BRC funding has been used to establish a Translational Research Laboratory (TRL), to undertake sample processing, banking and analysis, and also to appoint a Clinical Senior Lecturer to oversee the TRL which is based in a designated laboratory in the NHSBT building adjacent to research laboratories and to the GMP facility.

The TRL team comprises four BRC-funded laboratory staff together with two part-time nurses dedicated to consenting and clinical database management.

The TRL's main role is to process and store a variety of purified cell populations from blood or bone marrow obtained from a wide range of haematological malignancies. It is closely associated with our Regional Haemato-oncology Diagnostic Service which attracts samples from throughout the Eastern Region.

Banked samples support multiple research programs in multiple university departments and neighbouring institutes such as the Sanger Institute and Babraham Institute. Sample banking is most advanced for the myeloproliferative program (1 Nature, 4 NEJM and 2 Lancet papers in the past 5 years) and is currently being extended to include myelodysplasia, myeloma, and acute myeloid leukaemia together with normal haematopoietic stem and progenitor cells.

Samples representing several different cell types have been processed from over 900 patients in the past year. Research highlights over the past year include the unexpected demonstration that JAK2 functions in the nucleus as a histone kinase (Dawson et al Nature 2009), that bone marrow reticulin at diagnosis has important prognostic significance on myeloproliferative tumours (Campbell et al JCO 2009) and that a JAK2 haplotype predisposes to both MPL and JAK2 mutant myeloproliferative neoplasms (Jones et al Blood 2010).

There have been 2 highlights over the past year:

(i)Development of a non-endoscopic immunocytology screening test (Cytosponge) for Barrett's oesophagus (Patent filed UK and internationally, approved as a medical device by Medical Health Research Agency and trademarked).

We have tested our novel screening device in primary care (BEST trial n=500) which showed that the test was feasible and acceptable to patients with very promising accuracy (90% sensitivity and 94% specificity for the Cytosponge compared with gold standard endoscopy) (Kadri et al BMJ 2010).

(ii) Development of new clinical and molecular prognostic algorithm. The current staging system for oesophageal adenocarcinoma is a blunt tool which takes no account of the molecular features of the primary tumour. We have generated and validated a molecular prognostic signature (Saddi et al PNAS 2010) and uncovered gene of prognostic significance in the stroma (Peters et al Gastroentrology 2010). We are now testing this prospectively to see whether we can predict outcome at diagnosis and ultimately incorporate this into routine clinical practice.

Trials

The Cambridge Cancer Trials Centre is a collaboration between Cambridge University Hospitals NHS Foundation Trust, Cancer Research UK and the University of Cambridge.

Resources from the BRC are used to support the core common elements of the Cambridge Cancer Trials Centre. During the reporting period the CCTC has established a biostatistical capability in collaboration with the Cambridge MRC Biostatistics Hub.

The CCTC biostatisticians have formed close links with the Cambridge University Hospitals Clinical Trials Office. This will serve as an important model for clinical research across the BRC and early phase trials work is now expanding steadily.

Our strategy is to have an early phase programme in each of our focus tumour types. Accordingly, we are now seeking to appoint 2 CRUK-funded academic consultants - one will be in breast cancer therapeutics and one in cancer therapeutics associated with one of our focus tumour types (prostate, ovarian, upper GI, HPB, lung).

Lung

Between them Papworth Hospital and Addenbrooke's Hospital constitute one of the largest thoracic oncology practices in the country with over 500 new incident cases per annum.

Our own research effort aims to reduce the burden of lung cancer by concentrating on the pre-malignant and early stages of the disease, and financial support from the Cambridge BRC has enabled us to construct the team necessary to build this programme.

It has also funded new research sessions in respiratory medicine and research bronchoscopy, radiology and pathology at Papworth Hospital.

Achievements during the year include: selection as one of the 2 pilot sites for the UK Lung Screening study (PI: Eisen, Rintoul), excellent recruitment to studies investigating pre-malignant lung disease (LungSEARCH; PI: Rintoul), NSCLC staging (ASTER; PI: Rintoul) and management of Mesothelioma (MESOVATS; PI: Rintoul), securing funding for therapeutic study of premalignant lung disease (TIDAL; PI: Eisen).