Leeds Institute of Cancer and Pathology

Defining a research programme in advanced radiotherapy

Dr Ann Henry Associate Professor in Clinical Oncology

a.henry@leeds.ac.uk

Leeds Institute of Cancer and Pathology

Leeds Radiotherapy Research Group

2008 Move to Bexley – State of art equipment but no people nor time!

• UoL research group established 2012 • Pump priming through Burton family and LTHT Charitable

Foundation • Aims

– To become an internationally recognised Centre of Excellence

– To deliver world class patient focused research embedded in the NHS

– To realise patient benefit from new radiotherapy technology

Leeds Institute of Cancer and Pathology

What did we do?

• Building a multi-disciplinary team research team – Appointing UoL clinical academics with dedicated academic time – Supporting NHS research active clinical oncologists – Grants to support additional staff across physics and radiographers – External PhD/MD fellowships

• Promoting industry links – Elekta supported research on FFF and Agility heads – More recently MIRADA and Raystation

• Radiology support – Essential in radiotherapy research – Charitable funding to buy out radiologists time, support clinical fellows

and imaging costs

Leeds Institute of Cancer and Pathology

What did we do?

• Promoting interdisciplinary research – Translational – Imaging – Psychosocial Oncology Research Group – Health Economics – Leeds Institute of Data Analytics

• Clinical Trials Research Unit support – YCR support for early phase clinical trial unit – Access to trial methodologists and statisticians

• Increasing national and international profile – CTRad group – NCRI clinical studies groups

Leeds Institute of Cancer and Pathology

Translational work

Professor Susan Short

Leeds centre for translational neuro-oncology programme grant The Brain Tumour Charity. 2014-2019. £1.4 M

Leeds Institute of Cancer and Pathology

eRAPID: electronic patient self-Reporting of Adverse-events: Patient Information and aDvice.

Patient recruitment and retention in pilot and randomised studies in oncology

Galina Velikova, Kate Absolom1, Simon Pini1, Trish Holch2, Lorraine Warrington1, Marie Holmes1, Andrea Gibson1, Zoe Rogers1, Sarah Dickinson1, Robert Carter1, Beverley Clayton1, Susan Davidson3, Jacqueline

Routledge3, Kevin Franks1, Ann Henry1 University of Leeds, The Christie Hospital Manchester, Leeds

Beckett University

Leeds Institute of Cancer and Pathology

NIHR eRAPID Multi-centre programme in systemic therapy, radiotherapy and surgery (2011-18)

Radiotherapy

Upper GI surgery

Chemotherapy Radiotherapy

Improve the safe delivery of cancer treatment Enhance patient care and experiences Standardise documentation of AE

eRAPID Electronic patient self-Reporting of

Adverse events, Patient Information and aDvice system

53.2Gy 28F

58.8Gy 28F

61.6Gy 28F

Ph II

Ph III

Pilot

T3/4 Nany,T2N1-3

Pilot/Ph II/PhIII

N=640

ACT5

ACT3

Obsn

Margin ≤1mm

41.4Gy 23F

T1 N0/X Anal margin Local

excision

Phase II trial

N=90

50.4Gy 28F

41.4Gy 23F

ACT4

T1,T2<4cm N0/X

Randomised 2:1

Phase II trial N=162

PLATO - PersonaLising RadioTherapy dOse for Anal Cancer

Leeds Institute of Cancer and Pathology

CRUK CTRU Core funding - 2018

• £1.8m over 5 years • Two themes

– Radiotherapy – Haematology

• Radiotherapy trials – Drug Radiotherapy

Combinations – Novel radiotherapy including

Proton Beam – Innovative design including

platform studies

Leeds Institute of Cancer and Pathology

2017 CRUK Network Accelerator award

• ART NET: Advanced Radiotherapy Technologies award

• 4.2m over 5 years across five centres – Leeds £0.9m

• Optimising SABR, MRI and Proton RT

• Three posts – Research physicist – Research radiographer – Clinical PhD – Biostatistician

Oxford

Leeds Manchester

ICR/RMH

UCL

Leeds Institute of Cancer and Pathology

CTRad Centres of Excellence in

Academic Radiation Oncology

Outcomes 2009-2015

Leeds

National bench marking

Leeds Institute of Cancer and Pathology

CTRad Centres of Excellence

Leeds Institute of Cancer and Pathology

Sustainability: developing future academic leaders

YCR / University of Leeds University Academic Fellows (UAF) with 5 year funding (to Associate Professor)

– Academic component of salary – Consumable budget, support costs

Dr Louise Murray • Clinical Oncologist • CRUK PhD Leeds • Fellowship Toronto

Dr Ane Appelt • Physicist • PhD Copenhagen • Post doc Denmark

Highlights • MRC Confidence in Concept –

Reirradiation • EPSRC – ePROMS SABR toxicity

Highlights • Co-lead YCR Aphrodite trial in

rectal cancer • Big data distributed learning

anal cancer

Current PhD and MD students

Dr Chris Jones • Clinical

Oncologist

Dr Katie Spencer • Clinical

Oncologist

Dr Fin Slevin • Clinical

Oncologist

Dr Fei Sun • Clinical

Oncologist

Mr David Bird • Physicist

Early mortality outcomes and cost-effectiveness of palliative radiotherapy for bone metastases in the English NHS

Optimising pelvic SABR (ART NET)

Cardiovascular outcomes in lung cancer

Mri-only treAtmeNT planning for Anal and Rectal cAncer radiotherapY (MANTA-RAY)

Unravelling non-genetic oncogenesis in oesophageal adeno-carcinoma: characterising the stress-inducible FGFR2-Grb2-miRNA axis

Ms Emily Johnstone • Physicist

Automated MRI based radiotherapy planning for brain tumours

Leeds Institute of Cancer and Pathology

My story

• Intercalated degree with breast cancer project • MD Christie IGRT • NHS consultant post Leeds

– Work within CTRad and ESTRO – Co-investigator on national trials (PROMPTS,HYBRID,RAIDER) – PhD supervision (clinical fellow and medical physicist)

• Departmental support to buy out time – Challenge with clinical work and future uncertainty

• 2015 Move to University of Leeds – Associate professor post – Initial probationary period – Move to tenure

Leeds Institute of Cancer and Pathology

Challenges • Performance management

(Self and others) • Accepting rejection and

moving on • Developing a thick skin • Balancing NHS and

academic workload (letting go)

• Understanding culture and working within University

Advantages • Growing a team • Informing clinical practice • Flexibility • Variety • New people and new

places • Supervision and

mentoring • Lifelong learning and

participating in University life

Leeds Institute of Molecular Medicine

Radiation Therapeutics

University metrics

Grant income

PhDs

Publish

Radiotherapy Clinicians

Clinical Trainees Biostats Imaging Trainees

Radiographers

Manager

Physicists

Imaging Clinicians

Prof David Sebag-

Montefiore Research

Group

Prof Susan Short