Dr Andrew Clamp - research
My main research interests are;
- clinical trials in gynaecological cancers
- the optimisation of anti-angiogenic treatment strategies.
The results of the Japanese JGOG3016 trial suggest that weekly dose-dense scheduling of paclitaxel may improve survival outcomes when incorporated into the first-line management for women with advanced ovarian cancer compared to standard 3-weekly scheduling although at the expense of increased toxicity. However, it is currently uncertain whether the benefits of this approach can be extrapolated to a European population and also how dose-dense scheduling can be integrated with neoadjuvant treatment approaches and the use of anti-VEGF agents, in particular bevacizumab. The ICON8 trials programme (CI-Clamp) aims to answer these questions. In collaboration with the MRC Clinical Trials Unit, NCRI Gynaecological Cancer Studies Group and the Gynaecological Cancer Trials Intergroup, these 2 phase III trials will recruit over 2700 women with advanced ovarian cancer to determine;
- whether weekly dose-dense chemotherapy improves progression-free and overall survival compared to 3-weekly treatment (ICON8)
- whether dose-dense paclitaxel is as effective as the addition of bevacizumab to 3-weekly chemotherapy and is a combined approach more efficacious (ICON8B)
The prospective collection of tumour tissue, germline DNA and plasma samples from trial participants (in conjunction with Dr James Brenton -University of Cambridge) will enable a substantial associated translational research programme exploring predictive biomarkers of response and resistance to both weekly dose-dense chemotherapy and bevacizumab. It will also provide a resource for broader research on ovarian cancer biology.
Angiogenesis, the process of new blood vessel development and is vital for the growth of solid tumours. Strategies targeting VEGF the principal pro-angiogenic cytokine have been shown to improve outcomes in the treatment of a wide range of epithelial cancers. However many questions remain to be answered – in particular how should anti-angiogenic strategies be best employed and how can we identify those patients that are most likely to benefit? This last point is particularly apposite given the cost and toxicities of antiangiogenic treatments.
In collaboration with Professor Gordon Jayson, I have an active involvement in an early phase clinical trial programme evaluating predictive biomarkers for anti-angiogenic agents. A key component of these studies is the development of imaging and serological biomarkers that will allow us to direct the future development of these drugs. We have recently completed recruitment to a 70 patient translational research study exploring these biomarker modalities in the context of bevacizumab treatment for metastatic colorectal carcinoma. This has been conducted in collaboration with Professors Geoff Parker and Caroline Dive.