IReC - Current Studies

Our current research projects demonstrate our place as a world leader in this field.

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No other research active departments are able to demonstrate a similar spectrum and volume of research activity on recurrent cancers. We participate in several industry trials, and also support seven future academic clinicians who are performing research in the fields of molecular/genetic science, robotic surgery, and functional outcomes for recurrent cancers. The data from these projects will be used to enhance patient treatment and care and draw further grant funding from competitive national programmes. Some examples are shown below.

Surgical studies:

  • RECUT study  transoral Robotic surgery for rECurrent tumours of the Upper aerodigestive Tract: Sponsored. Chief Investigator: Professor Vin Paleri. Fellow: Mr John Hardman. Trial Manager: Amy O’Reilly

    • We are leading this study across 16 international centres which aims to demonstrate the benefits of robotic surgery in this setting using individual patient data. This will form the largest study of its kind and will publish results in 2021.

  • RECUT PLUS Study  Exploratory study of clonal evolution in cancer for patients undergoing transoral Robotic surgery for radiation Exposed residual/rECurrent tumours of the Upper aerodigestive Tract: Sponsored. Chief Investigator: Professor Vin Paleri. Researchers: Dr Ben O’Leary, Mr John Hardman. Trial Manager: Amy O’Reilly

    • The options to treat recurrent cancers are currently limited. Research has been constrained by information only being available for primary cancers at initial diagnosis. This important study will analyse serial blood and tissue samples from recurrent cancers to understand why they return. By comparing genetic cancer profiles, it may be possible to identify new treatment targets that may be vulnerable to the increasing range of novel agents available today.

  • Functional and quality of life change for patients undergoing treatments for recurrent oropharyngeal cancer and the impact on treatment decision making: Sponsored. Chief Investigator: Professor Vin Paleri. Researcher: Gráinne Brady

    • There is uncertainty in the swallow and speech outcomes following curative (surgery, re-irradiation) and palliative (best supportive care, chemotherapy and immunotherapy) treatment modalities for recurrent cancers. This doctoral work will look at all these modalities and capture data on functional outcomes that will be used to not only decide management for future patients but also to counsel patients after care.

  • Ambient Mass Spectrometry in Head and Neck Surgical Oncology i-Knife: Hosted study. Principal Investigator: Professor Vin Paleri. Fellow: Mr James Higginson. Trial Manager: Melrose Browne-Morgan
    • i-Knife: An 'intelligent knife' that can tell surgeons immediately whether the tissue they are cutting is cancerous or not. Modern electrosurgery generates smoke. Such smoke is a rich source of biological information. Different types of cell produce thousands of metabolites in different concentrations, so the profile of chemicals in a biological sample can reveal information about the state of that tissue. The i-Knife connects the electrosurgical knife to a mass spectrometer, an analytical instrument used to identify what chemicals are present in a sample. It has been shown to be highly accurate (91-98 per cent accuracy) in providing information about the make-up of tissue in real-time, which normally takes up to an hour to reveal using conventional costly laboratory tests. This study aims to integrate the i-Knife into the existing robot to allow real time margin assessment.
  • HoT Trial: Hosted study. Chief Investigator: Professor Dae Kim. Surgical Principal Investigator: Professor Vin Paleri. Oncology Principal Investigator: Dr Kate Newbold. Trial Manager: Melrose Browne-Morgan
    • We are leading this large international, multi-centre surgical trial which is likely to improve outcomes and quality of life for patients with thyroid cancer worldwide. Funded by the NHS and NIHR (£1.7 million), this important trial will provide high-quality evidence to guide the best treatment approaches for patients with thyroid cancer.

Oncological studies:

  • Characterisation of taste issues after radiation therapy: Professor Chris Nutting. Researcher: Dr Romelie Rieu. Trial Manager: Jeane Guevara
    • Taste affects patients variably after radiation. This work will help us to define the spectrum of taste issues after treatment and offer insight into recovery patterns. This will offer information to help counsel recurrent patients before further treatment.

  • T-cell receptor clonality as a marker of response to immunotherapy: Dr Shree Bhide. Researcher: Dr Pablo Nenclares. Trial Manager: Jeane Guevara

    • While immunotherapy has an important role in recurrent cancers, we do not yet have good predictors of response to treatment. This research aims to define new predictors so that the right drug can be used first time.

  • MR-Linac for Head and Neck Cancer: Dr Kee Howe Wong. Researcher: Dr Amit Gupta. Trial Manager: Jeane Guevara

    • Radiation therapy planning needs high resolution images to define the tumour. Conventional planning is performed using computed tomography scans, which are coupled with the linear accelerator (Linac), the machine that delivers radiation. By using an MRI scanner, which offers better soft tissue resolution, this research hopes to improve cancer control.

  • Synthetic lethal interactions between oncolytic virotherapy and targeted drugs: Professor Kevin Harrington. Researcher: Dr Joan Kyula. Trial Manager: Jeane Guevara

    • This lab-based research aims to understand how two experimental non-surgical cancer treatments can augment cancer cell death in the lab. Such work is needed to define possible candidate targets when conventional treatment has failed.

  • Novel plasma Human Papillomavirus DNA assay as a predictor of residual disease for head and neck cancer. Dr Shree Bhide. Researcher: Dr Ben O’Leary. Trial Manager: Jeane Guevara

    • We are leading this large multi-centre trial funded by the MRC and NIHR (£1.9 million) to detect recurrence in patients who have been treated with throat cancer.

  • Systemic immune-activating STING agonists plus radiation therapy: Professor Kevin Harrington, Dr Malin Pedersen. Trial Manager: Jeane Guevara
    • Radiotherapy has the potential to kill cancer cells in a fashion that can activate anti-tumour immune responses, but this process is inefficient and rarely leads to clinically meaningful benefits. In this laboratory-based research, we are evaluating the possibility of boosting the ability of radiotherapy to trigger anti-tumour immunity by using a new class of drugs, called STING agonists. Preliminary data are extremely promising and have resulted in planning for a first-in-human study, which will be led by our team at The Royal Marsden Hospital.
  • Enhancing the effects of Natural Killer cells in head and neck cancer: Professor Kevin Harrington, Dr Emmanuel Patin
    • Building on previous research in our laboratories, we have identified a potential role for Natural Killer (NK) cells in augmenting the anti-cancer effects of a combination of radiation and a novel drug (called an ATR inhibitor) that blocks the repair of radiation-induced DNA damage. By combining radiation and ATR inhibition with antibodies that increase the activation of NK cells, we are able to achieve hugely improved effects against head and neck cancers in experimental models. We plan to translate these results to the clinic in the near future.
  • Treating head and neck cancer with oncolytic viruses: Professor Kevin Harrington, Dr Joan Kyula, Dr Victoria Roulstone. Trial Manager: Jeane Guevara
    • We have an established track record of developing treatments based on the use of cancer-selective viruses that can kill cancer cells and activate immune responses. We are developing a new series of oncolytic herpes simplex (cold-sore) viruses, called RP1, RP2 and RP3, that are being tested in patients with recurrent head and neck cancers. In parallel laboratory studies, we are assessing how we might combine these viruses with existing (and novel) anti-cancer drugs to increase their effects on cancer cells and the immune system.
  • ​​​​​​​Investigation of novel plasma Human Papilloma Virus DNA assay for treatment response estimation in head and neck cancer (INOVATE): Dr Shree Bhide, Dr Maggie Cheang. Trial Manager: Jeane Guevara
    • ​​​​​​​INOVATE is a multicentre prospective biological sample collection and analysis study, which aims to validate circulating Human Papilloma Virus (HPV) DNA as a marker of residual disease in patients with HPV positive oropharyngeal cancer (OPC).