Cancer Research UK has awarded a £1million grant to doctors and scientists at The Christie NHS Foundation Trust and Cancer Research UK Manchester Institute to see if a pioneering blood test can detect if a commonly used treatment is working in people with cancer. So, for the first time doctors will be able to find out if a cancer treatment is working, without the patient having a scan.
If the test is successful, it will be available to patients within the NHS, and will be a global game-changer in cancer research and treatment.
This breakthrough discovery is the culmination of two decades of research by a team at The Christie, led by Professor Gordon Jayson and Professor Caroline Dive. The simple blood test will identify which patients will benefit from anti-blood vessel drugs. It will mean that when a cancer patient is treated with anti-blood vessel drugs (VEGF inhibitors) such as bevacizumab (which is more commonly known as Avastin), a blood sample can be tested to tell the medical team if the treatment is working for that particular individual.
The test will show if a protein called Tie2 in the blood has increased or decreased. When Tie2 levels are reduced, the anti-blood vessel drugs are starving tumours of blood and nutrients. When Tie2 returns to its previous level, the drugs have stopped working.
This is a global first for the Manchester team running the VALTIVE programme, which is a partnership between The Christie Pathology Partnership (CPP) and the Cancer Research UK Manchester Institute Cancer Biomarker Centre (CBC) and the NCRI ovarian cancer research group. The funding from Cancer Research UK for the clinical trial, known as VALTIVE1, will allow the laboratory tests to be validated before being put into routine clinical practice.
Currently patients have to undergo CT scans to establish if a treatment is effective. For many years, scientists have been looking for an alternative to scanning, which could allow patients’ progress to be monitored more easily, without success. The Manchester team decided to take a different approach leading to the creation of this simple and inexpensive blood test.
The test has been tried with three types of cancer (ovarian, bowel and biliary tract) and assessed two classes of anti-blood vessel drug. The test was able to identify the patients who would benefit from the anti-blood vessel drugs across all three tumour types. This information could be used to stop treatment when the drugs aren’t working so that side effects are minimised and their treatment can be changed to a more effective drug.
The test will be validated in the second phase for the VALTIVE programme, the VALTIVE2 trial, which will be the final step before the blood test is adopted by the NHS. However, it will still be several years before it becomes a routine measure of a treatment’s success.
Professor Gordon Jayson, consultant medical oncologist at The Christie explained: “This is a very exciting, long awaited and much-needed breakthrough in cancer research and treatment, which should have a global impact. We are moving towards a world of personalised cancer therapy using a combination of expensive, toxic drugs and it’s important we use them in the right way.
"Scanning is quite a crude way of seeing if a treatment is working. The blood test will enable us to rapidly react to a patient’s response to a treatment, stop it if it isn’t working and quickly consider other options which could be of more benefit to that particular individual, potentially extending their life.”
Dr Phillip Monaghan, consultant clinical scientist from The Christie Pathology Partnership said: “This blood test is a game-changer in the treatment of cancer. Previous research already shows us that we can use and reuse anti-blood vessel drugs. New combinations of anti-blood vessel drugs and other drugs (known as PARP inhibitors) are being evaluated now in the NIHR Manchester Clinical Research Facility at The Christie.
"This is about translating our knowledge about biology into techniques and tools for treating human disease and moving new biomarker tests from the bench to the bedside.”
Michelle Mitchell, chief executive of Cancer Research UK, said: “The development of tests like the one being trialed in VALTIVE is key to treating cancer patients more effectively, so people are not given treatments that won’t work for them. It’s fantastic to see this test move from the lab to an NHS setting. And I hope this success is the first of many that will come from our game-changing biomarker research programme that’s being undertaken with The Christie.”
Dr Hilary Morrison, 60, an ovarian cancer patient and retired GP from Stoke-on-Trent said: “This new blood test will be of tremendous benefit to patients. No patient wants to continue with a drug that isn’t helping them, or delay starting on something else that may benefit them more.
"Apart from losing the unwanted side effects, patients can hopefully start a more effective treatment more quickly, rather than persisting for months with their cancer continuing to grow and spread. And as a former GP, I am only too aware of the high cost of these drugs, so stopping an ineffective treatment will make more money available for other treatments that may benefit the patient more, so it’s a win, win all round.”