Cambridge is uniquely placed to bring together research and clinical expertise to develop a strategic approach to the prevention, early intervention in high risk individuals and early detection of lung and colorectal cancer. Leading research skills include cell and developmental biology, imaging, epidemiology and public health, chemistry and nanotechnology.
Addenbrooke's Hospital has a substantial patient base with over 500 new referrals annually, research bronchoscopy clinics, and a highly performing clinical trials team including early phase clinical trials expertise. Papworth Hospital will soon relocate to the Cambridge Biomedical Campus to form the largest cardio-thoracic centre in Europe.
Researchers in Cambridge are working towards building a detailed understanding of the complex biology of early lung cancer development. They are analysing the inter-relationships between carcinogen exposure, mutation accumulation, clonal expansion, stem cell behaviour and the evolution of pre-malignant lesions in the pulmonary epithelium.
Researchers at the MRC Cancer Unit are studying the molecular mechanisms responsible for tumour development with the goal of improving the diagnosis and treatment of lung cancer. They develop genetically modified tumour models to investigate the genetic and epigenetic alterations that drive lung cancer evolution using state-of-the-art genomics, microscopy and in vivo imaging.
Addenbrooke's Hospital carries out over 150 research bronchoscopies every year and is the second highest recruiter to LungSearch (a trial testing ways of detecting lung cancer at an early stage in people whose lungs are not working normally). Research is focused on developing minimally invasive strategies for identifying high-risk patients, including sampling upper airway mucosa, genomics of plasma and/or sputum DNA, novel imaging techniques, bronchoscopic studies, and detailed clinical and epidemiological surveys.
The genetic profile of colorectal tumours, both at constitutional and somatic mutation levels, have the potential to determine the best treatment for individual patients and their relatives. Genetic screening is being refined with the aim of developing a personalised medicine programme in colorectal cancer. Tumour profiling using immunohistochemistry (mlh1, msh2, msh6, pms2) is currently performed within the NHS on affected individuals from high-risk families to determine if constitutional mutation analysis should be performed. We aim to further refine this analysis to identify those with microsatellite instability testing (MSI). This will define which group of patients have the greatest risk of colorectal cancer and reduce the need for colonoscopy monitoring in families who are MSI-negative. Once indentified, the high-risk MSI-positive group can be considered for novel therapeutic strategies.
The Winton group focuses on intestinal stem cell biology, and has a particular interest in exploring the cellular biology of colorectal cancer. One priority is the functional testing of candidate gene mutations as drivers of colorectal cancer. Another is to establish the role of quiescent cells that are uniquely adapted to evade cancer therapies and determine if their occurrence is related to poor clinical outcome.
The Bienz group studies the molecular mechanisms of Wn/beta-catenin signalling and how the aberrant activation of this important cancer pathway drives colorectal cancer. They focus on the functions and molecular interactions of newly-discovered components of this pathway, aiming to understand how these control the transcriptional activity of beta-catenin and to develop their potential as cancer drug targets.
McDermott conducts high-throughput genomic screening of organoid cell lines derived from patient biopsies for sensitivity to anticancer drugs, aiming to take this forward to develop a personalised medicine programme in colorectal cancer. He also collaborates with the colorectal clinical team, to examine gene rearrangements in colorectal cancer and to assess whether these can be used as markers of relapse or to guide therapy.