NHS’ first genetics-based personalised treatment programme for brain tumour patients begins at Addenbrooke’s in Cambridge
Brain tumour patients at Addenbrooke’s Hospital are the first to get personalised treatment based on the results of genetic sequencing.
Patients with glioblastoma - the most aggressive and fatal form of brain tumour - are receiving a tailored treatment plan based on a more detailed diagnosis of their condition.
The Minderoo Precision Brain Tumour Programme (MPBTP) is designed to improve survival rates and is the first precision medicine system for brain cancer patients on the NHS.
“The idea here is: can we make sure that every patient gets the best possible personalised treatment for them? And surprisingly, that’s not done at the moment for adults with glioma, the commonest and most aggressive form of brain tumour in adults,” said Prof Richard Gilbertson, director of the Cancer Research UK Cambridge Centre at the University of Cambridge.
“So what we’re doing is making sure that in every patient, their tumour is sequenced. We read the DNA, like a book, from cover to cover, in every single patient, in every single tumour. And in doing that we can uncover the mistakes that drive that tumour and therefore think what is the best treatment option for this patient today and then perhaps tomorrow?
“We’re settlng in place within the National Health Service a way of routinely doing this so every patient, wherever they live, will get the best patient.”
The programme is a partnership between Cambridge University Hospitals NHS Foundation Trust (CUH), Minderoo Foundation, the Tessa Jowell Brain Cancer Mission, NHS East Genomics Laboratory Hub, CRUK Cambridge Centre and Illumina.
The initial target is to enrol 225 adult patients in Cambridge over three years and demonstrate the benefits of precision medicine for brain cancer patients within the NHS.
Ultimately, the aim is to roll out the approach nationally, aided by the Tessa Jowell Centres of Excellence initiative, and by integrating rapid genomic testing for these patients into the NHS Genomic Medicine Service.
Jess Mills is UK Ambassador for Minderoo Foundation and connected with the programme. Her mother, the late Baroness Tessa Jowell, spent the last months of her life campaigning for better brain cancer treatments on the NHS.
Jess said: “I am proud to carry on the campaign my Mum started after she was diagnosed with terminal brain cancer.
“Brain tumours are the biggest cancer killer of children and adults under 40 in the UK, and thanks to the support of Minderoo Foundation, my hope is that every patient with a terminal diagnosis will soon be offered precision treatment, so that they get to have the best chance possible of living and living well with their diagnosis.”
Ms Mills is a founding member of the Tessa Jowell Brain Cancer Mission, which was established to deliver her mother’s legacy.
The new programme is part of the Mission's national strategy..
“Mum felt a great responsibility, as a public servant for more than 50 years, that more should be done for patients that were being let down by the current system. So today there is hope that before long, this revolutionary programme will become the new standard of care for brain tumour patients across the UK, and beyond,” said Ms Mills.
Under the programme, a patient undergoing brain surgery at Addenbrooke's has a tumour sample taken, along with a benchmark blood sample.
These samples are sent to the Illumina Centre at Granta Park for full genetic sequencing. The DNA from the patient’s blood is compared with the DNA and RNA from the tumour sample in order to identify specific genetic mutations present in the tumour.
Within 10 days, these results are returned to Addenbrooke’s for discussion at a genomics tumour advisory board meeting that includes clinicians, researchers and data analysts to determine the best personalised treatment plan. This is designed to identify treatments most likely to work.
Richard Mair, consultant neurosurgeon at CUH who is leading the MBPTP, said: “This incredibly exciting new programme enables us to analyse the mutations driving a patient’s tumour in real-time. We hope to use this information to identify whether any new, targeted treatments can be offered to these patients.”
The programme will also provide researchers with unprecedented access to detailed genetic data on brain tumour patients, aiding the drive to identify potential therapeutic targets and new treatments, and to offer innovative clinical trials.
“The focus on this rare but really aggressive tumour type is critical,” added Prof Gilbertson. “Because Minderoo has an interest in uniting patient data from across the globe, this helps us work with colleagues around the world effectively, bringing together everything we learn from patients, wherever they live, so we can build a more complete understanding of this terrible disease.”
Collaboration is key to Minderoo Foundation’s approach, hence the push to bring together academic, clinical, industry and philanthropic partners.
Co-chair Nicola Forrest said: “Brain cancer research has had little investment over the last several decades so that’s where we decided was most important to focus. At Minderoo Foundation, we seek out the hardest challenges and if we could make a diﬀerence there then it could translate across all cancers.”
Dr David Bentley, vice president and chief scientist, Illumina, said: “We are delighted to embark on this project with the Addenbrooke’s team, and to see how our genomics expertise can best help patients suffering from this debilitating cancer now and in the future.”
The programme reflects the kind of approach envisaged at the planned Cambridge Cancer Research Hospital, bringing together Addenbrooke’s clinical expertise with research from the Cancer Research UK Cambridge Centre and University of Cambridge.