Professor David Dearnaley
Academic Title: Professor of Uro-Oncology, Personal Chair of University of London
Tel: 0208 661 3271
Location: Orchard House, Sutton
I have designed and led institutional and national trials testing conformal radiotherapy (CFRT) and dose escalation with the Medical Research Council (MRC) resulting in NICE guidance (March 2008) recommending high dose CFRT as the national standard of care.
I am leading further studies supported by the DoH, CRUK and NCRI studying intensity modulated (IMRT) and image guided (IGRT) radiotherapy with hypofractionation which tests the fraction sensitivity of prostate cancer. This study (CHHiP) will recruit 3,160 men and is the largest academically led prostate trial in the world. A positive result will benefit patient outcome and radiotherapy resource utilisation. Linked translational research relates toxicity and efficacy to physical (dose volume/surface histogram analysis), genetic (SNP and GWAS) and predictive biomarkers using tissue microarrays (TMA). I have established a national quality assurance programme to aid the generalisability of IMRT and now IGRT.
I am leading a CR-UK supported randomised controlled trial (RCT) to test and generalise high dose pelvic IMRT for high risk prostate cancer. I am further developing IGRT linking functional imaging using magnetic resonance imaging (MRI), dynamic MRI (dMRI) and magnetic resonance spectroscopy (MRS) to ultra high dose boost treatments which will include further study of a patented localising rectal obturator (ProSpare).
I established three joint research programmes with National Cancer Research Network (NCRN) support. The first of these, on familial genetics of prostate cancer, has recently identified several polymorphisms which may lead to risk stratification and new treatment targets. The second, concerning surveillance for early prostate cancer, aims to define parameters predicting low biological potential and need for treatment. The third is a 'survivorship' programme in testis cancer identifying the need for long term monitoring of treatment sequelae.
David Dearnaley joined The Institute of Cancer Research (ICR) almost 30 years ago. He is developing and assessing new radiotherapy techniques and helping to care for patients with urological cancer, including cancers of the prostate, testes and bladder. He is a Professor of Uro-Oncology and Honorary Consultant Clinical Oncologist at the ICR and The Royal Marsden NHS Foundation Trust.
Professor Dearnaley has been central to the development of better radiotherapy treatments for prostate cancer, including a high-tech method called IMRT which uses 3D modelling to target radiation precisely to the tumour shape. It reduces damage to healthy tissue, which means higher doses can be given without increasing side effects.
Professor Dearnaley first began treating patients using IMRT nine years ago and the technology has since been adopted across the country. He is now running a major trial in 35 of Britain’s 58 treatment centres looking at whether more patients can be cured without an increase in side-effects by giving larger doses of radiation but in fewer treatments.
In the future, he would like to make further improvements in radiotherapy techniques for prostate cancer and get these introduced nationally, something he is hopeful of achieving.
He is running several other patient trials involving prostate and testicular cancer including systemic treatments with hormonal treatments and chemotherapy and new image guided techniques to further improve the accuracy of radiotherapy. Additional projects include studies of new molecular and genetic markers to predict the outcome following radiotherapy.
The challenge for modern day radiotherapy is to harness the major technological and computational advances in radiotherapy planning and delivery with the development of targeted treatment agents for use in combination with radiotherapy.
Hypofractionation in Prostate Cancer
The main aim is to test the hypothesis that hypofractionated radiotherapy schedules for localised prostate cancer will improve the therapeutic ratio by either improving tumour control or reducing normal tissue side effects.