10 out of 10 - ten of the greatest health-changing research studies, to have taken place in North Thames over ten years of the CRN

The NIHR Clinical Research Network was formed 10 years ago, in April 2014. To reflect on its mission to support clinical research, we are taking this opportunity to look back on the 10 years of its existence, and revisit some of the incredible research to emerge in the region that has had an impact on treatments and on the health and wellbeing of patients across the UK.

Which aspect of health did this research focus on? 

Cancer

What was the study investigating?

The ATOMIC-MESO trial was looking at a new type of drug to help treat malignant pleural mesothelioma (MPM), a rare and often rapidly fatal form of cancer.

Why does it matter?

MPM is a rare, aggressive cancer that affects the lining of the lungs and is associated with exposure to asbestos. It is usually treated with potent chemotherapy drugs, but these are seldom able to halt the progression of the disease.

MPM has one of the lowest five-year survival rates of any solid cancer of around 5-10%. 

What did the study do?

The ATOMIC-MESO trial studied 249 patients with MPM. All patients were given standard chemotherapy treatment. Half of the patients also received a new drug (Pegargiminase) to determine if it could help increase their survival.

The trial was initiated by Professor Szlosarek of Queen Mary’s Barts Cancer Institute and conducted at 43 centres in five countries, including Mid and South Essex NHS Foundation Trust in North Thames, which was nominated for an award for their huge contribution.  

What did we learn?

The trial found that the combination treatment of traditional chemotherapy with the new drug, increased the survival of the patients by 1.6 months, and quadrupled the survival at 36 months, compared to chemotherapy alone.

This was the first successful combination of chemotherapy with a drug that targets cancer's metabolism developed for the disease in 20 years. 

The results were published in JAMA Oncology.

How has it benefited patient healthcare and treatments? 

The trial has changed the lives of people with mesothelioma, allowing them to live longer.

What next?

There are ongoing studies assessing ADI-PEG20 in patients who have sarcoma or glioblastoma multiforme (a type of brain tumour) and other cancers dependent on arginine. The success of this novel chemotherapy in MPM also suggests that the drug may be of benefit in the treatment of multiple other types of cancer.   

What was it like to take part in the study?

Mick, a patient at Barts was given only four months to live in 2018, but with the treatment is now enjoying life 5 years on. He says:

“It was a bit of a shock: I was given four months to live.” Mick explains. His doctor referred him to Professor Szlosarek, who enrolled him in the ATOMIC-meso trial. 

“I always believed in Peter. I said: ‘I’m in it to win it – you’re not getting rid of me.’ And here I am five years later.” 

What was it like to run this study?T

This study ran from 2017, through the COVID-19 pandemic when many hospitals had to postpone research studies and, in some cases, stop chemotherapy treatments for patients. 

Mid and South Essex NHS Foundation Trust worked tirelessly to open the study from 2020, allowing patients access to treatment and the study to continue locally. 

Tracey Camburn, Lead Research Nurse at Mid Essex Hospitals said:

“Opening the study during COVID-19 was a real challenge but we adapted the way we work to make it happen. MPM is a rare disease but there are a high number of cases in our area. Running this study allowed patients locally and from London to receive treatment that they would not have been able to have due to the pandemic. For patients it gave them a lifeline, hope and potentially, more precious time with their families.”

The ATOMIC-meso trial is the culmination of 20 years of research at Queen Mary’s Barts Cancer Institute that began with a discovery by Professor Szlosarek.

Professor Szlosarek said:  “It's truly wonderful to see this research come to fruition. This discovery is something I have been driving from its earliest stages in the lab, with a new treatment, now improving patient lives affected by mesothelioma. I thank all the patients and families, investigators and their teams, and Polaris Pharmaceuticals for their commitment to defining a new cancer therapy.”