x-rays to treat cancer. Our research aims to enhance the level of protons that reach tumour targets, whilst sparing neighbouring healthy tissues. We are exploring optimal means of delivering protons and are evaluating cancer therapies. For example,  

  • CRUK RadNet Centre of Excellence is based at UCL/UCLH and seeks to improve radiotherapy outcomes by use of protons, artificial intelligence and by combination with immunotherapy. 
  • We are also applying advanced imaging techniques to guide prostate cancer surgery. 

 

Early phase clinical trials  

Underling these strategies, investments have been made in cutting edge imaging, molecular profiling and facilities for early phase clinical trials. We also support clinicians to lead early phase trials that align with the BRC aims described above. Additionally, we will explore health economics of new treatments, supporting trials generating health economic evidence on costs and outcomes, and exploring elements of value supporting value for money propositions and future NHS implementation.

Professor Daniel Hochhauser
Cancer Theme Director
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Operations Manager, Cancer, Oral and Dental Medicine