Latest Research Research The Mutographs Project Mimi McCord, Founder and Chairman of Heartburn Cancer UK, is currently involved as one of the patient advocates in this fascinating international project, funded by Cancer Research UK and involving 5000 patients across five continents. Researchers in The Mutograph Project are collecting cells from people affected by five different forms of cancer; Bowel (also known as colorectal), pancreas, kidney, oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. They will compare the DNA in the cancer cells to the DNA from cells taken from blood to find out if there are any differences between them and will ask participants to fill in a questionnaire that gives detailed information about their lifestyle and the environment that they live in. DNA from the cancer cells donated by participants will be examined to find out if they contain certain signatures. Researchers will then investigate whether certain factors that they suspect might cause cancer are linked to the presence of these signatures. It is hoped that the project will advance our understanding of what causes cancer by identifying what factors are creating these distinctive DNA signatures. Some of the things being studied include: Establishing why some cancer types are more common in certain areas of the world Looking at whether it is possible to create a catalogue of what DNA signatures are caused by specific cancer-causing agents Establishing whether it might be possible to use DNA signatures as a signal that healthy cells are more likely to develop cancer As patient advocates, Mimi and Maggie, who is the founder of the Pancreatic cancer Research Fund, are involved to ensure that the project takes account of the views of patients and the public. They visit researchers, people affected by cancer and medical centres participating in the project, to explore ways of improving the patients’ experiences of cancer research. Their work will also help to influence future research directions. More detailed information is available at www.mutographs.org where there is also a blog which follows the project’s progress. The LINACRE Trial If you have Barrett’s oesophagus and would be interested in the opportunity to participate in a trial looking at an alternative treatment then please read on. The Oxford Clinical Trials Unit are applying for funding for an exciting new clinical trial for patients with Barrett’s Oesophagus. Barrett’s Oesophagus is currently treated with life long medication to reduce the risk of developing oesophageal cancer. This trial will give patients at various centres in the UK the opportunity to be randomised (by chance) to an alternative treatment or continue long-term medication. The alternative treatment is a day case surgical procedure using key hole surgery to place a LINX device around the oesophagus. The LINX device is used to prevent acid reflux entering into the oesophagus and may reduce symptoms and the requirement for long-term medication. Both groups of patients will be required to be available for follow up appointments, either in person or by telephone/email and to complete questionnaires. It is hoped that the LINX device may provide an alternative strategy in the prevention of oesophageal cancer that is more acceptable to patients. There is more information on the LINX device here if you would like it. Please contact us if you would be potentially interested in taking part in the study or if you would like more information. Add-Asprin Trial Add-Aspirin is a large clinical trial taking place in the UK, Republic of Ireland and India. The trial aims to involve 11,000 participants to help find out whether using regular aspirin after treatment of early stage cancer can help stop the cancer coming back (3). Add-Aspirin is open to patients with a number of different cancers including oesophageal cancer and stomach cancer. There is already data from smaller studies supporting the theory that aspirin can be both safe and useful in the treatment of cancer (4). Add-Aspirin is a much larger international trial designed to further investigate the potential benefits of aspirin. Participants that agree to take part in the study will be randomly chosen to either take daily small doses of aspirin, larger doses of aspirin, or a tablet with no active drug ingredient (called a placebo pill). Neither the patient nor the doctor will know which treatment is being given which helps to make the trial results more reliable. As a low-cost medicine that is widely available, aspirin could have a huge impact on cancer treatment worldwide. If you are interested in taking part in Add-Aspirin, please talk to your doctor who will be able to consider whether you are suitable for the trial. Coyle C, Cafferty FH, Rowley S, MacKenzie M, Berkman L, Gupta S, et al. ADD-ASPIRIN: A phase III, double-blind, placebo controlled, randomised trial assessing the effects of aspirin on disease recurrence and survival after primary therapy in common non-metastatic solid tumours. Contemp Clin Trials. 512016. p. 56-64. Bosetti C, Rosato V, Gallus S, Cuzick J, La Vecchia C. Aspirin and cancer risk: a quantitative review to 2011. Ann Oncol. 2012;23(6):1403-15. The BEST3 Trial Professor Rebecca Fitzgerald, one of the trustees at Heartburn Cancer UK, is leading the BEST3 Trial, aimed at making diagnosis of Barrett's oesophagus and oesophageal cancer less invasive. “Early diagnosis is essential to improve outcomes from cancer of the oesophagus. To do this we need to improve awareness of the importance of symptoms like heartburn and also provide easy access to tests. One approach that we have developed is a non-endoscopic test called Cytosponge which can be performed at the GP surgery" The trial was launched in 2017. Since this date around 120 GP practices have taken part with approximately 9000 patients being tracked for outcomes. The trial is assessing whether the test could offer a better way of detecting the early stages of oesophageal cancer in a shift towards prevention strategies. Surgeries across east Anglia, Hampshire, the North East, Nottingham and London have taken part. Preliminary results suggest that primary care patients are tolerating the test well, with more than half of patients rating their Cytosponge experience a 9 out of 10 (where 10 is totally acceptable). These early findings, as well as providing a practical opportunity to test out large-scale nursing management and laboratory processes, are promising in terms of the potential deployability of the test into primary care. The introduction of the test, if the study is successful, could represent a major shift in the way in which the condition is detected and eventually treated in the health service. HCUK, and more broadly patient and public groups, have played a key role in development of the materials used in the trial through their ongoing work with Prof Fitzgerald and her research teams. Results of the trial are expected later in 2020. Other research and opportunities to get involved Cancer Research UK has a comprehensive list of the many trials currently being undertaken around the subject of oesophageal cancer, some of which have results and some of which are recruiting for participants. If you are interested in getting involved in a trial or would like more information then their website is a great starting point to look for information.