Pre-surgery chemotherapy benefits to be explored

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The benefits of giving chemotherapy before surgery to bowel cancer patients will be further explored in a new £3.4 million trial, one of three awarded regional funding.

Patients are usually treated with surgery first and may go on to have chemotherapy to help stop the cancer coming back. 

However, a previous international trial has shown that giving six weeks of chemotherapy before an operation can lead to better surgery, reduce complications, and improve survival rates. 

Led by Dr Jenny Seligmann at Leeds and Professor Dion Morton at the University of Birmingham, the new trial will test whether more extensive chemotherapy can further improve benefits in fit patients. It will also test different ways of treating older and frail patients with chemotherapy ahead of surgery. 

The new trial will save lives and improve the experience of patients in Yorkshire.

Dr Jenny Seligmann, School of Medicine

About 3,200 people are diagnosed with bowel cancer every year in Yorkshire. It is the fourth most common cancer in the region. More than 1,500 people will be recruited to take part in the study, which has been developed through the University of Leeds Clinical Trials Research Unit and supported by the University of Birmingham Clinical Trials Unit. 

Dr Seligmann, Consultant Medical Oncologist in the School of Medicine, said: “A previous trial, FOxTROT, has shown that when chemotherapy is given before surgery, the operation had fewer complications and was more likely to remove all the cancer. Also, patients’ cancers were less likely to return in the future than with surgery first.  

“We now intend to build on this evidence by investigating the benefits in a wider range of patients. The new trial will save lives and improve the experience of patients in Yorkshire. As well as providing an opportunity to take part in research, which is known to improve survival rates, the trial will help bring gold-standard treatment to participating hospitals.” 

The trial is one of three to be awarded funding by Yorkshire Cancer Research

A second trial will investigate whether an existing pain assessment tool can be successfully introduced into outpatient cancer services across Yorkshire.

The £350,000 study, led by Dr Matthew Mulvey, Senior Research Fellow in Palliative Care in the School of Medicine, could lead to improved pain management for patients in the region.

The trial will also be supported by the Leeds Institute of Clinical Trials Research. 

Dr Matthew Mulvey, Senior Research Fellow in Palliative Care in the School of Medicine

Dr Matthew Mulvey, Senior Research Fellow in Palliative Care in the School of Medicine

And a third trial, which has received £500,000 from the charity, will test whether radiotherapy can be made more effective for people with rectal cancer, a type of bowel cancer found in the last few inches of the large intestine. 

Led by Aaron Quyn, Associate Clinical Professor of Surgery in the School of Medicine, and also developed through the Leeds Clinical Trials Research Unit, the research will find out if new technology can be used to increase the damage done to cancer cells by radiotherapy and reduce the need for extensive surgery, which can have significant side effects.  

Radiotherapy is designed to kill cancer cells, but the dose is often limited to avoid damage to nearby healthy tissue. The researchers will investigate using tiny fragments of matter called ‘nanoparticles’ to help deliver radiotherapy more accurately and enhance its effect.

‘Nanoparticles’ have been shown to gather passively within tumours, increasing the impact of radiation without damaging surrounding tissue.

Professor Quyn said: “Currently, radiotherapy treatment completely removes the cancer in just one in 10 patients. There is a significant need to improve radiotherapy and increase the number of patients who do not require surgery afterwards or are able to have surgery that doesn’t lead to a loss of bowel function.  

“The use of nanoparticles in cancer treatment marks a new era in modern cancer treatment. This trial aims to show that nanotechnology can be used to improve radiotherapy for some types of advanced bowel cancer and reduce the number of patients needing surgery. If successful, a larger scale study could follow, leading to significant benefits for patients in Yorkshire.”