The Cancer Network in Greater Manchester has 11 cancer tumour groups which meet every three months. These tumour groups are made up of the specialist staff who are involved in this area of care, including oncologists, cancer surgeons, managers, nurses and other staff. Importantly, the tumour groups also have a research lead to co-ordinate research across the group.
Two of these tumour group research leads – Dr Was Mansoor, oesophagogastric tumour group research lead, and Dr Michael Braun, colorectal tumour group research lead – have played a large part in increasing recruitment in their respective groups over the past year.
The research leads have been supported by Greater Manchester and Cheshire Cancer Research Network. Zoë Coombe, Research Network Manager, said: “Both Dr Mansoor and Dr Braun have done a lot to increase the amount of research being undertaken in their tumour groups. While both are Consultant Oncologists at the Christie NHS Foundation Trust, they have been helping to spread the research message across other Greater Manchester and Cheshire hospitals.”
Oesophagogastric tumour group research
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For the oesophagogastric group Dr Mansoor worked with the Research Network to develop a handbook for the multi-disciplinary team (MDT) meetings that gives an summary of trials that are on the NIHR Portfolio, an overview of each trial, and who and where to refer patients to.
Recruitment has also been improved by having oncology representation at MDT meetings. Dr Mansoor said: “This representation has been crucial to helping recruitment to trials and has not been present in recent years. It means there is someone at the meetings who is always looking out for possible patients for trials.
“Another area, which has arguably had the biggest influence in raising recruitment is capacity. You can’t run cancer trials without having medical, nursing or data management support and we’ve seen an increase in this support. For example, here at the Christie, in 2006 we had just a single Upper GI consultant who was looking at oncology and this was only a part time position who was helped by perhaps two research nurses. Now, those numbers have steadily increased so we have four consultants, a full research tem and data management support, giving us the capacity to take on more trials and with each trial it means we can meet the targets that we have been set.
“The increase in cancer trials on the NIHR Portfolio that we can recruit has also helped and we’ve got better at tapping into the support available from the National Cancer Research Network.”
While most of the improvements have been in randomised control trials (RCTs) across the Network, seven Greater Manchester and Cheshire hospitals have also contributed to non-RCTs.
Dr Mansoor said: “It is great to see sites contributing to research trials where they can. Regardless of if they are, simple questionnaires and blood samples they still count to recruitment and give sites an insight and an idea of what research involves.
“In 2011-12 we expected to have all 11 of our sites involved in some way in oesophagogastric research so I’m hopeful that this will provide more patients access to research studies.”
Colorectal tumour group research
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Matching trials to expertise and facilities is an important factor in increasing research away from Tertiary Centres and Teaching Hospitals and into District General Hospitals and is something Dr Michael Braun has been doing with the colorectal tumour group.
Dr Braun said: “We’ve been looking at other sites in Greater Manchester where we could do research. We have units in Stockport and Macclesfield that have the capacity to carry out chemotherapy studies but other sites don’t. So as a group we’ve been looking at other studies these sites can take part in, which could be surgical or a genetics study. This gives all sites and their patients access to research studies.
“For example, we’ve been successful in recruiting patients to a genetics study that purely identifies patients who are under 70 and have had bowel cancer in the last five years. Patients are recruited through a simple blood test and a questionnaire so it’s straightforward for a site with limited resources to do. Because it’s so simple and straightforward patients have been generally happy to take part and it has the added benefit that many patients have an interest in why they have developed cancer.
“For teams new to research, these ‘simpler’ studies can often be a precursor to starting other studies at sites and give staff an idea about what research involves. However, there are limitations to what studies some hospitals can carry out due to the nature of the study and the staff or facilities. All research generally improves the interactions between the clinical and research teams.”
While genetics has been a strong area of recruitment in the last year, the tumour group has also built up a number of new chemotherapy studies. Dr Braun added: “Many of these studies are based at the Christie but we’ve also opened some chemotherapy studies at other sites. Many are randomised studies and it’s a key objective that we improve recruitment to RCTs. We’ve also indentified a lack of surgical trials as a gap that we are looking to fill as this would allow more sites to offer patients the option of recruitment to a trial. This helps us to meet our objectives as a Research Network.”
