Bladder Cancer Research
Chairman: Professor Alan Horwich
Bladder Cancer
Radiotherapy dose is limited by late radiation damage to the bladder. A pilot study has shown that reducing the volume of bladder irradiated limits toxicity. The potential benefits of this and other approaches, including intenstity modulated radiotherapy (IMRT), are being studied in a series of patients. The Royal Marsden/Institute co-leads the CR UK Phase III BC2001 trial assessing treatment volume and the use of concomitant chemotherapy. We continue to participate in national trials of new or modified chemotherapy schedules in an attempt to reduce toxicity and increase efficacy. In the laboratory microarrays are being established to define prognostic factors in bladder cancer. In collaboration with Professor Colin Cooper a gene called E2F3 has been studied using the Institute's microarray facility and shown to be over expressed in more advanced and invasive cancer types (Feber et al, Oncogene online publication, 29 December 2003).
Projects in progress or completed
- A Randomised Trial of Radical Radiotherapy in PT1G3 NXM0 Bladder Cancer, an MRC Study (BA06)
- A Phase III Study of the Role of Oxpentifylline in the Management of Radiation-induced Bladder and Rectal Injuries
- Hypofractionation of Radiotherapy in Bladder Cancer [Treatment Development]
- A Randomised Trial of MVAC Chemotherapy with or without Folinic Acid
- Observational Study of Bladder Filling and Size during Radiotherapy Treatment
- Evaluation of Magnetic Resonance Imaging in Patients Receiving Treatment for Invasive Bladder Cancer
- Toxicity and Efficacy of Chemo-radiotherapy and Reduced Radiotherapy Volume in the Conservative Treatment of Muscle
- Invasive Bladder Cancer
- Phase II Study of Vinfluanine as Second Line Therapy in Advanced TCC of the Bladder - this study showed that vinfluanine had substantial activity at a dose of 320mg/m2 and manageable toxicity, comparable with most active agents in the second-line treatment of TCC of the bladder
- A Feasibility Study of the Use of 3D Ultrasound to Localise the Bladder during Radiotherapy Treatment
- GEM versus MV in Advanced TCC of Urothelium
- Paclitaxel/Cisplatin/Gemcitabine versus Cisplatin/Gemcitabine in Patients with Metastatic Urothelial Cancer
- Identification of genes involved in the development of bladder cancer
- EORTC randomised Phase II trial comparing immediate vs deferred chemotherapy after radical cystectomy in patients with pT3-pT4, and/or N+M0 transitional cell carcinoma (TCC) of the bladder
- Evaluation of selective bladder preservation in patients with muscle invasive (T2-T3) transitional cell bladder cancer
- A randomised double blind parallel group study conducted under in-house blinding conditions to determine the safety, tolerability and efficacy of aprepitant regimen compared to an ondansetron regimen for the prevention of chemotherapy-induced nausea and vomiting associated with high dose cisplatin in cycle 1
Renal Cell Carcinoma
The Unit is a major international centre for the management of renal malignancies. In recent years the size of the unit has dramatically increased and were seeing over 200 patients newly referred to the unit every year. Both Professor Martin Gore and Dr Tim Eisen are members of the UK National Cancer Research Institute Renal Cancer Studies Group, charged with developing a national portfolio of trials for patients with renal cancer. The former is the coordinator for the current national MRC trial for patients with metastatic disease.
Surgeons in the unit have a particular interest in the management of locally relapsed disease and resection of advanced primary tumours. In 2003 Dr Vincent Khoo, Consultant Clinical Oncologist was appointed to the team. His presence greatly strengthened the Unit.
Projects in progress or completed
- Radical Surgery versus Kidney Sparing Surgery for Low Stage Renal Cell Carcinoma - a randomised trial
- Management of Renal Pelvic Transitional Cell Carcinoma (TCC) with Percutaneous Resection and Brachytherapy
- Adjuvant interleukin-2,interferon-A and 5-fluorouracil for patients with high risk of relapse after surgical treatment for renal cell carcinoma
- A Phase II/III trial comparing thalidomide with provera in patients with metastatic renal cell carcinoma
- A randomised controlled trial of interferon-a, interleukin-2 and 5-fluorouracil versus interferon-a alone in patients with advanced renal cell carcinoma
- A Phase II study of gemcitabine and capecitabine in metastatic renal cell carcinoma
- A study investigating the frequency, biological and therapeutic importance of genetic polymorphisms in patients with metastatic renal cell carcinoma.
- A parallel-arm multicentre open label randomised Phase II study of orally administered GW572016 as single agent second line treatment of patients with locally advanced or metastatic renal cell carcinoma
- Whole body MR imaging and bone scintigraphy in the detection of skeletal metastases in patients with renal cancer
- A Phase II study investigating the potential role of infliximab (remicade) in patients with metastatic renal cell carcinoma (RCC)
