A University of Leeds researcher whose work has improved the lives of thousands of cancer patients around the world has been presented with a prestigious lifetime achievement award.
Professor David Sebag-Montefiore has been recognised by the European Society for Radiotherapy and Oncology (ESTRO) for his outstanding contribution to rectal and anal cancer research and treatment with radiotherapy over a distinguished 40-year career.
An Audrey and Stanley Burton Professor of Clinical Oncology at the University of Leeds and former Honorary Clinical Oncologist at Leeds Teaching Hospitals NHS Trust, Professor Sebag-Montefiore was presented with his award at ESTRO’s annual congress in Stockholm.
He said: “I'm deeply humbled to receive the award and to be recognised by my peers. None of this work is possible without collaboration and without great minds to work with, so I also consider it as acknowledgement of the brilliant teams I work with too. It is a great privilege to work with outstanding people, in Leeds, in Yorkshire and internationally.
“I am most proud of the difference I've made to patients with anal and rectal cancer through my research. Leeds is a fantastic place to do this, and I still remember many of the thousands of patients I’ve treated over the years.”
Professor Nick Plant, Leeds’ Pro-Vice-Chancellor: Research and Innovation, said: “This recognition is a fitting tribute to David’s outstanding contribution to cancer research and patient care over many years. Through his leadership, clinical expertise and commitment to advancing rectal and anal cancer research and radiotherapy treatments, he has helped improve outcomes for patients in Leeds and internationally. This lifetime achievement award reflects both the scale of his impact and the high regard in which he is held by colleagues across the field. Congratulations to David on this well-deserved honour.”
Early years
Professor Sebag-Montefiore trained in medicine at St Bartholomew’s Hospital Medical School in London, qualifying in 1983. Here he joined the ACT1 trial, the first ever anal cancer trial to test chemo-radiotherapy, which delivers both treatments together.
He said: “At the start of my career, anyone diagnosed with anal cancer had to have surgery and a permanent colostomy bag. I saw that patients were struggling with the major challenges this posed – and treatments were not as successful as we wanted them to be. When we couldn’t eradicate people's cancers, they suffered a great deal, and I was motivated to find smarter and kinder treatments with fewer side effects and eradicate more cancers.
“ACT1 was one of very few randomised anal cancer trials, due to the rarity of the disease. We saw that chemo-radiotherapy produced really good results, and as soon as we presented them, practice started to change internationally almost overnight.
“It was incredibly exciting to be involved at the earliest stages and see the success of this treatment. I saw it as a huge opportunity, where chemo-radiotherapy could eventually replace surgery. Now, radiotherapy plays a vital role in the management of these cancers.”
Move to Leeds
In 1995, Professor Sebag-Montefiore became Consultant in Clinical Oncology at Leeds Teaching Hospitals NHS Trust, specialising in rectal and anal cancers.
He said: “By 1996, chemo-radiotherapy was the international standard of care for anal cancer, thanks to ACT1 and two other international trials. Although we were eradicating many anal cancers, the radiotherapy of the time left patients with a lot of side effects.
“Over the past 20 years, radiotherapy has advanced dramatically. Today we give a highly precise, targeted, safe and effective treatment, in outpatient appointments of just a few minutes, with substantially reduced side effects. I’m amazed at the advances we've made - the progress is far greater than I expected, and it has fundamentally transformed patient treatment.
“Those patients with uncontrolled symptoms that I saw as a trainee are not nearly as common in the clinic today. The disappearance of rectal and anal cancer after treatment is wonderful to see. Radiotherapy has not only helped eradicate the cancer in the short term, but has been incredibly powerful in preventing recurrence in the original treatment site, which can cause such a major burden on patients and is much more difficult to treat and cure. Looking back over my 40-year career, that's an incredible, transformative change.”
I am most proud of the difference I've made to patients. Leeds is a fantastic place to do this."
In 2010, Professor Sebag-Montefiore became Honorary Professor at the University of Leeds, and in 2012 he became a University Chair, establishing a radiotherapy research group.
The group was awarded funding by Cancer Research UK as one of seven Radiotherapy Research Centres of Excellence, becoming CRUK RadNet Leeds in 2019. Further funding was secured for another five years in 2024.
He said: “The success of the group is one of the things I’m most proud of. At first it was just me. Now, we have many brilliant researchers, who have flourished and are leading the research themes for a range of different cancers within our Centre of Excellence.
“It is the most exciting time of my career to work in radiotherapy research and we’re on the verge of major breakthroughs - by better understanding the behaviour of the tumour, and connecting the lab with the clinic, we will accelerate progress to develop new smarter, kinder treatment approaches that reduce side effects and improve cure rates.”
International impact
Over the years, his research has produced several key findings that would change international standards of patient care for both cancers.
In rectal cancer, he set out to address the major clinical problem of cancer coming back in the same area. Known as local recurrence, it was difficult to eradicate and resulted in distressing pelvic symptoms. He led the international Medical Research Council CR07 trial showing that a one-week course of radiotherapy prior to surgery halved the risk of local recurrence.
Furthermore, he and Leeds’ Professor Philip Quirke, an internationally recognised expert in colorectal pathology, demonstrated that the quality of surgery for rectal cancer directly impacted the chance of the cancer recurring.
The findings led to a national training programme, an increased use of radiotherapy, and helped establish a previously disputed surgical technique as standard practice, changing rectal cancer treatment across the globe.
The most recent phase of research has focused on whether radiotherapy can replace the need for major surgery and a temporary or permanent colostomy bag. The short-term results of the STAR-TREC and APHRODITE clinical trials represent a very encouraging step in this direction.
In anal cancer, a series of trials has tested different radiotherapy doses with the aim of reducing side effects and improving treatment effectiveness.
Professor Sebag-Montefiore presented the long-term results of the ACT4 anal cancer trial last year, which showed that shorter, lower dose radiotherapy results in fewer side effects, a better quality of life, and a cure for nine out of 10 patients. It is the first clinical trial to change anal cancer practice in over 25 years.
He said: “Our goal is to know exactly the right dose of radiotherapy, the right drug and the right time to treat people, to really transform their lives. That's one of the areas that really excites me."
Looking forward
Future research at CRUK RadNet Leeds includes how treatment is influenced by cancer biology, and the human papilloma virus (HPV), which is associated with several cancers, including head and neck cancer, cervical cancer and anal cancer. Despite the link with HPV, these cancers have distinct biological and treatment differences. Research will unravel the role the virus plays, enabling greater treatment personalisation.
Professor Sebag-Montefiore said: “Within the next 10 years, I think we'll be able to say to a newly diagnosed patient not only that we know how to treat their cancer with radiotherapy, but we know the right dose, and whether they are likely to need additional treatment like new drugs or immunotherapy.
“The research we’re doing now will show us the best treatment for each patient, and our clinical trials will tell us how well these new treatments are working.
“A patient with cancer at the start of my career would have a vastly different experience if they were diagnosed today. And it’s very exciting to know that in future we can go even further.”