Our Trials

rs154038_pg1_9383-hpr

This is a phase III, multicentre, randomized, controlled, open, parallel group trial in patients with previously untreated CLL. A total of 754 participants will be randomized on a 1:1 basis to receive standard therapy with fludarabine, cyclophosphoamide and rituximab (FCR) or ibrutinib plus rituximab (IR)

This is a non-interventional study to look at the use of a myeloproliferative neoplasms- symptom assessment form (MPN-SAF) diary in order to assess the patient reported outcomes.

Myeloploliferative neoplasms (MPNs) are associated with a high chance of patients experiencing a range of symptoms affecting many of the body systems. There are few studies that have investigated the effects of standard therapies on symptoms experienced by patients with MPNs.

 

This study is designed to test the effectiveness of a new questionnaire to collect information about the symptoms experienced by patients with myelopreliferative neoplasms. The questionnaire is in the form of a diary completed by patients. We want to see how well the diary can capture all the information we might need. The study is being organised by the Mayo Clinic in the US.

Patients with a persistent high white cell count with or without swollen glands/ lymph nodes are often diagnosed with cancers of the lymphatic system. However a significant proportion of these patients are not assignable to a specific category based on current technology. This can have an adverse impact on their treatment as the optimal treatment in these unclassifiable cases is not clear. Moreover, these patients are often excluded from entry into clinical trials and so cannot access new drugs. In many cases of lymphatic cancer received by the Royal Marsden, a specific category cannot be assigned using current technology. Recently, new genetic technologies have identified a number of key mutations associated with lymphatic cancers. We propose to introduce these new genetic tests to improve categorisation of these disorders in order to improve patient outcomes by increasing opportunities for entry into clinical trials as well as identifying new therapeutic targets.

It is estimated that the number of indolent B-Cell Lymphoproliferative Disease (B-LPD) cases that are assigned a definitive category using current technology is 30%. Our plan therefore is to systematically study unclassifiable groups of B-LPD by creating a well defined immunomorphology work flow for their identification. Samples thus identified will be screened using an Next
Generation Sequencing (NGS) panel which is able to detect well established, B-LPD associated genetic aberrations including IgH translocations and genetic mutations.

Based on the numbers above, we are looking to screen at least 120 samples over 2 years with the hypothesis that mutation screening will increase the number of cases with a definitive diagnosis or detectable mutation by at least
15%.

AML 19 will build upon the results of previous trials in acute myeloid leukaemia. It will evaluate several relevant therapeutic questions in patients who are 18-60 years old and suitable for intensive chemotherapy. For patients who do not have the APL subtype, the investigators will evaluate the best way of adding mylotarg to induction chemotherapy. After induction, patients will be characterised based upon their prognosis and may enter different randomisations, the randomisations allow patients to access different treatments based on their disease profile. The investigators will also evaluate whether continued monitoring of patients can improve outcomes and affects quality of like. Patient with the APL subtype will enter a different part of the trial.

10% of the cases referred to the specialist diagnostic haemato-pathology service at RMH are for cytopenias. Although we identify a cause in only third of cases of cytopenia, this leaves a significant proportion of patients without an answer.

 

The hypothesis we will test is that a proportion of patients with idiopathic cytopenias have mutations in myelodysplasic syndrome (MDS) associated genes. We will sequence a panel of known MDS associated genes in patient material (bone marrow and blood) that is sent routinely to the diagnostic service where conventional techniques have failed to establish a clear diagnosis. 200 patients with idiopathic cytopenia will be followed up to determine their survival, blood counts and development of acute leukaemia and other haematological malignancies. The clinical outcomes will be correlated with any mutations detected.

www.HORIZONS-HUB.ac.uk

HORIZONS is a cohort study to explore recovery of health and well-being in adults diagnosed with cancer. Experiences and outcomes of cancer treatment and care are changing. A growing number of people are experiencing cancer not as a life-limiting disease, but as a life-changing and long-term condition. There is a growing imperative to understand the changing landscape of cancer and its consequences: as we do so, we will be better able to inform the design and delivery of cost effective interventions that make possible supported self-management, as well as service organization and delivery.
The key research questions are:
What impact does cancer and its treatment have on the lives of people diagnosed with cancer in the short, medium and long term?
What are the health outcomes, experiences and self-management activities over the life-course across different cancer types and who and what influence these?

HORIZONS is a series of prospective cohort studies of adults treated for non-metastatic cancer to capture their health outcomes and experiences from before they begin active treatment and regularly over their life-course. Our initial cancer cohorts will be breast cancer (diagnosed under age 50), non-Hodgkin lymphoma, and gynaecological cancers (ovarian, cervical, uterine). We will start recruitment with three pilot sites in NHS Trusts before rolling out full recruitment to approximately 50 NHS secondary care Trusts. Questionnaires will be completed before treatment (baseline), and followed up at regular intervals.

We will maintain and develop HORIZONS as a national and international resource to explore consequences of different cancer diagnoses and treatments from the individual perspective across the life-course.

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