Dr Ranjit Manchanda

Dr Ranjit Manchanda

MD, MRCOG, PhD
Centre: Centre for Experimental Cancer Medicine
Clinical Senior Lecturer, Consultant Gynaecological Oncologist
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My main research areas are:

  • Risk prediction, screening and prevention of ovarian and endometrial cancer
  • Population based approach(es) to genetic testing for risk stratification and cancer prevention
  • Targeted surgical approaches for prevention of gynaecological cancer
  • Familial gynaecological cancer

Research Details

Research interests

Population based genetic testing for cancer prevention

Development and implementation of a population based risk stratification approach for prediction and prevention of gynaecological cancers

Targeted surgical strategies for prevention of tubal/ovarian cancer: risk reducing salpingo-oophorectomy, opportunistic salpingectomy, early salpingectomy and delayed oophorectomy

Cancer MDT coordinated Precision medicine (CMP) approach for genetic testing of population based ovarian and endometrial cancer case series for ascertainment of high penetrance genes

Familial ovarian and endometrial cancer screening

Management of familial gynaecological cancer such as: breast and/or ovarian cancer families, Lynch Syndrome; Cowden’s Syndrome

Gynaecological Oncology Training; Role and importance of accredited training

POPULATION-BASED GENETIC TESTING

PROMISE Feasibility Study
Pilot study led and coordinated from BCI, QMUL which aims to evaluate the feasibility and acceptability of undertaking a study to predict and stratify a population on the basis of ovarian cancer risk as well as offer risk management options of screening and prevention based on their predicted risk.

Cost-effectiveness of population based genetic testing strategies for cancer prevention
We are developing a number of models to explore and evaluate cost-effectiveness of different population based genetic testing driven cancer prevention strategies: BRCA testing in the Ashkenazi Jewish population (stratified by levels of ancestry), BRCA testing in the Sephardi Jewish Population; and multigene panel testing in the general non- Jewish population. Our collaborators include teams at LSHTM, UCL, UNSW Sydney Australia, Melbourne University Australia, University of Manchester, Shaare Zedek Jerusalem, & University of Cambridge.

PROMISE (Predicting Risk of Ovarian Malignancy Improved Screening and Early Detection) research Programme
PROMISE is a multicentre, international programme bringing together 36 researchers from a number of leading centres (Manchester, UCL, Barts Cancer Institute QMUL, Cambridge University, Harvard University, UNSW Australia and Cedars Sinai USA) to address the challenge of effectively translating advances in risk stratification, screening and early detection for ovarian cancer into population-based interventions by developing and validating models for risk stratification, early detection and diagnosis of ovarian cancer which incorporate clinical, epidemiological, genetic, proteomic and imaging data and evaluating health behavioural aspects of their application to large populations.

GCaPPS (Genetic Cancer Prediction through Population Screening) Study
We use the Ashkenazi Jewish population as a population model and BRCA1/2 gene mutations as a disease model for research into a population based approach to testing for high penetrance cancer genes. GCaPPS is a randomised trial (ISRCTN73338115) comparing the family history and population based approaches to genetic testing for BRCA mutations in the North London Jewish population. In a non-inferiority cluster randomised trial we compare DVD-based and standard genetic counselling approaches to BRCA testing in an unselected Jewish population.

We are interested in evaluating the BRCA detection rates across the greater London population within the NHS and predicting time to detection of the estimated pool of carriers.

FORECEE (Female Cancer Prediction Using Cervical Omics to Individualise Screening and Prevention)
We collaborate on a UCL led multicentre H2020 programme which uses omics-based methods to develop a test for the stratification and risk prediction of breast, ovarian, endometrial and cervical cancer.

SIGNPOsT study: SystematIc GeNetic testing for Personalised Ovarian cancer Therapy
We are evaluating a Cancer MDT driven Pathway for panel based germline and BRCA somatic tissue testing in high grade epithelial ovarian cancer patients.
We are developing projects for evaluating a CMP approach for unselected testing in endometrial cancers.

TARGETED SURGICAL APPROACHES FOR OVARIAN CANCER PREVENTION

We are interested in undertaking studies in the area of targeted surgical prevention strategies for prevention of ovarian cancer.

PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal): National study on Early Salpingectomy and delayed oophorectomy for ovarian cancer prevention in high risk women. (expected to commence towards the end of 2017)

Defining the ovarian cancer ‘risk thresholds’ for risk reducing salpingo-oophorectomy (RRSO) for ovarian cancer prevention.
We have developed models to define the risk thresholds for undertaking surgical prevention for ovarian cancer. This provides utility for implementing model based risk and testing for intermediate risk genes. Guidelines for surgical prevention of ovarian cancer need changing.

Exploring attitudes, acceptability and behaviour towards salpingectomy based surgical prevention strategies in high and low risk women.

Developing studies around opportunistic salpingectomy in low risk women.


OVARIAN & ENDOMETRIAL CANCER SCREENING

We collaborate with the team at Dept of Women’s Cancers, University College London on ovarian and endometrial cancer screening research projects.

UKFOCSS (United Kingdom Familial Ovarian Cancer Screening Study): National trial for screening for Ovarian cancer in high risk women.


OTHER

Developing core outcome sets for gynaecological cancers
We are developing patient reported core outcomes sets for endometrial cancer, atypical endometrial hyperplasia and fertility sparing treatment in cervical cancer in collaboration with Prof Khalid Khan’s group at Blizzard Institute, QMUL

Gynaecological oncology training
We are interested in evaluating outcomes and factors affecting gynaecological oncology training

Collaboration with Tata Memorial Hospital Kolkata
We are partners on their UKIERI - UK India Education Research Initiative, Dept Science & Technology Grant. Investigating BRCAness in epithelial ovarian cancer in India to develop stratified surgical & chemotherapy options. We also support training in gynaecological oncology and management of familial gynaecological cancer.

We collaborate on Quality of life and cost-effectiveness studies in endometrial cancer with teams at UCL and London School of Hygiene and Tropical Medicine.

CLINICAL INTERESTS

  • Advanced complex laparoscopic surgery in gynaecological oncology
  • Ultraradical debulking surgery for ovarian cancer
  • Familial gynaecological cancer

My clinical practice is at the Royal London Hospital, Barts Health NHS Trust.

Profile

I joined Barts Cancer Institute as a Clinical Senior Lecturer and Consultant Gynaecological Oncologist in June 2015. I previously worked from 2014 as a Consultant Gynaecological Oncologist at St Bartholomew’s Hospital & was an Honorary Senior Lecturer at University College London, UK.

I completed a PhD in gynaecological oncology at UCL, along with subspecialty training in gynaecological oncology from UCLH and Bart's Hospital. I have served as the president of the European Network of young Gynaecological Oncologists (ENYGO) and a member of the European Society of Gynaecological Oncology (ESGO) council (2011-2013).

I chair the Gynecological Oncology clinical trials group at Barts & QMUL. I am a member of the NCRI Ovarian Cancer Surgical Sub group. I am Acting-PI, research lead and co-ordinator of the GCaPPS (Genetic Cancer Prediction through Population Screening) trial; CI on PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal) trial, the PROMISE Feasibility Study and the SIGNPOST (SystematIc GeNetic testing for Personalised Ovarian cancer Therapy) study. I am a co-investigator of the ‘Predicting Risk of Ovarian Malignancy, Improving Screening and Early detection’ (PROMISE) 2016 programme, member of the UKFOCSS (UK Familial Ovarian Cancer Screening Study) team. I lead the Bart's Hospital familial gynaecological cancer clinical service and co-chair the London Cancer high-risk gynaecological cancer MDT.

I am also actively involved in gynaecological oncology training issues, have helped develop and establish ENYGO (European Network of Young Gynaecological Oncologists) from its inception and both led and undertaken a number of initiatives for European and international trainees in gynaecological oncology. I am the deputy director of the Barts Health RCOG gynaecological oncology training programme.

Previous posts

March 2014 – May 2015 – Consultant Gynaecological Oncologist at Barts Hospital &Honorary Senior Lecturer at University College London.

Feb 2010 – Feb 2014 - NIHR Walport Clinical Lecturer & Sub-Specialty trainee Gynaecological Oncology (University College London Hospital, Bart’s Hospital, University College London)

Oct 2013 – Nov 2013 - Visiting Fellow (Bydgoszcz Cancer Centre, Poland)

Feb2007 – Jan 2010 - Clinical Research Fellow, Gynaecological Oncology (University College London)

Sep 2002 – Jan 2007 - Specialist Registrar Obstetrics & Gynaecology East of England Training Programme (Cambridge rotation)

Aug 2001 – Aug 2002 - Acting Registrar Obstetrics & Gynaecology Southend Hospital

July 2000 – July 2001 - Indian Council Medical Research Fellowship, Obstetrics & Gynaecology, All India Institute of Medical Sciences, India

July 1993 – Oct 1999 - Junior and Senior Resident Obstetrics & Gynaecology (6 year training programme), All India Institute of Medical Sciences (AIIMS), India

Education & Qualifications

2014 CCT in Gynaecological Oncology and CCT in Obstetrics & Gynaecology
2014 BSCCP accreditation in Colposcopy: BSCCP
2013 PhD (Gynaecological Oncology): University College London, UK
2011 NIHR Leadership Programme for Trainees: Ashridge Business School, UK
2005 MRCOG : Royal College of Obstetricians & Gynaecologists (RCOG), UK
1996 MD (Obstetrics & Gynaecology): All India Institute of medical Sciences (AIIMS), Delhi, India
1993 M.B.B.S : All India Institute of medical Sciences (AIIMS), Delhi, India

Funding

2017-2020 PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal) study. Role – CI; £368,142, Barts & the London Charity

2017-2020 Investigating BRCAness in epithelial ovarian cancer in India to develop stratified surgical & chemotherapy options. Role- Co-investigator, Partner. £194,405 UKIERI - UK India Education Research Initiative, Dept Science & Technology (India)

2016-2018 Systematic genetic testing for gynaecological cancers. Role- CI; £81,000 Barts Charity

2016-2019 Developing Core Outcomes Sets to standardise reporting in endometrial cancer & atypical endometrial hyperplasia. Role- Co-investigator; £163,790, Cancer Research UK

2016 Lady Freemasons equipment grant. Role- CI; £3957, Barts Charity

2016-2018 Evaluating cost-effectiveness of population testing for ovarian & breast cancer gene mutations. Role – CI; £77,340/- The Eve appeal

2016-2019 Systematic genetic testing for ovarian cancer. Role- CI; £178,000 Barts Charity

2017-2018 PROMISE Feasibility Study. Role- CI; £130,000 CRUK & The Eve appeal

2011-2018 PROMISE 2016 Programme. Role - Co-investigator; £3.26M CRUK & The Eve appeal

2015-2017 Use of Plasmajet in ultraradical ovarian cancer surgery. Role- Co-investigator; £77,000 Bart’s Charity

2008-2017 Genetic Cancer Prediction through population Screening (GCaPPS). Acting CI; £561,523 The Eve Appeal.

2011-2013 European Network of Young Gynaecological Oncologists (ENYGO) budget grants. €50,000 European Society of Gynaecological Oncology (ESGO).

2010-2014 NIHR Walport Academic Clinical Lecturer Award. £261,800, NIHR

Key Publications

Specifying the risk threshold of premenopausal risk reducing salpingo-oophorectomy for ovarian cancer prevention: a cost-effectiveness analysis. Manchanda R, Legood R, Antoniou AC, Gordeev SV, Menon U. J Med Genet. (2016); 53:591–9 PMID: 27354448

Cluster randomised non-inferiority trial comparing DVD-based and traditional genetic counselling in systematic population testing for BRCA1/2 mutations. Manchanda R, Burnell M, Loggenberg K, Desai R, Wardle J, Sanderson S, Gessler S, Side L, Balogun N, Kumar A, Dorkins H, Wallis Y, Chapman C, Tomlinson I, Taylor R, Jacobs C, Legood R, Raikou M, McGuire A, Beller U, Menon U, and Jacobs I. J Med Genet. (2016); 53(7):472-80 PMID: 26993268

Cost effectiveness of population screening for BRCA mutations in Ashkenazi-Jewish women compared to family-history based testing.
Manchanda R, Legood R, Burnell M, McGuire A, Raikou M, Loggenberg K, Wardle J, Sanderson S, Gessler S, Side L, Balogun N, Desai R, Kumar A, Dorkins H, Wallis Y, Chapman C, Taylor R, Jacobs C, Tomlinson I, Beller U, Menon U, and Jacobs I. J Natl Cancer Inst. (2015); 107(1) PMID: 25435542

Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomised controlled trial.
Manchanda R, Loggenberg K, Sanderson S, Burnell M, Wardle J, Gessler S, Side L, Balogun N, Desai R, Kumar A, Dorkins H, Wallis Y, Chapman C, R, Jacobs C, Tomlinson I, McGuire A, Beller U, Menon U, and Jacobs I. J Natl Cancer Inst. (2015); 107(1) PMCID: PMC4301703

A Risk Prediction Algorithm for Ovarian Cancer Incorporating BRCA1, BRCA2, Common Alleles and Other Familial Effects.
Jervis S, Song H, Lee A, Dicks E, Harrington P, Baynes C, Manchanda R, Easton D, Jacobs I, Pharoah P, Antoniou A. J Med Genet. (2015); 0:1–11. PMID: 26025000

The need for accredited training in gynaecological oncology: a report from the European Network of Young Gynaecological Oncologists (ENYGO).
Manchanda R, Godfrey M, Wong-Taylor LA, Halaska MJ, Burnell M, Grabowski JP, Gultekin M, Haidopoulos D, Zapardiel I, Vranes B, Kesic V, Zola P, Colombo N, Verheijen R, Bossart M, Piek. J. Ann Oncol. (2013); 24(4), 944-52 PMID: 23172637


Further Publications

For additional publications, please click here

My main research areas are:

  • Risk prediction, screening and prevention of ovarian and endometrial cancer
  • Population based approach(es) to genetic testing for risk stratification and cancer prevention
  • Targeted surgical approaches for prevention of gynaecological cancer
  • Familial gynaecological cancer

External Activities

  • Lead Familial Gynaecological Cancer Service, Bartshealth NHS Trust, 2014-
  • Member UKCTOCS Trial Outcomes Committee, 2016-
  • Member Surgical Working Group, NCRI Ovarian Cancer Subgroup, 2016-
  • Chair Gynaecological Oncology Trials Group, Bartshealth, Bart’s Cancer Institute, 2015-
  • Member OOP (Out of Programme) London Deanery Academic committee for appointment and monitoring of Academic Trainees
  • Deputy director Gynaecological oncology RCOG training programme Barts Health, 2017-
  • Scientific advisor BRCA Umbrella, 2014-
  • Member ESGO Task Force: Prevention, Early diagnosis of Women Cancers (ENPIGO): 2014- 
  • President ENYGO (European Network of Young Gynaecological Oncologists): 2011 – 2013
  • ESGO (European Society Gynaecological Oncology) Council member Sep 2011- Oct 2013
  • Member Meeting committee, Fellowships committee, Training and Accreditation committee of ESGO Council, Sep 2011 – Oct 2013. Accreditation visits for ESGO
  • Acting PI, Trial Co-ordinator, TMG and TSC member GCaPPS study
  • CI of SIGNPOST, PROTECTOR and PROMISE Feasibility Study
  • TMG, TSC member UKFOCSS trial
  • Member Organisation and Scientific committee, 18th ESGO conference 2013, Liverpool
  • Programme Chair of Young Doctors Session (YDS): First international conference for gynaecological oncology trainees/fellows, IGCS, Vancouver Oct 2012
  • Organised/ directed Cadaveric workshops on advanced laparoscopic surgery in gynaecological oncology: AIIMS Delhi, India 2017; Bangalore, India 2015 (AGOI); London, UCLH (ESGO) 2012
  • Organisation of a number of national and international workshops and meetings

News

May 2017: Chair Gynaecology working group session, NCRI workshop: The role of Germline Genetic Profiling for risk-based prevention and cancer screening, London.

April 2017: Invited Speaker, Gynae Oncology Trials. University College London Partners (UCLP) Research Day.

Mar 2017: Key Note Speaker, Population testing for risk stratification and ovarian cancer prevention. Annual Research Summit, Clinical Support Services CAG, Bartshealth NHS Trust.

Mar 2017: Invited Speaker, Population based testing for targeted ovarian cancer prevention. Annual Academic Meeting Joint RCOG/ Blair Bell Research Society, RCOG, London.

Feb 2017: Invited speaker, Para aortic node dissection. 3rd Cadaveric Workshop Gynae Onco Skills, FOGSI oncology committee and AGOI, AIIMS, Delhi, India

Dec 2016: Invited speaker, Laparoscopic para-aortic node dissection. Association of Gynaecological Oncologists of India (AGOI) National conference, Delhi, India.

Dec 2016: Invited speaker, Genetic Testing in ovarian cancer. Panel discussion. Association of Gynaecological Oncologists of India (AGOI) National conference, Delhi, India.

Nov 2016: Invited Speaker, BRCA and the UK Jewish Community, Panel discussion, Jewish Medical Association meeting, University College London.

Nov 2016: Invited Speaker, Ovarian Cancer Screening: UK trials (Screening integrato dei carcinomi ovarici). “Highlights in Ginecologia Oncologica” – Camogli, Genova, Italy.

Nov 2016: Invited Speaker, BRCA and High risk women: “risk reducing surgery”. “Highlights in Ginecologia Oncologica” – Camogli, Genova, Italy.

Nov 2016: Organisation of Gynaecological Oncology Away Day North East London Cancer MDT

July 2016: News coverage on Specifying the threshold for Risk reducing surgery in ovarian cancer.

See other researchers working on:

Clinical Trials Genetics Ovarian Cancer
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