A personalised pathway: cancer’s road to recovery

COVID-19 has had an unprecedented impact on cancer research and services. In response to the global pandemic here in the UK, cancer screening was suspended, routine diagnostic work deferred and only the most urgent cases prioritised for treatment.

Most face-to-face consultations I had done on the phone, clinical trials were halted and research labs were shut down.

As the lockdown has eased, things aren't getting going again. Clinical trials have re-started and the labs have reopened, but we're no way back to anything like full capacity.

The reality is that there is a backlog across the entire cancer pathway with thousands of patients waiting for diagnosis. In the last two months, a lot less people began treatment compared to this time last year. But cancer isn't going away.

Many of us, our friends, our close family members will still be affected by this disease at some point in their lifetime and so we fully expect to see a rebound with substantial increases in cancer deaths over the next few years.

Later detection means lower survival rates more, costly treatments, more palliative care. All of this will put an extra burden on the NHS. Now, the last 20 years we've seen great progress improving cancer treatments so if we're to continue to improve the outcomes for cancer patients in the face of the COVID-19 pandemic, then urgent action will be necessary to mitigate its expected impact.

So, more than ever, it's critical that we get the right treatment to the right patient at the right time. This concept of course is not news the very essence of personalised oncology.

But now - more than ever - we need to get better at tailoring treatments to the needs of the individual cancer patient based on the specific features of their specific disease.

In Manchester, we're already pioneering personalised cancer treatments through our basic research, our research on biomarkers and our efforts to understand and develop novel anti-cancer drugs. In addition, we're creating living biobanks, where we collect patient biopsies and rather than fixing them for standard pathology analysis, we bring the tumours into the lab and generate growing cell cultures.

Figuring out how to do this was not easy, but it's an amazing advance because it allows us to study the living tumour cells in the lab with each culture reflecting the specific cancer from that patient.

This is especially important with ovarian cancer, where there's so much disease heterogeneity. So far in my lab, we've established cell cultures from over 50 different ovarian cancer patients and we're now testing them against a battery of chemotherapy agents - both traditional drugs and new therapies - in order to determine which drugs any given tumour will or will not respond to.

Now, in parallel, we're analysing the molecular features of the tumours to see if we can identify biomarkers that will predict which drugs are likely to be effective for that individual.

In several cases, we have multiple samples from the same patients collected at different times, for example before treatment after treatment and then when the disease progresses.

This is very exciting as it allows us to study the tumour as it evolves in response to treatments and develops drug resistance. We already have lots of excellent anti-cancer drugs, but many tumours develop resistance against them.

So, if we can counterbalance or delay the emergence of resistance, we might be able to prolong the effectiveness of existing drugs before moving on to the new ones.

So, you know, while the concept of personalised medicine is not new, what we're doing in this space is new, including, for example, our work building a living biobank of ovarian cancer samples.

Consequently, Manchester is emerging as a beacon in terms of personalised cancer approaches. And by building on existing efforts, but also seizing new opportunities, we hope to be able to continue improving outcomes for cancer patients in Manchester despite the COVID-19 pandemic.

But it's not just about cancer patients in Manchester. As a global institution with social responsibility at our core, our purpose is to make discoveries and bring about advances that will bring benefits for cancer patients across the globe.

What we learn here in Manchester will have a global application because it doesn't matter where in the world you are, getting the right treatment to the right person at the right time - that's a concept that transcends boundaries.