Why we should all Love Research: An interview with Cambridge University Hospitals’ Ashley Shaw as campaign launched
Three NHS trusts have teamed up to launch the ‘Love Research’ campaign, which will raise awareness of vital medical research in Cambridgeshire and encourage more people to get involved.
Cambridge University Hospitals NHS Foundation Trust (CUH), Royal Papworth Hospital NHS Foundation Trust, and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) are shining a spotlight on how research here is helping to find better ways of preventing, diagnosing, treating and curing illnesses.
The Cambridge Independent is supporting the campaign, and in the coming weeks will be telling the stories of ground-breaking research under way here.
To launch our converge, we spoke to CUH medical director Ashley Shaw about the campaign, medical trials and how research is making a difference to people’s lives.
Why are you launching the Love Research campaign?
“In Cambridge, across all of the hospitals and universities, there is a massive tradition of research and innovation and what we know is that patients who are treated in a hospital active in research get better outcomes, irrespective of whether they are in a trial or not. That attracts better doctors, nurses and researchers.
“We’ve had huge successes over many years in many different areas. What we are trying to do is to make sure that patients and staff are aware of what we are doing and trying to spread out the research to all areas of the community – to primary and secondary care – to make sure everybody has the opportunity to be involved.
“At any given time, we have about 750 clinical trials ongoing in Cambridge and about 16,000 people participating in research.
“At the same time, we run things like the BioResource, to which people nationwide can sign up if they have a particular condition and volunteer to get involved in research.
“We want as broad a community of people as possible. What we don’t want is the same demographic of people.
“So we want to let our patients and staff know that being involved in research is a good thing for them and others and to build on things like genetic testing, which has enabled so many advances in care.”
What are the benefits for people of getting involved in medical research?
“The benefits for the individual are oftentimes the opportunity to access a medication that is not available elsewhere.
“The majority of trials with patients involving drugs will compare the best available treatment against something we think will be better. So you have a chance of getting a better drug through a trial.
“Secondly, we can learn more about you – if we’re doing things like genetic testing, we can identify whether you might be suitable for new medications and new drugs and start to think about how future generations of your family might be affected by a certain disease process, and pick things up at an earlier stage.
“At Royal Papworth, they have done lots of research into things like breath testing for lung cancer. That sort of thing will impact not just on you, but your friends and future generations.
“You are adding to the wider knowledge base without having to give up much yourself. There is usually a slight increase in monitoring, but it’s really about letting us use your data anonymously to benefit the wider community.
“Remember that everyone treated now has benefitted from the research that someone else has put themselves forward for before.”
How do clinical trials happen?
“There are lots of different types of trials but they have certain components.
“Firstly, you need ethical approval. We have an ethics committee that will look at what we are asking the patients to do. Is it reasonable? Is it necessary? Are the things we are doing safe? Is it evidenced-based? Is it proportionate?
“Then we look at what people are proposing to do with the data and any tissues. So we put in all the safeguards.
“The next thing you’ve got to have is the money. Usually, people with an ethically-approved trial will try to get the money from a research grant-giving body, like the Medical Research Council, the Wellcome Trust or Cancer Research UK, and Addenbrooke’s Charitable Trust will pump-prime some trials too. So you have to convince two different groups: one that will independently decide if it is ethically sound to do and there are good governance processes, and the funders.”
Who devises the research projects?
“We have doctors employed by the University of Cambridge who spend the majority of their time as academics and a small proportion of their time in clinical practice in the hospital. And we have some NHS-employed people who do research who have a few sessions a week of funded research time.
“We try to have a seamless approach. If you’re in clinic, you don’t know who they have a contract with – they all work here.
“Clinicians will have different funding bodies. They come up with the ideas after investigating a particular aspect of biology and identifying a disease process, then a drug that might change it.
“We have everything from very early phase trials with basic science in the laboratory, all the way through to first-in-man trials, and we do a very small number of those.
“Then there are larger phase trials when we have a drug we know is safe and we know works reasonably well and we need to test it on a large scale against existing drugs. As you go through the process, the number of patients involved increases.”
Can you give us some examples of research successes in Cambridgeshire?
“The most common drug used in multiple sclerosis is called Campath, which is short for Cambridge pathology because it was invented here.
“If we go back in time, the very first immunosuppressant drugs for liver transplantation were invented by Sir Roy Calne, who passed away earlier this year.
“More recently, we have the artificial pancreas, which is a way of detecting sugar levels in the human body and automatically responding.
“You may have seen diabetes patients wearing pumps around their waist which give them a continuous infusion of insulin to give much better control. That was developed by an academic called Roman Hovorka and his team. So we’ve seen a number of drugs and devices coming through.
“Then we see the results of genetic testing. We had a young boy recently whose tumour we were able to very precisely identify. You can now take a biopsy of a tumour and create a vaccine for it. It’s individual to that patient. The more we do, the more we learn and the better we get at it.
“There are a number of examples of drugs and devices invented in Cambridge and developed in the hospital or in the ecosystem around us, where we have a lot of pharmaceutical start-ups.”
The value of whole genome sequencing – to reveal an individual’s complete DNA make-up – is becoming increasingly clear and Cambridge is flying the flag for it. What are the benefits for patients?
“For patients with an active disease, it can be really useful to look at tumour types. Lung cancer, sarcomas and all of the blood tumours go through genetic sequencing.
“Then there are rarer diseases. Children born with a less common condition previously would have gone through a whole series of tests that we called a diagnostic odyssey, which could take 18 months or so. What we now do very early on is to do genetic testing to try and identify genetic mutations, which enable us to identify very specifically what the condition is and whether there are any medications out there to alter the course of that disease.
“It’s important because in a lot of conditions, patients can deteriorate quite quickly, so the earlier you can get into it, the earlier you can get on with the right treatment.
“In other genetic testing, we can start to identify whole families or communities of people with things like genetic high cholesterol – familial hypercholesterolaemia – who are as yet asymptomatic. If we find their parents, we test the whole family and then we can get them on a treatment to prevent a heart attack in 20 or 30 years time. It can prevent people from having a heart attack at 40 or 50 years of age.”
The NIHR BioResource now has more than 250,000 volunteers, with and without health conditions, who have agreed to take part in health-related research, and the co-ordinating centre is hosted by Cambridge University Hospitals in partnership with the University of Cambridge. Tell us about it.
“There are BioResources for certain conditions or groups of conditions. For example, we have one for inflammatory bowel disease so that people across the country with IBD can sign up online and are sent out details. They send in a genetic sample and researchers from anywhere in the country who have ethical permission and funding can access their anonymised data and start to work with it to answer a particular research question, so they haven’t got to go out from the start to find patients.
“So it’s a group of people with a condition who have said ‘You can use my data, or contact me for further information if needed’.
“We’ve just set up one for children and young people. There’s another looking at mental health conditions.
“We are looking at different conditions to identify genetic and environmental causes.
“The BioResource creates a big pool of people from across the country, from all walks of life. It reaches out to coastal regions that are not well supplied by big teaching hospitals.”
Tell us about the breadth of research expertise across the health trusts involved in this campaign.
“Royal Papworth has particular expertise in cardiac and respiratory conditions, at the more severe end of the spectrum.
“Cambridgeshire and Peterborough NHS Foundation Trust – CPFT – is doing lots of work on dementia, depression and other mental health conditions.
“As a broad trust, CUH has expertise covering everything from metabolic conditions – looking at obesity – and genetics, to neurosciences and transplants.
“Tying all these together are the academics and the University of Cambridge who work across the different sites.
“We are very lucky in Cambridge in having all of these options in one fairly small place, with access to great academic facilities. That has attracted in pharmaceutical companies like AstraZeneca and GlaxoSmithKline and the major research charities, like Cancer Research UK, and we’ve been lucky over the years to get lots of funding from other bodies, like governmental bodies and charities.
“The colocation is good – it means people can work together and share ideas. And as we build the new hospitals in the coming years, we’re building research into the fabric of them to optimise what we do.”
How will the new cancer research hospital and children’s hospital coming to Cambridge Biomedical Campus bolster our research capabilities?
“We want to make sure that what we are building is not a facsimile of what we do now. We’re not trying to build an extension to Addenbrooke’s.
“With the cancer research hospital, we’ll have a floor of researchers coming and going where they can work on how we get the diagnosis of cancer at an early stage. Too many patients in the UK and across the world with late-stage cancer.
“Early detection is absolutely crucial if we are going to shift the dial to move from rescue to prevention and early phase treatments.”
Visit https://www.cuh.nhs.uk/our-research/love-research/ for more details on how you can participate in the ‘Love Research’ campaign and contribute to the future of healthcare,
