The Royal Marsden Healthcare experts

Q&A: Dr Naureen Starling, Consultant Medical Oncologist

Dr Naureen Starling is a Consultant Medical Oncologist based in The Royal Marsden’s Gastrointestinal (GI) Unit, where she specialises in the treatment of patients with oesophageal, gastric, pancreatic, neuroendocrine and colorectal cancers

As well as treating patients, Dr Starling researches these cancer types, with her work focusing on earlier-phase clinical trials, novel therapeutics and the delivery of individualised medicine to patients with GI cancers.

Dr Starling is the principal investigator on numerous international clinical trials and a member of several multicentre clinical trial steering and safety review committees. At The Royal Marsden, she is Associate Director of Clinical Research, Clinical Lead for the West Wing Clinical Research Centre, and Upper GI Lead for the South London Cancer Research Network.

Dr Starling also serves on the UK National Cancer Research Institute oesophago-gastric subgroup and the National Institute of Clinical Excellence Oesophago-gastric Cancer Guideline Committee. She is NIHR Training Lead for the Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), and is one of three Deputy Training Programme Directors for South London Medical Oncology Training.

Some GI cancers can be particularly challenging, but there has been a move to personalise treatments to the individual where possible.

Dr Naureen Starling

Q&A

What services can you and The Royal Marsden offer patients?

The Royal Marsden has an internationally renowned GI Unit, which I am part of, and my area of expertise is in systemic therapies including innovative therapies, used within clinical trials to treat my patients and help them to live well during and beyond cancer. One of our strengths in treating patients is through our multidisciplinary team (MDT) meetings. These are critical to us providing the best treatment and care to patients.

Why are MDT meetings so important?

We meet once a week; included in the meetings are surgeons, clinical oncologists, radiologists and interventional radiologists, along with our colleagues in histopathology and nuclear medicine. They are all experts in their field and we come together to jointly review our patients and devise individual treatment plans. Not only does this mean patients get the best treatment from world experts, but the approach ensures efficiency and a more streamlined treatment pathway for them.

What developments are taking place in the treatment of GI cancers?

Some GI cancers can be particularly challenging to treat, but there has been a definite move to personalise treatments to the individual and their tumour where possible while exploiting new technologies. The GI Unit is an academic unit and we are at the leading edge in terms of clinical research. This means that there is a culture of innovation, and we aim to rapidly translate new treatment options and technological advances into the clinic for the benefit of our GI patients. Increasingly in some GI cancers, we are looking at how we can harness the body’s own immune system using immunotherapy. This is evolving research for what is currently just a small group of patients. However, considerable clinical research is being done in this area and it could lead to more durable treatments for patients and better outcomes.

During your career, what have been the biggest changes in treatment for patients with GI cancers?

For some of the GI cancers I treat, patient outcomes can be poor, but in the past decade there have been some significant breakthroughs. For example, there has been the introduction of targeted treatments for molecular drivers of some gut cancers, including using herceptin in gastric cancer and cetuximab in colorectal cancer. These have led to better outcomes for these patients. It is an exciting time in the clinical and translational field of GI cancers as we start to learn more about the complexity of the different types of gut cancers. For instance, gastric cancer is not just one disease but probably several that might require treatment in different ways. The same applies to pancreatic and colorectal cancers. There are exciting national and international research efforts in these areas, many of which we are part of or leading. This sort of research and the knowledge it provides will help us to develop new treatments and personalise treatment further for our patients.

How can patients be referred to you?

They can be referred to me or the team by their GP, or by another clinician involved in their care.