Precision medicine
We are committed to optimising the delivery of personalised medicine to patients, precisely and effectively targeting their molecular signatures. Our innovative studies draw on Birmingham discovery science and genomics capabilities.
Co-located with the CRUK Clinical Trials Unit (CRCTU), we deploy our ECMC funding on the development of these novel programmes, working collaboratively within the network, to offer access to these experimental therapies to patients across the UK.
Towards effective personalised therapies
National Lung Matrix Trial (NLMT) – this platform study in non-small cell lung cancer had an innovative, multi arm, multi stage flexible structure, designed by our CRCTU team. It sought to offer ‘matched’ therapies to patients, increasing the number of actionable genetic abnormalities. Crucial to its successful delivery was input and expertise from across the national ECMC network, with all centres recruiting patients.
The NLMT’s results were published in July 2020. They demonstrate the challenge of targeting genomically complex tobacco-associated NSCLC, where tumours harbour many more oncogenic drivers that can drive oncogenesis.
Following on from these results, our Director Professor Gary Middleton and CRUK Chief Clinician Professor Charlie Swanton have outlined their vision for the next wave of Precision Medicine studies.
Current portfolio
Tessa Jowell Brain Matrix study (TJBM) - This innovative platform led by Birmingham CI Professor Colin Watts and our CRCTU is galvanising the development of stratified trials in glioma, an area of significant unmet need. It aims to improve both outcomes and quality of life for patients, collecting their genomic, pathological and imaging data. It will then offer them the chance to participate in novel experimental studies aligned to their individual profiles. TJBM is currently being delivered at 6 ECMCs across the UK, alongside two other sites.
University Hospitals Birmingham was also awarded Tessa Jowell Centre of Excellence status in 2021, in recognition of the outstanding care that they give to brain cancer patients.
Rare Cancers
DETERMINE – a multi-drug, precision medicine platform trial for adults and children with rare cancers. Opening in early 2022, it will enrol patients who have an identifiable genetic alteration in their cancer that can be targeted by treatments that are already approved for use in other cancer types. This offers the opportunity for rapid NHS approval of any treatments that are shown to provide patient benefit.
Birmingham ECMC Lead Professor Gary Middleton is the Translational Lead and NLMT lead statistician Professor Lucinda Billingham has developed its novel, Bayesian design.
Experimental haemato-oncology is a new strategic priority for our ECMC, and here we offer targeted therapies focusing on epigenetics, utilising the outcomes of the TSO panel 500 testing.
Theme Lead: Dr Manoj Raghavan is a haematologist with research interests in the use of genomics for diagnostics. Manoj is also chair of the West Midlands Genomic Tumour Advisory Board for Haemato-oncology, Sarcoma, Neuro-oncology, Paediatrics and Cancer of Unknown Primary.