Sarcoma Unit: research and clinical trials

Soft tissue sarcomas (STS) comprise a group of more than 50 different disease entities with a wide spectrum of malignant behaviour.

Surgery is curative in a significant proportion of cases, aided by radiotherapy, but many patients with advanced disease require drug treatment to control the disease, and in a few diseases chemotherapy plays a major role in contributing to a multidisciplinary curative process.

Increasingly, clinical trials in sarcomas are being stratified according to the individual disease entities and in some cases the presence of specific chromosomal abnormalities or other molecular characteristics are used both to confirm the diagnosis and define the treatment.

At The Royal Marsden we are able to define the molecular pathology of these diseases with the help of world class histopathology and a comprehensive service molecular diagnostic service. We also have the facilities to provide a full range of translational research support in terms of functional imaging and laboratory studies.

The Sarcoma Unit now registers more than 850 patients a year, many of whom come for primary disease management or for second opinions regarding further therapy. This combination of patient numbers and research infrastructure makes us ideally placed to make a major contribution to sarcoma research nationally and internationally.

We try to maintain a portfolio of clinical trials that encompass the major sarcoma subtypes, supporting the studies being conducted by the NCRI Sarcoma Clinical Studies Group, the EORTC Soft Tissue and Bone Sarcoma Group, working with Pharma on industry sponsored trials and conducting our own, investigator-initiated studies.

Our clinical trials team comprises a Clinical Trials Coordinator, a Data Manager/Trials Coordinator, three research nurses and a Clinical Research Fellow. More than 20 years ago we established a comprehensive, prospectively maintained clinical database and now have data on 8,500 patients, providing a hugely valuable resource. This has generated a steady flow of research papers, providing valuable information on the behaviour of individual diseases and hypothesis generating ideas for future, disease-orientated clinical trials.

Clinical research on the Sarcoma Unit is underpinned by the close links with research in histopathology, molecular pathology and molecular biology. The clinical database, one of the largest in the world, is linked to a large library of archived formalin-fixed paraffin embedded tissue samples and a smaller collection of frozen tissue.

Oak Foundation Drug Development Unit

The Royal Marsden has the largest phase I oncology unit in Europe (our Oak Foundation Drug Development Unit) which uniquely affords access to first in-man and early clinical trials for appropriate sarcoma patients.