September 2008 transcript

00:00

Kat: Welcome to September's Cancer Research UK podcast. In this month's show you can find out how to have your say on the recent decision by NICE to reject four kidney cancer drugs, and there’s an interview with TV newscaster Nicholas Owen.

Coming up later, we visit a new £20 million drug development centre that we're building just outside London. But first, here's the news with Jo Owens.

00:58

Jo: Cancer Research UK has expressed deep concern over the decision by NICE, the National Institute of Health and Clinical Excellence, to reject four kidney cancer drugs. NICE has ruled that although the drugs are clinically effective for people with kidney cancer that has spread, they are not good value for money for the NHS.

Because metastatic kidney cancer is rare, affecting fewer than 2,000 people every year in the UK, there isn't enough data from large clinical trials to know for sure that the drugs work. But evidence from smaller studies shows they can be effective, and there are no other treatment options for this type of cancer.

Here’s Jon Spiers, from our Policy and Public Affairs team.

"Cancer Research UK is very disappointed with NICE's preliminary decision but we want to know what you think. You can email us at kidney@cancer.org.uk or you can leave a post on our blog. We will be making representations to NICE about this so it would be really nice to hear from people - please do get in touch."

A report funded by Cancer Research UK and published in the British Journal of Cancer has shown that cancer survival for teenagers and young adults is up by around 11% over the past two decades. The greatest increase was seen in leukaemia, where survival rates have increased by more than 20%.

Previous studies had classed cancer patients as either adults or children, but this work looks specifically at people aged 13 to 24.

The report will act as a baseline for monitoring further improvements in survival for this age group, as well as informing the development of specialised cancer care for teens and young people. It has also identified specific cancers where more work needs to be done, such as brain tumours and bone cancers, where survival rates have changed little since the mid-80s.

And finally, Cancer Research UK scientists in Edinburgh have carried out an important study highlighting depression in people with cancer. The team found that cancer patients are three times more likely to think they would be "better off dead" or to contemplate suicide than the rest of the population.

Patients were most likely to have these thoughts if they had substantial pain and particularly if they had serious emotional distress.

Almost 3,000 people took part in the study at the Edinburgh Cancer Centre. The results highlight the need for more support services to be available for cancer patients, particularly in the area of pain management.

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.

03:28

Kat: TV presenter and news anchor Nicholas Owen is a familiar face to many people from his work on ITN and BBC News 24. But you may not know that he's a tireless supporter of Cancer Research UK, and has helped out at many of our events. He's also a cancer survivor.

I spoke to him at the rather noisy Parliamentary launch of our recent Screening Matters campaign to hear his story.

"Five and half years ago I was suffering from "grumbling gut". My wife got tired of hearing me complain about it and she said why don't you go and see a friend of our who's a specialist in that area? He examined me and said he didn't think there was anything wrong with me, but why not have a scan just in case.

I had the scan and there was a tumour on my right kidney. I had no idea about it, I had no symptoms. But here's a great example of cancer being spotted really early - I'm very, very lucky. The kidney was removed and here I am, five and half years on, and the specialist tells me I'm alright so far!

I've been very fortunate to be involved with Cancer Research UK and I'm an enormous admirer of the charity. My roles in it have included all sorts of extraordinary things. I remember addressing a meeting in Brighton not too far from where I live, encouraging people to leave money to Cancer in their wills - a most important thing to do. Another thing that I do a lot of is with our local Cancer Research UK shop in Reigate where I live. I pop in and out of there and take a lot of my old ties in there. I've got a nasty feeling I end up buying half of them back!

It's a marvellous team there - they epitomise to me what is good about Cancer Research UK, depending on the work of marvellous volunteers. The oldest lady serving in our shop is over ninety! The effort that goes in, the dedication, the long hours, it's been extraordinary.

Over the years, the picture has changed for cancer. I hope that the word "cancer", which is still whispered in some quarters, gradually we’re changing that. In America now, getting cancer is like getting pneumonia - it's serious but with a bit of luck it won't kill you. If screening programmes are widely used, scans and early diagnosis, that's the absolute key.

We are moving away from the idea that cancer is an absolute killer and that's the end of it. Unfortunately many people do pass away from the disease, but an enormous number of people are now living with rather than dying from cancer, and that message is gradually getting out there. I'm always banging on about it - "Look at me! Look at me! I'm still here!".

The future is very bright. In this country we have a very good cancer screening programme. We fall down in some other areas, and we must do better of course. But GPs are getting better at spotting things, loads of things are getting better over time. Just look at the figures - it's very simple. We're all living a lot longer, and within that people are being diagnosed with cancer and having it treated so it doesn't kill them off early.

If someone was thinking of supporting Cancer Research UK, I'd say please do it. It makes really good sense. It's a massive organisation, but at the same time it's not so big that it isn't effective. I know that with some charities, people worry that the money doesn't get spent properly, but this really does do the job.

It's been rationalised over the past few years, bringing together two big charities that were competing. It's out there, it's spreading the word, encouraging things like screening and early diagnosis and getting away from the stigma of cancer. All these things are gradually changing and Cancer Research UK is doing a tremendous amount towards it."

Kat: And you can find out more about all the different ways to support our vital work on the web at www.cancerresearchuk.org/supportus

08:02

Kat: Biotherapeutics - or biological therapies - are treatments that use molecules made by living organisms. Research shows that antibodies, proteins, DNA and viruses all have the potential to target cancer cells, but progress has been fairly slow - partly due to a lack of suitable research facilities.

So in 2006, Cancer Research UK decided to fund a new £20 million Biotherapeutics Development Unit in South Mimms, Hertfordshire. Once completed, it will provide a unique centre for scientists across the UK, and will hopefully increase the number of drugs making it to clinical trials.

Our roving reporter Anna Lacey went to see how the building work is coming along, and was guided round the site by Gill Lewis, the Head of the Biotherapeutics Unit.

Biotherapeutics Development Unit package

After passing through security and putting on a hard hat and fluorescent jacket, I was finally ready for my tour of the new Biotherapeutics Development Unit. It's still a building site at the moment - which explains the exciting wardrobe - but there were enough walls and doors in place for Gill Lewis to show me round.

"We're now in the heart of the building where w'’re going to manufacture the products. We've got this corridor that we're standing in, which is a general access and viewing corridor. What we do is make biological products - products from animal cells or bacterial cells or yeast cells. Those products range from antibodies through to cancer vaccines, or even viruses. We have to grow those up - that's called fermentation - and then we need to purify them. That gets them into a state where we can send them off to the clinic.

With regard to cancer, these days people are moving towards therapies where they can have fewer side effects. Traditional therapies affect all the cells in the body, but these can be targeted directly towards the cancer cells. Also, we're hoping to use them in combination with traditional therapies, to get those better targeted towards cancer cells.”

A well-known example of a biotherapeutic drug is Herceptin - an antibody used to treat breast cancer. But most other biotherapeutics are still in development or going through early phase clinical trials. Gill hopes that this new facility will speed up the process and bring more biological therapies to the clinic sooner.

"Our current facility only has the capacity to do two or so new products per year, and we can only make products from mammalian cells or bacteria, because of the size and the space restraints that we have. But in this facility, we would have the potential to do a lot more - maybe up to ten new products a year from a whole range of sources.

One of the up and coming things is working on viral vaccines, and in this facility we are going to have a dedicated unit where we can manufacture these. It's very important because the charity wants to continue to develop these projects, but at the moment the only way to do that is to contract them out to outside companies. But actually the unit is going to have the facility to do this for ourselves. It means that we can push forward on the development of these viral vaccines that are really at the cutting edge of some of the new biological therapies that people are working on."

As we continued on the tour, it became clear that the building had been specially designed to stop the drugs becoming contaminated at any stage of the manufacturing process.

"This corridor is the clean corridor - and although we're standing here in hard hats and boots, in manufacturing you’d be dressed up in clean room clothing - we call it a "bunny suit", it's an all-in-one suit. You have gloves, a hat, a mask and special shoes as well, a bit like in the movies.

Although it's all about the science, developing these better treatments, most importantly it's about patient safety. All of the rooms and the set-ups are to ensure that when we manufacture, we don't introduce any contaminants.

I've been working on this for ten years plus, and it's purpose-built to our needs. So to have a brand new purpose-built facility with the right air handling and the right cell services, and able to house the number of people to do the job, and to showcase what Cancer Research UK has been doing very well since 1990 is just unbelievable. Every time I come down and visit this building I have a smile on my face, and for Cancer Research UK to invest such a huge amount of money and confidence in the unit is just amazing."

13:40

Kat: When you hear the words "clinical trial" you probably think of testing new drugs. But that's not always the case. I spoke to Richard Stephens, a senior research scientist at the Medical Research Council Clinical Trials Unit in London, to find out more.

"Trials are not just all about new drugs that come along. It's important that we test all medical procedures and interventions. In fact many medical treatments come into general use simply because the benefits seem obvious at the time. Sometimes we need to go back and have a more formal look at some of these treatments. It's surprising when you look back how few treatments that patients routinely receive have actually undergone rigorous clinical trials.

Let me tell you about one of the trials we're running here, looking at patients who have lung cancer and then develop brain metastases - the cancer has spread to their brain. These patients have a very poor prognosis, which is usually only weeks, at most months. Steroids can be given to palliate symptoms, but over the years there has been a move towards giving such patients whole brain radiotherapy - giving them a course of radiotherapy to the brain to try and palliate the metastases in their brain.

This has really just come along through clinicians wanting to do something for these patients, but it has never been tested in a randomised trial. So the trial we're involved in is called Quartz, and what we're doing in this trial is trying to see whether giving patients whole brain radiotherapy is actually beneficial, in terms of increasing their survival or improving their quality of life.

This is a really interesting trial because we have a situation where the standard routine treatment is to give radiotherapy, and the questions we want to ask is "Is this doing patients any good?" Is it improving their quality of life, or extending their survival?

In a sense, the new experimental treatment is to not give radiotherapy, which is quite a difficult concept for people to take on. You normally think of trials adding treatments or investigating new treatments and here we are actually stepping back and saying "Are we actually doing any good?" and the experimental arm is actually not to give the radiotherapy.

Lung cancer is of course the most common cancer worldwide, and about a third of patients will actually develop brain metastases. So this is a big problem. We're hoping to recruit about a thousand patients into the trial, to clearly show the benefits - or not - of whole brain radiotherapy.

We currently have about 80 centres in the UK who've expressed interest in the trial. There's groups in Australia and New Zealand who are participating, and we are hoping that groups in Canada and the rest of Europe will also come on board, so that we can get a large number of patients into the trail and the results are very reliable."

Kat: And you can find out more about the Quartz trial from our clinical trials database.

17:27

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, and because it's October, we'll be focusing on breast cancer awareness, so until then, goodbye!

• Credits:
• Presented and produced by Kat Arney
• News by Kat Arney and Jo Owens
• Biotherapeutics Development Unit package by Anna Lacey
• Original music written and performed by Kat Arney and Henry Scowcroft
• With special thanks to all the participants