(within the UCL Cancer Institute, Faculty of Medical Sciences)
The Cancer Trials Centre is a virtual member of ICTM
Director: Professor Jonathan Ledermann
Research areas: Cancer, Phase I, II and III trials
Number of staff: ~100
Number of trials: 70-100
The Cancer Research UK and UCL Cancer Trials Centre (CTC) is one of the largest dedicated cancer trials units in the UK. It was formed in 1997, and is now a research department within the UCL Cancer Institute. The CTC develops and conducts high quality studies to find new ways of treating or detecting cancer, and understanding mechanisms of how cancer develops. It has established collaborations with clinicians and scientists, nationally and internationally, to generate new scientific research proposals, develop laboratory projects associated with CTC studies, and train a new generation of clinical trials specialists.
Studies are conducted in a wide range of tumours, primarily, lung, lymphoma, gastrointestinal, head and neck, gynaecology, brain, and sarcoma. Cancer Research UK provides the main source of core funding, with additional core support from the Lymphoma Research Trust. Individual projects are funded by competitive grants from Cancer Research UK, the Lymphoma Research Trust, the Medical Research Council, NIHR, and major pharmaceutical companies.
Cancer therapies evaluated in CTC trials include established chemotherapy drugs, novel/unlicensed agents, radiotherapy or surgery; and combinations of these. Practice changing trials, published in high impact journals have been reported in cancer of the anal canal, biliary tract, blood, breast, lung, and thyroid. The CTC has a growing number of early phase studies with unlicensed drugs and has recently started trials of advanced therapy medicinal products [ATIMPs] (gene therapies in haematological cancers, and stem cell therapy in lung cancer). This strategy has great potential for cancer research, but requires specialist knowledge to set up and conduct. The CTC also conducts or collaborates on large scale randomised trials in lung and bowel cancer screening, and observational studies to evaluate imaging techniques. About half of all studies involve translational research with collection of patient material. TRACERx, for example, is a multi-million pound large scale cohort study (funded by Cancer Research UK) which aims to understand how lung cancer develops by examining the genetic changes over time, and identifying biomarkers that could predict disease progression and survival.
About 25% of CTC studies are randomised phase III trials (superiority or non-inferiority), 65% phase I/II (including randomised phase II), and 10% observational studies. Both standard and Bayesian methods are currently being used for early phase trials. The CTC also has established expertise in systematic reviews.
Senior CTC staff develop and deliver national training courses in clinical trials (for investigators and other trials units); and post-graduate courses within and external to UCL, for example, the MSc Cancer (UCL Cancer Institute), the MSc Clinical Trials (Institute of Clinical Trials & Methodology), Research Methods (UCL Graduate School), and the UK Clinical Scholars Research Training programme (through Harvard University).
- Case Study - ABC-02
The ABC-02 trial changed the international standard of care for treatment of advanced biliary tract cancer by demonstrating an increase in median overall survival from 8.1 to 11.7 months for cisplatin with gemcitabine compared to cisplatin alone. This was accomplished without a substantial increase in toxicity. The trial recruited 410 patients from across the UK in 6.5 years, and was published in the New England Journal of Medicine (2010). This was a considerable feat and has showcased to an international audience the UK’s ability to conduct large trials in this rare tumour.