April 2008 podcast transcript

00:00

Kat: Welcome to the Cancer Research UK podcast, with me, Dr Kat Arney. This month we'll be finding out how doctors test new cancer treatments in clinical trials, and we're pulling on our football boots to raise money for bowel cancer research.

Coming up later, we'll be hearing about one woman's experience of cancer screening. But first, here's the news with Josephine Querido.

00:55

Josephine: Cancer Research UK scientists at Newcastle University are starting the first UK trial of a new drug which targets breast and ovarian cancer caused by inherited faulty genes.

The trial is open to women who have already developed an advanced form of breast or ovarian cancer and have been diagnosed with faults in the known cancer genes BRCA1 or BRCA2.

The new drug, called a PARP inhibitor, works by knocking out a key DNA repair mechanism in cancer cells.

Dr Ruth Plummer is the chief investigator on the trial. Here she explains where we go next with this exciting new drug.

"Drug development is a very long process. Here in Newcastle with Cancer Research UK funding we've been working to develop PARP inhibitors for about 18 years. When this trial is finished, in about 18 months, the results of the trial will be available soon after that. If the results are positive, then the drug will go forward for registration"

The new treatment could potentially make a big impact on the way that women with these hereditary cancers are treated. Breast cancer survivor Amanda Monaghan has a fault in her BRCA2 gene. We asked her to explain what this new trial means to her.

"This is just another step forward - I feel as though there's hope. I'm just over the moon that if it ever came back for me and I had to have chemotherapy or radiotherapy a few years down the line they're not going to say "right, that’s it, we've tried everything", now we've got a drug that we could maybe use."

Cancer Research UK-funded scientists at the Institute of Cancer Research have announced the results of a major clinical trial investigating the best way to give radiotherapy to women with breast cancer.

The trial, called START, compared the standard treatment of radiotherapy every day for five weeks, with fewer, larger doses spread over five or three weeks.

After studying around 4,500 women, the researchers found that fewer doses of radiotherapy were just as effective at controlling the cancer as the standard treatment.

Lead researcher on the study, Professor John Yarnold, explains what the results of the trial could mean for patients.

"If the consensus emerges among cancer specialists, and other interested parties such as patients, that this approach is confirmed to be at least as good as the standard schedule, then this approach is at least going to be more convenient for patients because they're going to need to come up [for treatment] at least half the number of times that they usually do - so that's the main benefit.

And there would be benefits for treatment costs for health services, but that was not the driver for the trial. The main reason was a scientific hypothesis that actually we could do better this way."

And finally, just a reminder that our SciencePod podcasting competition for 14 to 16 year olds is now open. A fabulous digital camcorder and an mp3 player are on offer to the lucky winners - but hurry, as the deadline for entries is April the 30th.

To find out more, just visit the Youth and Schools section of our News & Resources website.

Kat: And if you want find out more about these stories, or get the latest from the charity's scientists, and researchers around the world, then have a look at our News & Resources website.

04:28

Kat:In last month's podcast we heard how Cancer Research UK's Screening Matters campaign is moving into the next phase, asking people to contact their MP to push for improvements in screening services.

To highlight the importance of cancer screening, we recently hosted the parliamentary launch of the campaign at the House of Commons. At the reception, MPs heard from Donata Fernandes, whose breast cancer was picked up by screening. Here she tells her story.

"In 2004 I joined my husband in the UK on a spouse visa and I was registered with the GP. Immediately I got a call for a mammogram, which I did attend, even though I was keeping good health - I was wondering what was the point of going. I was very lucky that the mammogram detected a very early stage cancer which the doctors told me was setting in because of the menopause.

I was very shocked, I was confused, but my husband told me that I'm in the best place - the UK - which has got so much research into breast cancer. The doctors, nurses, my GP, everyone told me I should be here. I had the operation, I got medication and today I'm back at work and I'm doing very well. I'm very happy with myself, settling in at the age of 55.

If it wasn't for the screening I would never have known - the cancer in me would have grown to a stage where maybe there would be no comeback. I would just have to live with it and get along with however many days I get."

06:20

Now it's time for the third part of our series on drug discovery. So far we've heard how new cancer targets are discovered in the lab, and how translational research turns them into drugs suitable for humans. From there, the drugs must then go into clinical trials.

To find out how they work, our reporter Anna Lacey went to visit Jonathan Ledermann, the director of the Cancer Trials Centre at University College London.

Clinical trials package

"Clinical trials evaluate new treatments for cancer, and there are different phases of trials. A phase 1 trial is a trial where one assesses whether a drug is safe to give, and this is often given to patients with a number of different types of cancer.

When we have determined the safety, and to some extent the dose and schedule of a drug, then a phase 2 trial is conducted in a larger group of patients with a particular type of cancer. And if the results of that look promising, then the drug is taken into a phase 3 trial, which is in a much larger population of patients with a particular type of disease. So the whole process could take between 5 and 10 years in some cases."

Cancer Research UK currently funds over 100 clinical trials around the UK, and in the first stage - known as phase 1 - the new drug is taken by humans for the first time. To find out who takes part, I spoke to Ian Judson, an expert in early clinical trials at the Royal Marsden Hospital in London.

"Generally speaking, [for a phase 1 trial] we’re looking for patients who have exhausted all the standard treatment options, so there aren't any conventional treatments left to try. Apart from the proof of principle that it's doing what it's designed to do, we're also looking for evidence of anti-cancer activity - looking to see if we get tumour shrinkage, or at least cessation [stopping] of tumour growth, and of course, because these are safety studies, we're looking to document all of the side effects that might be caused by the drug.

In a phase 2 study we're looking for activity against a particular disease, so the end point isn't "what’s the recommended dose?" - that's a phase 1 trial - but it's the percentage of patients that get clinical benefit. Phase 1 trials generally will recruit 30-40 patients. In a phase 2 trial, the minimum size is around 35-45, but some of these are randomised trials so they'll be at least double that size. "

Randomised trials are an important part of drug development, because they allow researchers to see which drug is best without biasing the results. The people in the trial are randomly allocated into two groups - one that takes the new drug and another that takes the best drug currently available. Depending on the results, the drug will either be developed further or put aside.

Last year, 37,000 people took part in clinical trials like this funded by Cancer Research UK. And for scientists like Jonathan Ledermann who run large phase 3 trials, it's these thousands of volunteers who make the research possible.

"Patients would be approached in clinics or on the ward and if they wanted to participate they would give their written consent. We would then be notified at the trial centre and start the process of allocating the treatment, if it’s a randomised trial, to one or other of the groups and the patients would then undergo the treatment.

There can be problems with any treatment for cancer, but in a trial we're particularly careful about monitoring the side effects of treatment and we do this in several ways. Firstly we have a legal responsibility to collect and report important side effects, we have an independent data monitoring committee, and they make a decision as to whether a trial should continue or should stop."

Although it's difficult to say exactly, Jonathan estimates that between one in four and one in three of the trials have a positive result at the end of phase 3. Thus the funding of clinical trials by Cancer Research UK plays a vital part in the drug development process.

"Clinical trials are essential to this process. They're part of the huge developmental process of taking a drug from its design through its various steps in the clinic. It's important to remember that there are many more drugs coming through now, so we need to have more clever designs of trial so we can look at several drugs in quick succession and decide which one or ones to take forward. So I think there are a number of strategies that we’re going to have to develop to make the whole process more rapid."

11:51

Kat: And finally, if you play football then here's a great fundraising event for you to get involved in. The Bobby Moore Fund for Cancer Research UK has teamed up with Gillette to create an exciting five-a-side football tournament, with the final taking part in West Ham's ground at Upton Park.

I caught up with Luke Pickering to find out what it's all about.

"This summer we're hosting the first ever five-a-side football tournament in aid of bowel cancer research. It's going to see about 200 teams up and down the country battling it out to reach Upton Park.

There's 8 regional heats and each heat will have 30 teams. They're taking place across the country at Teesside, Leeds, Sheffield, Birmingham, Southampton, and there's three in London at Wimbledon, Wembley and Dagenham. They're taking place on Sunday 18th of May, the day after the FA cup final. The final is on the 2nd June at Upton Park.

People can register a team online at www.bobbymoorefund.org/football. It's £100 for a team to enter, and then once you enter you get a fundraising pack including T-shirts, ideas for fundraising etc. We ask each team to raise about £150 per team, so if you've got a team of 8 lads that's only about £20 per man. There can be 5-8 players in a squad, but only 5 on the pitch at any time, and it's just for men. We're hoping to raise about £70,000 for the Bobby Moore Fund.

Tom is taking part in the championship. "I decided it would be really good to get a group of lads together to play football in London, and because of the fact that it's for the Bobby Moore, Fund, which is something that's close to my heart, I thought it would be really enjoyable. We've got a good group of lads together and I hope can surprise everyone and make it to Upton Park and do our best when we get there.

If you play football on a Saturday or Sunday or even midweek, you're doing it to keep fit and play football, just because it's a great game. But because of the link with the Bobby Moore Fund it gives it a little more emphasis to get involved. In the long run it's football - it's what we enjoy, it's competitive, and to get ourselves to Upton Park would be fantastic."

14:59

We've reached the end once more so we hope you've enjoyed the podcast. Don't forget that your feedback is vital in helping us improve the show, so please send us your comments and suggestions by email to podcast@cancer.org.uk.

We'll be back next month with all the latest news from Cancer Research UK, including our top tips for staying SunSmart this summer.

• Credits:
• Presented and produced by Kat Arney
• News by Josephine Querido and Kat Arney
• clinical trials package by Anna Lacey
• Outside broadcast assistance from Jonathan Shelton
• Original music written and performed by Kat Arney and Henry Scowcroft
• With special thanks to all the participants