We are trying to improve the benefit patients receive in Phase I trials by selecting treatments specific to their cancer type - Dr Emma Dean

Dr Emma Dean - Consultant in Medical Oncology

Dr Emma Dean - Consultant in Medical Oncology

The Experimental Cancer Medicine Team specialises in treating patients in Phase I Clinical Trials. These trials help us find out if a new drug is safe and has side effects, as well as how much of the drug can be given safely and whether the drug is effective against cancer. 

Treatments are experimental and unproven and there can be risks, but these are managed by treating small numbers of patients with strict safety controls and regular reviews in clinic.

One of the things that always surprises me is patients’ reasons for wanting to take part in a clinical trial. You would expect that for most patients it is the chance to receive, and possibly benefit from, a new treatment when they have limited or no further treatment options available. This is one reason, but another is to ‘give something back to research’ to benefit patients in the future.

Our patients are referred by their oncologists, and I always like to see new patients at an early stage (even while they are still receiving other cancer treatments), so we can assess their suitability and prepare for the possibility of a clinical trial. We receive referrals from within The Christie, Greater Manchester and from across the UK – the patient’s oncologist will advise if a referral is appropriate.

A trial must be carefully explained and written information provided to patients. It is entirely the patient’s decision whether or not to take part. Before we can start treatment, patients must provide written consent and undergo a series of tests to check that they are suitable for any given clinical trial. There are frequent hospital appointments to ensure the safety of the patient, and often long days in hospital when we take blood samples to measure the effect of the new drug on the body and try to learn more about the drug. The start of treatment can be an anxious time and patients may experience some side-effects which require management.

We are trying to improve the benefit patients receive in Phase I trials by selecting treatments specific to their cancer type. This is usually done by looking at the genes in a biopsy specimen, but we are also investigating whether we can also look at the DNA of tumour cells that may be circulating in the bloodstream. This research is not easy and because the technology is new, it is expensive for us to fund. We also need to work with lots of companies to provide the experimental drugs to ensure that, if we do find a genetic aberration in a patient sample, we can do something about it and offer our patients access to drugs which may not be widely available.

Successful drug development depends on effective collaboration with scientists from academic institutions such as The University of Manchester, CRUK, the UK network of Experimental Cancer Medicine Centres and pharmaceutical companies. The most challenging aspect of my job is when we don’t have a trial slot immediately available and a patient has to wait for a clinical trial. Also, telling a patient when a treatment is not working. The best part of my job is when a patient tells me that they are glad to have taken part in a trial and that they have been well looked after by our team of dedicated staff, even if the outcome is not positive. Of course, it is thrilling when a patient responds well to a new treatment, probably the first sign in the world that the drug could be a successful treatment in the future.

To find out more about phase one trials at The Christie please follow this link.