Research using a sophisticated web tool, which is being carried out with help from doctors and patients at Addenbrooke’s Hospital, could lead to cancer patients receiving personalised medicine.
Research using a first class web tool which is being carried out with help from doctors and patients at Addenbrooke’s Hospital, has led to cancer patients on a clinical trial receiving personalised medicine according to the molecular profile or “fingerprint” of their tumour.
The Molecular Tumour Board Portal (MTBP) uses futuristic AI and machine learning, along with leading human expertise, to pool together complex clinical and genetic data taken from patients.
Clinicians can use the web tool to easily analyse the data – and compare it with the results of other databases across Europe – to work out the optimum personalised care for patients.
All the data collected so far has come from patients who are signed up to the European-wide ‘Basket of Baskets’ trial.
The trial is being run by seven specialised cancer centres across Europe, known collectively as Cancer Core Europe. The Cancer Research UK Cambridge Centre comprises Cambridge University Hospitals NHS Foundation Trust, Cancer Research UK and the University of Cambridge.
The Basket of Baskets trial is looking at whether patients with different types of cancer could, in the future, be treated with the same targeted therapies because they share a common genetic mutation that is causing their cancer.
The amount of data collected from cancer patients is increasing exponentially along with our understanding of which biomarkers determine how the disease will progress and which predict how tumours will respond to different treatments.
The MTBP system has been set up by Cancer Core Europe to automatically collect data extracted from biopsies and blood samples taken from the 500 patients enrolled on the trial so far. It then interprets these large volumes of patient data, extracting the most clinically relevant information to produce an interactive data-rich online report.
Every patient report generated from the online clinical decision support system is discussed during one of the weekly web-based multi-disciplinary team meetings where members from all seven centres evaluate the results and agree on each patient’s personalised treatment plan.
One of the first patients to have her data analysed is Vera Webster, 71, a part-time book keeper who lives near Cambridge.
Vera was diagnosed with endometrial cancer in 2017 and was treated with surgery and radiotherapy at Addenbrooke’s. Unfortunately the cancer returned 18 months later, this time to her lungs. She has since had six cycles of chemotherapy, completed a year ago, to shrink the tumours.
Molecular analysis of her tumours has revealed that Vera’s cancer is caused by mutations on two genes – PMS2 and MLH1 – which makes her likely to benefit from a targeted treatment offered on the Basket of Baskets trials.
She said: "I started the Basket of Baskets trial in January 2020 in the light of the results I have received. I decided to join because research is always important and valuable for me and others taking part. I am happy to take part if it furthers progress."
An article published in Nature Medicine on July 6 describes the development and clinical use of the MTBP.
Vera’s consultant, Dr Richard Baird, from the Department of Oncology at the University of Cambridge and consultant oncologist at CUH, is the Cambridge principal investigator on the trial. He said:
This is an important step forward in improving treatment for cancer patients. By collaborating with other leading centres across Europe, and accessing vast computational power to process masses of complex data, we can consider each individual patient in a different light and hopefully provide the optimal care for them at that moment in their journey
Many were sceptical that centres located in seven different European countries could develop such a tool that works in practice every week. We are delighted to have pushed the boundaries and proven the unlikely is possible using modern web-based and intelligent tools such as the MTBPProfessor Carlos Caldas, Cambridge lead for Cancer Core Europe and Director of the Breast Cancer Programme, CRUK Cambridge Centre.
Although designed and developed by Cancer Core Europe, the MTBP is also freely accessible to other cancer centres (mtbp.org).