ECMC Annual Network meeting 2018
- Phase I trail: OMO1.01.02 - Professor Sarah Blagden, Oxford and Professor Ruth Plummer, Newcastle
- Cambridge Brain Mets Trial 1 (CamBMT1) - Dr Richard Baird, Cambridge
- UK Delivery of first-in-human, first-in-class oral CDK7 inhibitor - Alice Fickling and Dr Matthew Krebs, Manchester
A collaborative approach to platform trials
Following a very successful ECMC meeting earlier in the year where complex trials were discussed, one of the afternoon parralell sessions concentrated on Platform Trials, the term we are using to describe the various types of complex trials.
The session was very well attended and heard from clinicians, patients, commercial trade associations, NHS R&D and regulators. It had already been decided at the earlier meeting that a consensus paper would be produced around how to effectively set up and deliver Platform Trials.
The ANM session presented further views and then focused on what the paper would contain and who would be responsible for writing and editing. Great strides were made on achieving the more detailed planning this very important work requires and on 27 June the Programme Office will hold the first writing workshop for the consensus paper.
New technologies and techniques in translational research – how they are supporting early phase trials
In another afternoon parallel session, delegates experienced a snapshot of new cutting-edge technologies being used within the ECMC network to drive the discovery and development of new cancer treatments.
Nanopore sequencing, introduced by Dr Andrew Beggs (Birmingham), is a ground-breaking new method to sequence DNA. Nanopore sequencing allows direct DNA sequencing of long strands of nucleic acid by utilising the changes in ionic current generated as the strands of nucleic acid pass through the microscopic pores. This happens in a low-cost, pocket-size portable device and has important implications in the analysis of the cancer genome.
Dr David Jamieson (Newcastle) presented the use of the ImageStream system to characterise Circulating Tumour Cells in patients with leukaemia. ImageStream is a powerful device that combines the advantages of traditional analysis of heterogenous cell populations by flow cytometry with fluorescent microscopy allowing the capture of cellular changes that otherwise wouldn’t be visible.
Prof Philippe Clezardin presented his novel work on the mechanisms driving the formation of bone metastasis in breast cancer. His laboratories are shared between Lyon and Sheffield and make important contributions to the characterisation of circulating miRNAs as a prognostic, non-invasive biomarker.
Finally, Dr Daniel Leff (Imperial) introduced the ‘intelligent knife’ known as iKnife, a revolutionary device which enables real time identification of the cancerous tissue. iKnife is analysing surgical smoke by mass spectrometry while surgeon cuts through the tumour, permitting precise detection of the tumour margins. This innovative technology will have significant implications in improving the quality of life in breast cancer patients by reducing the need for full mastectomies, and the re-operative interventions. The iKnife is currently being validated in the ‘REI-EXCISE’ trial, supported by CRUK.
The Changing Landscape of Clinical Trials workshop, chaired by Professor Oliver Ottmann (Cardiff) examined from different discipline’s the challenges and lessons learnt from today’s clinical trials landscape.
A recurring theme introduced by Dr Andrew Davies (Southampton), was how the network will cope with the increased fragmentation of disease, both through greater pathologist sub-classification of disease, and of disease pathways by translational scientists. He asked; as disease becomes more fragmented, are the biomarker platforms, able to support todays clinical trial?
Karen Turner (Birmingham) emphasized the increased role of the research nurse in ensuring patients understand the complex trials they are asked to consider. She highlighted the need for continued Research Nurse training, and for those involved in providing PPI, also considering the increased volume of misleading information available on the internet.
With a greater number of drugs in development, particularly those in un-drugable targets and challenging tumours, as highlighted by Industry representative, Dr John Stone (Astrazeneca), Dr Davies discussed that collaboration in the network was essential to success, giving the example of The Precision Medicine for Aggressive Lymphoma Consortium (PMAL), setup by Southampton to develop and validate predictive molecular assays for use in stratification to support trials. The challenges of engaging stakeholders in platform trials was discussed, emphasized by Dr Stone that Industry needs to be more selective about the combinations they support.
Pooling Network resources was suggested as a future direction, with Statistical expertise being highlighted as one area that could benefit the network. Centres that may need more ongoing statistical modelling to support adaptive trial designs, should be able to access it via the network to optimise trial design. Dr Quentin Campbell-Hewson, (Newcastle), also agreed that collaboration and networking across the UK has improved paediatric recruitment into clinical trials, and identified the need for the Network to be flexible to challenge the lower age limit of all adult trials as appropriate to allow more paediatric patients to access clinical trials.