Early Phase Clinical Trials in Lung Cancer at the CRCTU

Dr Laura Crack

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Lung cancer is a devastating and very common healthcare problem. Lung cancer is the biggest cause of cancer death in the UK, accounting for more than one in five cancer deaths and is the second most common cancer in both men and women. Recent campaigns such as the plain packaging campaign aim to reduce the numbers of people smoking, particularly targeting children and young adults. Whilst these campaigns targeting environmental and lifestyle factors are crucial to reducing incidence of lung cancer, new and more effective treatments are urgently needed to increase the chances of surviving this devastating disease.

The Cancer Research UK Clinical Trials Unit (CRCTU) has designed and run many clinical trials for both main types of lung cancer (small cell and non-small cell lung cancer) patients over the past 2 decades. A good example of this is in small cell lung cancer (SCLS), the STOMP Trial, which is investigating the safety and activity of a drug (Olaparib) which prevents cancer cells from repairing damage to their DNA; by inhibiting a molecule called PARP. This trial, led by Professor Penella Woll, is actively recruiting patients around the country. The STOMP trial is due to run for another year and will be asking if Olaparib can be used as maintenance therapy for people with SCLC, whether it can increase the length of time people live with the disease and can it be used as maintenance therapy for SCLC.

Because of this expertise, the CRCTU and the University of Birmingham’s Gary Middleton, Professor of Medical Oncology, have been selected to lead on the National Lung Matrix trial; a joint initiative between the University of Birmingham, Cancer Research UK with pharmaceutical partners AstraZeneca and Pfizer. This trial will utilise an existing network of Experimental Cancer Medicine Centres (ECMCs) across the UK to deliver a plethora of drugs to lung cancer patients. Patients will be stratified according to genetic abnormalities in their cancer. This information will be generated in phase 2 of Cancer Research UK’s Stratified Medicine Programme, which was launched in April this year. The trial is due to open to recruitment later in 2014. Once open the National Lung Matrix trial will see cancer treatment moving towards the promise of personalised medicine where a patient’s treatment is guided by the individual genetic make-up of their cancer.

This advancement has been made possible through the Cancer Research UK Stratified Medicine Programme which has looked to establish a network for nationwide molecular testing that will form a vital platform to launch future targeted treatments. Colleagues in Birmingham have been acting as a technology hub for the stratified medicine programme and are in an excellent position to help inform this new stage of cutting edge early phase clinical trials.

TraxerX is another exciting example of the rapidly developments in personalised medicine for lung cancer patients across the country. Researchers in Birmingham are working with nationwide colleagues to further their understanding of lung cancer, how it adapts and responds to treatment along with where its Achilles heels are.

A new era is dawning and Lung Cancer researchers and clinical teams are pushing boundaries to change the devastating effects of a lung cancer diagnosis. Birmingham’s CRCTU is working collaboratively with many leaders in the field to ensure that effective developments reach patients faster.

Dr Laura Crack is EDD Team Leader in the School of Cancer Sciences at the University of Birmingham.

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