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In May, the Irish Clinical Oncology Research Group (ICORG) announced that it was changing its name to Cancer Trials Ireland (CTI). The decision was made in order to better reflect the work by the group, which was established in 1996 to create a conductive environment for cancer trials to take place in Ireland. The new name is also intended to make the activities of the group clearer to patients.
“It is a name that will make a lot more sense to the public,” Clinical Lead of Cancer Trials Ireland Dr Bryan Hennessy told the Medical Independent (MI).
Dr Bryan Hennessy
“Our old name, ICORG, served us very well for 20 years in the global research environment. However, through research and feedback from our membership, the Health Research Board’s 2015 International Panel Review and our Patient Advocate Advisory Group, we identified that we needed to do better in reaching out and connecting with the general public. We needed to communicate in language that is easily understood by the wider community. The new name says exactly what we do — cancer trials. The stylised question mark reflects what cancer trials do — they ask questions and seek answers. Our strap line, ‘Together, we are finding answers to cancer’, reflects that our work is a collective enterprise — it requires working together with clinicians and patients, not only within Ireland but on a global scale. Since we introduced the new name, we have had very positive feedback and more recognition of what we do and that we are here to help the community.”
Dr Hennessy, a Consultant Oncologist in Beaumont Hospital, Dublin, and Our Lady of Lourdes Hospital, Drogheda, was appointed as Clinical Lead of CTI in January, when he took over the role from Prof Ray McDermott. He has long had a great interest in research, ever since completing his medical degree in University College Dublin. After his degree, he did an oncology fellowship in the Anderson Cancer Centre in the University of Texas, US, where he was later appointed onto the Faculty as a Professor of Oncology. He returned to Ireland in 2010, with the ambition of contributing to the country’s expanding field of high-level oncology research.
“I do translational research,” Dr Hennessy explained.
“I try to develop new understandings about cancer and new insights into potential ways to treat cancer in my laboratory in the RCSI. Then I try to translate those advances into potential new clinical trial opportunities for people with cancer. In the translational clinical research field, I also treat people about half of the time. In training as an oncologist in Ireland and then the States, you see that what we can do for many cancer types is relatively limited. You still obviously have a lot of people who succumb to their cancer and there are still big gaps in our understanding and ability to treat cancers.
“When you are working across the clinical research bridge, like I do, it gives you the potential not just to deliver the best treatment, which we currently have, to people with cancer, but to participate in new and potentially better ways to treat cancer and make those available to people with cancer as early as possible.”
A few years ago, the Health Regulatory and Products Authority (HPRA) and the Irish Cancer Society funded Dr Hennessy to examine potential new ways to treat HER2-positive breast cancer. Current treatments that specifically target HER2, such as trastuzumab (herceptin), are effective at helping to slow or even stop the growth of breast cancer cells. However, resistance to HER2-targeted treatments can develop, meaning that current treatments can become ineffective.
Dr Hennessy’s research led to the observation, also made by others, that P13-K are particularly important in allowing HER2-positive breast cancer to develop resistance to current treatments. A collaboration was eventually formed with Bayer, which had developed a a PI3-K inhibitor called copanlisib.
“We then showed in lab models and in cancer cells that this drug targeting this protein is a very effective way to overcome resistance of HER2 breast cancer cells to standard treatments,” explained Dr Hennessy.
“And that opened the door to a clinical trial, which recently opened. Basically, we are combining this new drug, copanlisib, with herceptin in women with HER2-positive breast cancer, whose cancer has developed resistance to herceptin, to try to put the cancer into remission.”
Bayer has funded the clinical trial, which will cost approximately €750,000 and will be led CTI, under the guidance of Dr Hennessy.
It is expected that up 34 patients will take part in the trial, which will be conducted over the next two-to-three years in Dublin’s Beaumont Hospital, St Vincent’s University Hospital and St James’s Hospital, as well as University Hospital Galway and Cork University Hospital.
“The investment by the HRB and the Irish Cancer Society originally allowed us to leverage nearly a million euro in funding from an international pharmaceutical company to take our research to women,” he said.
“This means that Irish women will be among the first in the world to get this new drug. Worldwide, only a couple of hundred people have already got this new drug in clinical trials so Irish women with an aggressive type of breast cancer, HER2-positive breast cancer which has come back, will hopefully be among the first to potentially get access to this new novel and potentially very active drug.”
Translational research will be a strong focus for CTI over the next 12 months. The organisation is organising a conference as part of its Disease Specific Group Meeting for 14 October to showcase what is currently happening in the area. The conference is titled ‘Translational Research in Cancer: Delivering on the Bench-to-Bedside promise’.
It follows a successful conference on immunotherapy held in June.
The conference hopes to trigger some productive conversations among those involved in cancer research that will lead to closer working relationships.
Dr Hennessy feels the infrastructure developed by CTI is unique, in that it offers a world-class ‘one-stop-shop’ for cancer trials.
“It also works with leading groups in the US and Europe to bring new treatments and new clinical trial opportunities from them to Irish patients,” he said.
“I certainly think the cancer research environment in Ireland is quite active and at the cutting-edge, even at an international level. CTI has provided people with cancer in Ireland with very early access to brand new treatments. I mean, the example I have from my lab is one. It was through CTI that women with breast cancer got access to herceptin very early in the development of that drug and that turned out to be a very effective treatment. It was through the efforts of cancer researchers and CTI that Irish women were getting that drug several years before it became part of the standard of care.”
Dr Hennessy added that CTI also participates in the development of new tests for cancer that allow for the identification of people who do or do not need extra treatment. As an example, he cited the Oncotype DX test, which is useful for women with certain types of breast cancer. The test looks at the activity of a group of 21 genes in a tumour and can help oncologists decide whether the patient will benefit from chemotherapy as part of their treatment.
‘I certainly think the cancer research environment in Ireland is quite active and at the cutting-edge, even at an international level. CTI has provided people with cancer in Ireland with very early access to brand new treatments’
“CTI participated in the development of that test and the demonstration of its benefits in the clinic in women with breast cancer,” he said.
“Through CTI working with the group that developed that test, we were the second country in the world to make that test routinely available. We were second only to the US, who were using it routinely before.”
In general, Dr Hennessy believes the environment for cancer research in Ireland is healthy. He acknowledged, however, that funding is a constant challenge. He would also like to see cancer research being regarded as a more integral part of the health service than is currently the case.
“Obviously, we would always like to see further funding of cancer research because that would increase our opportunities even further,” Dr Hennessy commented.
“One other aspect is that CTI and our cancer research efforts have all evolved because of the individual efforts of people who have spent a lot of time, a lot of their free personal time, to develop all of this. But it is recognised internationally now that cancer research should not be an add-on and should not be dependent on the good will and efforts of individual oncologists and cancer researchers like me and everybody else in the country. It really needs to be an integral part of the health system in terms of treating cancer.”
The new national cancer strategy will go some way to rectifying the current situation and will see a greater emphasis placed on research. Dr Hennessy welcomes this commitment, as he strongly believes the health system as a whole needs to take more responsibility for the running and administration of cancer research.
He also wants to increase the public’s awareness of cancer trials. This was a major theme at this year’s ASCO meeting in Chicago and one of the reasons why ICORG decided to change its name.
“I found that many people are fundamentally sceptical about cancer trials and cancer research, about being ‘guinea pigs’,” Dr Hennessy said.
“That sort of thinking about cancer research and trials does potentially hold an impediment to patient participation in trials that may improve their outcomes, because if a patient is fundamentally sceptical about cancer research, they are going to be less likely to want to participate in a clinical trial. We have been working to put the message out there to work with patient advocacy groups, such as the Irish Cancer Society. We even have documentaries on television.
“We are trying to mobilise all the resources we can to try and get the message to people that cancer trials are not something to be sceptical about, that cancer trials are something that can actually improve the outcome of people with cancer and even to try to get it to a point where patients actively ask their doctor is there a trial they can participate in. That is our goal.”