Pioneering Research
Background
The early funds raised by the then ‘Orchid Cancer Appeal’ supported three groundbreaking programmes being undertaken by staff from The Men's Cancer Unit at St Bartholomew's & The Royal London Hospital's NHS Trust, under the direction of Professor Tim Oliver in his capacity as holder of the Maxwell Joseph Chair of Medical Oncology in the School of Medicine, Queen Mary University College, London.
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Clinical Research
This programme was initially set up as a Clinical Trials Unit. Since the necessary structure was not available elsewhere in the hospital, the charity funded not only a Clinical Senior Lecturer (Dr J Shamash) and the Clinical Trials Nurses, but also a Computer Programmer, Data Manager and Administrator without whom the trials could not have taken place. Dr Shamash’s background in dose intensification chemotherapy in cancer has enabled him to focus on improving the combination and sequencing of existing drugs, and investigate how to treat effectively testicular disease that has failed conventional regimes. In addition, he has had some considerable success in developing new treatments for aggressive or recurrent prostate cancer from his laboratory research, in particular in identifying possible means by which to re-sensitise the prostate tumour to hormone therapy after it had become resistant to it. He has been recently joined by another Senior Lecturer, Dr Tom Powles, to enable more rapid progress in taking these and the associated laboratory studies forward.
Dr Shamash’s specialism complemented Professor Oliver’s research strengths in immunology and hormone therapy, where his work on trials in prostate and early testis cancer has focused on two specific trials, i.e. the use of intermittent hormone therapy for prostate cancer and the use of chemotherapy for conserving the testis in men with compromised testicular function. This work was initially thought to be somewhat speculative, but is now receiving increasing recognition. The International Study into the use of Intermittent Hormone Therapy in the treatment of Carcinoma of the Prostate (ISICAP) saw pan-European and North American trials confirming the early observations that interrupting courses of hormone therapy for prostate cancer could lead to longer period of remission and fewer side effects. In addition, more recently, the national clinical trials group in the UK has begun to explore ways of expanding the observations on testis conservation through a larger trial. Dr Powles has taken over some of these programmes, now that Professor Oliver has officially retired.
We at Orchid are especially proud to have supported this activity for more than 5 years. If evidence of its success was needed, beyond the numerous publications of its results and the positive outcomes for patients involved, it is the establishment in the School of Medicine, QMUL, of one of a small number of Experimental Cancer Medicine Centres, under the aegis of the Medical Research Council and Cancer Research – UK. The Director of the CR-UK Clinical Cancer Centre said that the Orchid CTU was a pivotal factor in the success of this initiative, as it was a model for how the Trials activity should be organised.
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Scientific Research
Professor Oliver’s vision has long involved a holistic approach to the challenges of fighting male cancers, as he recognised the need to link scientific and clinical research, since that is the only way to ensure that the work is focused on, and in the end benefits, patients. He was ahead of his time, as only last year the government announced that the key component of medical research in UK must be its translational nature. So, in sound bite terms, it must be ‘bench-top to bed-side’, or in the case of male cancers, perhaps more appropriately – ‘lab to lad’.
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Laboratory Programme
Under Principal Investigator, the Senior Lecturer Dr Yong Jie Lu, has developed the work by a previous Orchid researcher, Dr Jon Strefford, and is investigating new techniques using molecular cytogenetics to improve the early diagnosis of testis and prostate cancer. In addition, his work aims to understand the genes and molecules that contribute to the chemo-sensitivity of testis cancer and sperm precursors in infertility.
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Carcinogenesis Programme
This has build on past observations on the common factors linking infertility and testis cancer. Senior Lecturer Dr David Prowse, first studied the role of the HPV "wart" virus associated with penile and cervix cancer as a "hit & run" starter motor for prostate cancer. This was based on the hypothesis that the disease is acquired as a result of early sexual experience, and persists because of poor nutrition and hygiene, in order to explore ways of developing a preventative vaccine. Recently he turned his attention to signaling pathways - the mechanisms by which cancer cells circulate through the body - which is the very essence of why cancers that start in one organ ultimately end in spreading (or ‘metastasising’) through out the patient’s body and causing death.
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The Orchid Tissue Bank
To ensure that scientific research can be converted into clinical outcomes, Orchid also funds vital enabling research activity, including investigation into the effect of drugs on the body - called pharmacology – and what causes cells to respond differently to treatment regimes and dosage. The most significant funded research stream in this area is that of histopathology, under Dr Dan Berney, newly awarded a Readership at QMUL. His work has seen the establishment of the Orchid Tissue Bank, a nationally accredited facility that is involved in important international collaboration to secure, save, and analyse tissue in partnership with the scientific and clinical teams. The use of human tissue is naturally a highly sensitive subject, and as such warrants the most careful and compassionate handling whether in relation to gaining consent for its use, retrieving the material itself, or its subsequent use. But tissue remains vital to the proving the efficacy of scientific and clinical innovation.
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Independent Peer Review
The Scientific Advisory Board. By its very nature, medical research is expensive and takes a long time to complete - even assuming that the ideas being investigated ultimately bear fruit, which is inevitably not always the case. It’s critical to make sure that the work the charity supports is of the highest quality, and also managed cost-effectively – not just for its own sake, but for the thousands of people whose generous donations enable its funding. Although Orchid’s Board of Trustees contains medical professionals, it is essential to have the independent opinion of eminent individuals in the field. The charity is therefore honoured to have the assistance of a prestigious Scientific Advisory Board, under the chairmanship of Professor Norman Maitland of York University, to review its funded research work.
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Achievements
In its 4th Annual Review, the SAB noted significant progress within the programmes, and commended success in some key research streams.
"The output is formidable, in excellent journals for the most part (a previous criticism) and with a considerable impact."
"…..performing as a respected and important team member for a number of international collaborations….. first rate publications."
"…undoubtedly productive, … science is cutting edge."
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