Posted on 20th May 2024 by Charlotte Ridler

International Clinical Trials Day – how Barts clinical trials are changing cancer care

To mark International Clinical Trials Day, we’re spotlighting some of our clinical trial work and how it is helping to transform the lives of people with cancer. We're grateful to everyone who enables these trials to take place, including the patients who participate.

Queen Mary’s Barts Cancer Institute works with Barts NHS Health Trust as part of the Barts Experimental Cancer Medicine Centre (ECMC), one of the largest cancer trial centres in the UK. Between 2017 and 2022, the Barts ECMC played a role in:

  • approval of eight new cancer drugs from Barts-led research
  • publication of more than 700 new scientific papers
  • supporting a portfolio of more than 350 trials worldwide, 35 of which were led by Barts investigators
  • leveraging £31m of funding, including £23m from industry

Here, we highlight three teams whose clinical trial work is leading to changes in cancer care.

Close-up medical syringe with a vaccine.
Breast Cancer

Professor Peter Schmid (Barts ECMC lead) is investigating innovative ways to improve care for people with breast cancer. A particular focus of his work is a hard-to-treat breast cancer subtype known as triple-negative breast cancer (TNBC), which grows quickly and does not respond to therapies commonly used to target other types of breast cancer, such as hormone therapy. This means that while survival of breast cancer as a whole has doubled in the past 50 years, TNBC has not seen the same improvements.

Professor Schmid and his team are testing new types of immunotherapy, which help our own immune system fight cancer. These include immune checkpoint inhibitor drugs, which stop cancer cells from hiding from the immune system, and antibody-drug conjugates, which bind to distinctive molecules on cancer cells and release a tumour-killing payload.

Professor Schmid led the Impassion130 trial, which found that a combination of immunotherapy drugs extended survival in people with TNBC. This led to the first approval of an immunotherapy for people with breast cancer. Professor Schmid also led the KEYNOTE-522 study, which found that people with TNBC who were given an immunotherapy in addition to chemotherapy before surgery had a 37% lower chance of their cancer coming back.

Bladder and Kidney Cancer

Professor Tom Powles’ research focuses on bladder and kidney cancer. Historically, bladder cancer hasn’t attracted as much research attention as some other cancer types, leading to a lack of effective treatments. Most patients with advanced disease die within a year of diagnosis.

This year, following decades of work, Professor Powles and his team published groundbreaking results of the EV302 trial, which revealed that a drug combination that uses both immunotherapy and chemotherapy doubled life expectancy in people with advanced bladder cancer from around a year to two-and-a-half years.

This advance has been referred to as “the biggest breakthrough in the treatment of advanced bladder cancer that we’ve had in roughly 40 years”. The results led to Professor Powles being featured in Nature’s top 10 list of people who shaped science in 2023 and TIME magazine’s top 100 most influential people in global health in 2024.

Professor Powles' clinical trial work in kidney cancer has also seen recent success, with results from the KEYNOTE-564 trial showing that an immunotherapy can improve survival when given to patients after they receive surgery for their cancer.

Mesothelioma

Professor Peter Szlosarek’s research has unveiled a breakthrough in the treatment of a rare but rapidly fatal form of cancer known as malignant plural mesothelioma. This tumour type affects the lining of the lungs and is usually caused by to exposure to asbestos. It currently has one of the lowest survival rates of any solid cancer, with only around 5-10% of patients surviving for 5 years.

Professor Szlosarek has developed a unique approach that starves tumours by cutting off their food supply. Twenty years ago, while completing his PhD studies in Professor Fran Balkwill’s lab, Peter discovered that some tumour cells lack an enzyme called ASS1 that allows them to manufacture an important nutrient – the amino acid arginine. This was the first step in two decades of research that eventually led to the ATOMIC-meso clinical trial. The combination of Professor Szlosarek’s arginine-starvation technique with conventional chemotherapy quadrupled the number of patients still alive after 3 years, with certain patients seeming to respond especially well to the treatment. Professor Szlosarek and his team are investigating whether this approach can also be applied to other types of cancer.

Looking to the future

Hundreds of different trials across a spectrum of cancer types are currently underway within Barts ECMC, and we look forward to seeing similar success stories emerging in the coming years. Going forward, the centre plans to build on existing strengths such as immunotherapy while also pursuing emerging therapies and approaches to running trials that show exciting potential. Another focus will be to increase engagement with patients and overcome barriers to access – the Barts ECMC is pleased to serve an incredibly diverse patient population in London, and will work to reduce barriers to access and engage with patients no matter their background.


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