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Researchers at the Royal Orthopaedic Hospital and Aston University explore novel bone cancer therapy

Written by Louise Stanley on . Posted in Cancer outcomes, Experimental medicine.

Lucas Souza, Research Laboratory Manager for the Dubrowsky Regenerative Medicine Laboratory at the Royal Orthopaedic Hospital (pictured), is partnered with Professor Richard Martin, director of the Advanced Materials Research Centre at Aston University to explore a new way to treat bone cancer.

As bone cancer researchers, we are seeking to tackle the problem of bone tumours across all fronts. We are currently exploring how the metal element gallium could be used to support the treatment of bone tumours due to its cancer-killing properties.

Bone tumours can be either primary (originated in the bone tissue) or secondary (originated in another tissue and metastasise to bone tissue). We have already proved in a previous study that primary bone cancer cells are four times more sensitive to gallium than normal cells. In that study we wanted to understand if doping bioactive glasses, used in orthopaedic and dental surgeries for its bone forming properties, with gallium would support positive outcomes for bone cancer patients. We were able to show that the use of gallium embedded in bioactive glasses is an excellent strategy to support bone repair whilst selectively killing bone cancer cells which can potentially culminate with better treatment outcomes and reduced cancer recurrence rates.

The next phase of this study is exploring the use of gallium against bone metastases – cancer that originated in another tissue before spreading to bone. The ultimate goal is to prove whether cells from bone metastases also have greater sensitivity to gallium so it could be used as an adjuvant medicine to control metastatic growth in the treatment of other types of cancer that usually metastasise to bone, such as breast, lung, and prostate cancer.

If successful, we will combine the gallium-doped bioactive glass powder with biodegradable polymers to make a minimally invasive injective gel that surgeons can use to treat both primary and secondary bone tumours. This gel will have the potential to reduce cancer recurrence and implant failure rates, leading to reduced time in hospital beds, reduced use of antibiotics, fewer revision surgeries, and increased survival rates.

It is also hoped that this innovation could be used to improve outcomes for patients with vertebral metastases and other types of primary bone tumours where surgery and radiation is less effective due to their proximity to the spinal cord.

The safety and effectiveness of these biomaterials will need to be tested further, but the initial results are really promising. Treatments for a bone cancer diagnosis remain very limited and there’s still much we don’t understand. Research like this is vital to support in the development of new drugs and new methodologies for treatment options.

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Patients with recent onset diabetes fast-tracked more effectively for pancreatic cancer screening

Written by Louise Stanley on . Posted in Cancer outcomes, Early diagnosis and detection, Inflammation and chronic disease.

A recent study, funded by Pancreatic Cancer UK and conducted by researchers at BHP’s University of Birmingham, in collaboration with University of Oxford, University of Nottingham and fellow BHP founder-members University Hospitals Birmingham NHS Foundation Trust, developed a new prediction model as an effective way of identifying individuals suitable for fast-track abdominal imaging.

Weight loss and glycaemic control are known biomarkers that can indicate pancreatic cancer risk and in, accordance with NICE recommendations, people over the age of 60 years with recent onset diabetes and weight loss currently undergo urgent abdominal CT imaging to assess for pancreatic cancer.

Pancreatic cancer is known for its poor prognosis, with less than a quarter of patients surviving past one year after diagnosis. Early detection is important as patients with early-stage disease are more likely to be able to tolerate chemotherapy and therefore have an improved 5-year survival rate, but most patients are not diagnosed until the later stages of the disease. One way of detecting pancreatic cancer patients sooner is through screening patients with diabetes as there is a known association.

By looking at further potential biomarkers to determine which patients would benefit from referral for abdominal imaging, there is a chance of picking more cancers and reducing the cost of imaging those who are not so high-risk.

Dr Shivan Sivakumar, Associate Professor in oncology, specialising in pancreatic, liver and biliary tract cancer, said: “One in ten pancreatic cancer patients have new-onset diabetes and we know that some patients with newly diagnosed diabetes are worth exploring further to improve early detection of pancreatic cancer. We need to more accurately predict which of those patients should be referred for further investigation. We used health data records, from a larger patient population than has previously been studied, to develop a more nuanced method of stratification that could improve referral pathways.”

This study used large-scale, population-representative, linked electronic health data records to develop and evaluate a new prediction model that can be used to predict risk of developing pancreatic cancer within two years of a diabetes diagnosis. The new models used a variety of potential markers and were able to predict pancreatic cancer risk in patients aged between 30 and 85 years, rather than relying on the 60+ rule of thumb.

This study was the largest of its kind and offers improved accuracy compared to previous prediction models as it used a larger data set. The new prediction model could be more effective than current ‘rules-based’ referral guidelines. Further external validation and health economic assessment is recommended.

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Children’s brain tumours could be diagnosed with 10-minute scan

Written by Louise Stanley on . Posted in Cancer outcomes, Early diagnosis and detection.

Children with the most common malignant form of brain cancer could see diagnostic wait times dramatically reduced thanks to new research that trialled a quicker and less invasive way of determining which type of tumour they have. 

The study, published in eBioMedicine, was conducted by a team of researchers led by the University of Birmingham (UoB) and Newcastle University, with Birmingham Children’s Hospital as the lead clinical centre, and funded by Children with Cancer UK and Cancer Research UK. UoB and Birmingham Women’s and Children’s NHS Foundation Trusts are both founding members of BHP.

The collaborative team identified how the four different groups of medulloblastoma, a malignant children’s brain tumour, had a specific profile based on their individual metabolism. Taking cell samples from 86 tumours, a laboratory test was used to accurately identify metabolic markers including chemicals specific to the different tumour groups.  

The study also validated previous research that found that glutamate, a metabolite present across all of the tumour cells, is linked closely with tumour prognosis. 

Significantly, the research could pave the way for using MRI scanning combined with machine learning to assess medulloblastomas for their ‘signature’ metabolic profiles without the need for invasive biopsy and could rapidly reduce the current 3-4 week wait from presentation to full diagnosis. 

Andrew Peet, Emeritus Professor of Clinical Paediatric Oncology at the University of Birmingham and an Honorary Consultant at Birmingham Women’s and Children’s NHS Foundation Trust, who is lead author of the study said: “Time is so important in cancer diagnosis so our findings on different types of medulloblastoma having a detectable signature metabolism could be game changing for quickly diagnosing, and then offering the best possible treatment for children.”

Professor Steve Clifford, Chair of Molecular Paediatric Oncology at the Newcastle University Centre for Cancer, who jointly led the study said: “Providing a rapid diagnosis using innovative scanning and AI (artificial intelligence) techniques, has the potential to revolutionise patient management, allowing early non-invasive diagnosis, tailoring of treatment decisions and reducing the period of uncertainty for patients and parents while awaiting a full diagnosis. Further, our biological findings provide critical new insights into the metabolism underpinning these tumours, and the potential to exploit these therapeutically.”

The latest findings could be game changing for children like Jack Bourne, aged six, from Birmingham who was diagnosed with medulloblastoma in March 2023.

Jack’s dad Tom said: “We’ve been through 13 months of treatment but six weeks of that was just waiting to find out what type of tumour he had. We were so scared.”

Within weeks of starting school, Jack had started experiencing sickness and headaches which doctors put down to possible separation anxiety or vertigo. But when parents Tom and Tom and Suzanna noticed that he was struggling to walk, they sought a second opinion and Jack was referred to Birmingham Children’s Hospital the same day.

“When they told me the results of the MRI scan, I didn’t know what to feel,” said Tom. “As we were trying to digest everything, they were asking us to sign consent forms because they wanted to operate first thing the next morning. You’re reading these forms and all you see is – he might not make it out alive. It’s heartbreaking, it really is.”

Jack pulled through the ten-hour operation to remove the tumour, but it would take more than four weeks for doctors to figure out what specific type of medulloblastoma he had in order to effectively treat it.

“The research that’s going into diagnosing tumours is really important,” said Tom. “In Jack’s case there was quite a delay while they sent his tumour to Great Ormond Street to be analysed. During that time Jack was given some chemo just to start things off because they just wanted to do something rather than just wait. But all you want is for your child to be given the best possible treatment right from the start.” 

Christiana Ogunbote, Head of Research at Children with Cancer UK said: “We are incredibly proud to help fund this innovative medulloblastoma research and are excited to see how it could change the experiences of children diagnosed with this disease and their families. Discovering new ways to improve outcomes for children with cancer is at the heart of what we are trying to achieve. Through continued and sustained investments in research we look forward to a day where every child can survive their cancer diagnosis.” 

Dr Laura Danielson, Children’s and Young People’s Research Lead at Cancer Research UK, said:  “Developing quicker, less invasive ways to accurately diagnose the different types of medulloblastoma, the most common malignant brain tumour in children, is a crucial step in improving outcomes for young patients. 

“This important study has identified a new way to distinguish between the four subgroups of medulloblastoma. This discovery paves the way for the development of simple imaging tests that could quickly and accurately diagnose the different types of medulloblastoma. 

“This kind of discovery research is important to drive new and improved ways to better detect and treat cancers affecting children and young people.”

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World-first colorectal cancer vaccine trial treats first UK patient in Birmingham

Written by Louise Stanley on . Posted in Cancer outcomes, Clinical trials, Experimental medicine.

The Queen Elizabeth Hospital Birmingham (QEHB), operated by BHP founder-member University Hospitals Birmingham NHS Foundation Trust, has treated its first patient in England with a personalised vaccine against their bowel cancer, in a clinical trial which is part of NHS England’s new Cancer Vaccine Launch Pad (CVLP).

In a national first, father-of-four Elliot Pfebve received the developmental jab within the Clinical Research Facility at QEHB, one of several sites taking part in the colorectal cancer vaccine trial sponsored by BioNTech SE.

The trial is one of several that will be taking place in NHS trusts across the country to treat different types of cancer. Thousands more patients are expected to benefit from NHS England’s new CVLP, which will enable those wanting to participate in clinical trials to be fast-tracked to one of the nearest participating hospitals.

Patients who agree to take part have a sample of their cancer tissue and a blood test taken. If they meet a clinical trial’s eligibility criteria, they can be referred to their nearest participating NHS site, meaning patients from hospitals across the country will find it easier than ever to take part in groundbreaking research.

The investigational cancer vaccines evaluated in the colorectal cancer trial are based on mRNA – the same technology used for the Pfizer-BioNTech COVID-19 vaccine – and are created by analysing a patient’s tumour to identify mutations specific to their own cancer. Using this information, medics then create an experimental individualised cancer vaccine.

The developmental vaccines are designed to induce an immune response that may prevent cancer from returning after surgery on the primary tumour, by stimulating the patient’s immune system to specifically recognise and potentially destroy any remaining cancer cells.

The investigational cancer vaccines being jointly developed by biopharmaceutical companies BioNTech and Genentech, a member of the Roche Group, are still undergoing trials and have not yet been approved by regulators.

Higher-education lecturer Elliot, 55, had no cancer symptoms and was diagnosed through a routine health check with his GP.

A CT scan and a colonoscopy confirmed he had colon cancer and Eliott had surgery to remove the tumour and 30cm of his large intestine. He was then referred to the QEHB for initial rounds of chemotherapy and to take part in a clinical trial.

Eliott said: “Taking part in this trial tallies with my profession as a lecturer, and as a community-centred person. I want to impact other people’s lives positively and help them realise their potential.

“Through the potential of this trial, if it is successful, it may help thousands, if not millions of people, so they can have hope, and may not experience all I have gone through. I hope this will help other people.”

Thirty hospitals in England are already signed up to the pioneering Cancer Vaccine Launch Pad – one of the biggest projects of its kind in the world – with more sites joining the platform over the coming months.

The scheme aims to expand and work with a range of partners in the pharmaceutical industry to include patients across many cancer types who could potentially join a vaccine trial, such as those with pancreatic and lung cancer.

Principal Investigator for the trial at QEHB, Consultant Clinical Oncologist, Dr Victoria Kunene, said: “The investigational cancer vaccines are based on mRNA and are created by analysing a patient’s tumour to identify mutations specific to their own cancer. Using this information, we can create an individualised investigational cancer vaccine, but it is too early yet to say if these will be successful, though we are extremely hopeful.

“Based on the limited data we currently have of the in-body response to the vaccine, this could prove to be a significant and positive development for patients, but more data is yet needed and we continue to recruit suitable patients to the trial to establish this further.”

Amanda Pritchard, NHS chief executive, said: “Seeing Elliot receive his first treatment as part of the Cancer Vaccine Launch Pad is a landmark moment for patients and the health service as we seek to develop better and more effective ways to stop this disease. 

“Thanks to advances in care and treatment, cancer survival is at an all-time high in this country, but these vaccine trials could one day offer us a way of vaccinating people against their own cancer to help save more lives.

“The NHS is in a unique position to deliver this kind of world-leading research at size and scale, and as more of these trials get up and running at hospitals across the country, our national match-making service will ensure as many eligible patients as possible get the opportunity to access them.”

Trials have already enlisted dozens of patients, although the majority of participants are expected to be enrolled from 2026 onwards.

Professor Peter Johnson, NHS national clinical director for cancer at the NHS said: “We know that even after a successful operation, cancers can sometimes return because a few cancer cells are left in the body, but using a vaccine to target those remaining cells may be a way to stop this happening.

“Access to clinical trials could provide another option for patients and their families, and I’m delighted that through our national launch pad we will be widening the opportunities to be part of these trials for many more people, with thousands of patients expected to be recruited in the next year.”

Executive Director of Research and Innovation at Cancer Research UK, Iain Foulkes, said: “It’s incredibly exciting that patients in England are beginning to access personalised cancer vaccines for bowel cancer.

“This technology pioneers the use of mRNA-based vaccines to sensitise people’s immune system and in turn detect and target cancer at its earliest stages. Clinical trials like this are vital in helping more people live longer, better lives, free from the fear of cancer. If successful, the vaccine will be a game changer in preventing the onset or return of bowel cancer.”

Last year, the Government signed an agreement with BioNTech to provide up to 10,000 patients with precision cancer immunotherapies by 2030.

BioNTech has already begun conducting clinical trials in the UK, and the NHS launch pad is helping to accelerate the identification of eligible patients for those trials in England.

The vaccines being tested as part of the trials aim to help patients with different types of cancer and, if successfully developed, researched and approved, cancer vaccines could become part of standard care.

The NHS is working in partnership with Genomics England on the launch pad, with work already helping patients access the latest testing technologies and ensures they are given more targeted precision treatments for their cancer.

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Birmingham scientists win funding to develop ‘lollipops’ for mouth cancer diagnosis

Written by Louise Stanley on . Posted in Cancer outcomes, Early diagnosis and detection.

A ‘lollipop’ that can diagnose mouth cancer early could become a reality, thanks to a pioneering project funded by Cancer Research UK and the Engineering and Physical Sciences Research Council (EPSRC).

Scientists at BHP founder-member the University of Birmingham have been awarded £350,000 over the next three years to develop a prototype flavoured ‘lollipop’ from a material called a smart hydrogel.

Smart hydrogels – previously developed by the University’s Dr Ruchi Gupta and her team – work a bit like a fishing net: they absorb large quantities of water while ‘catching’ larger molecules, such as proteins. The ‘net’ can then be cut open to release the larger molecules for analysis in the lab. The idea is that patients suck on the lollipop, transferring a saliva sample into the hydrogel. Scientists can then release the ‘caught’ proteins by blasting the hydrogel with UV light and then analyse the liquid for saliva proteins which indicate the early stages of mouth cancer.

Around 12,400 people are diagnosed with cancers of the head and neck in the UK every year*. Currently, diagnosing mouth cancer can involve putting a flexible camera on the end of a tube through the nose or mouth and taking a biopsy for testing. This procedure is invasive, time-consuming and requires an endoscopist.

Mum of five, Rachel Parsons, needed a biopsy after being referred to Coventry University Hospital with a lump on her cheek in 2008. She admits she was unprepared for the procedure which, in her case, turned out to be painful.

“I had no idea what a biopsy really was,” said Rachel, from Coventry. “I had the kind of injection you get at the dentists and, when it wore off, it was really sore because I’d needed stitches.”

That was just the beginning of a 12-month nightmare for Rachel who ended up needing a nine-and-a-half-hour operation to remove a cancerous tumour from her cheek and replace the skin with tissue and veins from her forearm.

“The thought of putting a lollipop round your mouth instead of having a biopsy in the first instance is amazing,” said Rachel who has spent years as a patient ambassador, campaigning for more awareness of mouth cancer. “I wish something like that had existed when I was diagnosed.”

Dr Ruchi Gupta, Associate Professor of Biosensors at the University of Birmingham, said she was thrilled to receive funding to begin the next phase of the project: “Smart hydrogels have really exciting potential for diagnosing mouth cancer,” she said. “They can be easily moulded into shapes as a solid to ‘catch’ proteins in saliva.

“We’re really excited to start the next phase of this project. We’re hoping that we can be the first to make a device which is much kinder for diagnosing mouth cancer for patients and easier for GPs to use.”

Rachel, who still has numbness around her face and can’t open her mouth wide enough to eat a burger, added: “I’m so grateful for the research and treatment that saved my life. Things have improved immensely since then but what’s happening now could be absolutely brilliant for people diagnosed in future.”

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said: “Biopsies and nasoendoscopy are the gold standard for diagnosing mouth cancer, but it requires great skill to carry out and can feel unpleasant for patients. We want an accurate, faster and kinder alternative test which can help us diagnose cases of mouth cancer sooner.

“This project is an exciting first step towards an entirely new way to identify mouth cancers earlier. Research like this is guiding us towards a future where people can live longer, better lives, free from the fear of cancer.”

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Revolutionising diagnosis and management of cartilage tumours

Written by Louise Stanley on . Posted in Cancer outcomes, Early diagnosis and detection.

The musculoskeletal radiology department at BHP member the Royal Orthopaedic Hospital (ROH) has developed a new website designed to enhance the diagnosis and management of cartilage tumours.

bactip.co.uk is a platform that equips healthcare professionals with the tools and knowledge to navigate the complexities of central cartilage tumours. By offering drawings and real case examples, it serves as a valuable resource for interpreting musculoskeletal radiology imaging findings related to these tumours, ensuring their accurate and consistent reporting. Developed collaboratively by experts in the field, bactip.co.uk offers an approach for assessing, diagnosing and monitoring these lesions.

A standout feature of bactip.co.uk is its integrated calculator, which streamlines the grading process based on tumour characteristics, like size and aggressiveness. This innovative tool aims to simplify decision making processes for healthcare professionals dealing with cartilage tumours. This advanced tool also standardises the reporting of central cartilage tumours, reducing subjective differences and improving patient care.

bactip.co.uk enables radiologists and clinicians to make informed decisions by offering an imaging follow up plan. Whether it involves suggesting a referral to an oncology specialist or safely discharging a patient from surveillance monitoring, the protocol provides a detailed framework customised for each unique case.

As a leading authority in orthopaedic excellence, the ROH musculoskeletal radiology department is proud to share its expertise through bactip.co.uk, an open-source free resource.

Dr A. Mark Davies, consultant radiologist at the ROH commented: “This initiative reflects our commitment to openness making sure that healthcare professionals worldwide can access our cutting-edge knowledge and best practices without any barriers. Our dedication to spreading knowledge and best practices aligns with our shared goal of enhancing patient outcomes on a global scale.”

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