Wigan great-grandfather agrees to trial new cancer treatment technique

The study, involving Alan Featherstone from Golborne is being run at The Christie NHS Foundation Trust in Manchester.

The innovative “opt out” study is made possible thanks to a £2.3m grant from the National Institute for Health and Care Research and is sponsored by The Christie.

The aim of the study is to help improve the survival of patients who have been successfully treated for lung cancer but may go on to experience serious heart problems as a result of the cancer treatment.

The Christie lung team is using a new approach to do this that means all patients treated with radiotherapy for lung cancer can take part.

This is much more inclusive than traditional clinical trials where participation is often restricted to small, selected groups and means the study team can learn from every patient with lung cancer treated with radiotherapy.

Alan, who is married to Barbara, is one of The Christie patients who is taking part in the study, having been diagnosed with primary lung cancer in each lung in March this year.

He said: “I had a persistent cough and lost weight so went to the doctor and they found I had a tumour in each lung.

"Surgery wasn’t an option so after chemo, which reduced the tumours, I’ve started a six-week course of radiotherapy.

"I’m very comfortable being part of the trial and my data being used. I believe if you’re offered the chance to be on a trial you take it. It’s not about me. Without research we wouldn’t have the advances in cancer care.”

The study is the first of its kind anywhere in the world, and the culmination of more than seven years work by the radiotherapy research team at The Christie.

Radiotherapy is one of the most effective and common treatments for lung cancer, but is known that when the top of the heart is irradiated it can lead to heart disease including heart attacks and irregular heartbeat.

The aim of the research is to change clinical practice by understanding how best to treat lung cancers with radiotherapy without causing damaging the heart.

Lung cancer is the leading cause of death from cancer in the UK with 35,000 people dying and 48,000 people are diagnosed annually.

Five-year survival is low at 15 per cent. Manchester has one of the worst lung cancer mortality rates in England, double the national average. Radiotherapy is recommended for half of patients and it cures 40 per cent of those treated.

Patients eligible for the study include those with stage 1, 2 and 3 lung cancer that hasn’t spread to other parts of the body who are receiving radiotherapy with the aim of curing them of cancer.

The Christie team is recruiting patients at a rate of 50 per month to the RAPID-RT study, with the aim of gathering data from at least 2000 people by 2027.

To manage the large numbers, the team has developed special AI (artificial intelligence) auto-contouring software to define the part of the heart to spare, which is two and half times faster than doing the task manually.

Without this AI tool, doctors have to draw a line around healthy organs on scans ahead of radiotherapy to protect the healthy tissue surrounding the cancer from being exposed to radiation.

It can take between 20 minutes and three hours to do this for each patient.

This new technology, design specifically for treating lung cancer, can identify the areas that need to be spared and the oncologist just needs to check the scan before performing the procedure.

Corinne Faivre-Finn, a professor of thoracic radiation oncology at The University of Manchester and honorary consultant clinical oncologist at The Christie, who is a world-leader in lung cancer radiotherapy research, said: “Lung cancer treatment has improved dramatically over the last decade.

"However, we now need to reduce the serious side-effects of treatment for cancer survivors. This is a unique study in that all patients with lung cancer stage 1-3 treated with standard of care radiotherapy are eligible.

"That way we can include everyone.

"Clinical trials usually only recruit people in general good health. Here, we’re able to examine the effectiveness of a reduced dose of radiotherapy to the heart for a much wider group of people including the elderly, people from all backgrounds and ethnicities and those that have other health conditions in addition to lung cancer.

“In addition, patients opt out instead of opting in, which also helps make this study more inclusive.

"And no extra hospital visits or procedures are required. The real-world data from this large numbers of patients allows us to learn very quickly, be more agile in altering the dose, and improve results far faster than we would be able to do with a traditional trial design.

"We hope this study will pave the way for new standard of care for lung cancer patients receiving radiotherapy to treat their disease. Study results may also benefit other cancers affecting the chest area such as lymphoma or oesophageal cancer in the future.”

“With the recent announcement by Government that they are introducing a national targeted lung cancer screening programme for people aged 55 to 74 who are at high risk of lung cancer in England, we are likely to see 900 patients diagnosed a year through the screening programme just in Greater Manchester alone.

"Therefore, using AI as a resource to plan treatment for each individual patient is becoming more vital.”

Any patients interested in taking part in clinical trials should discuss this option with their consultant or GP. Not all patients will fit the criteria for a specific trial. While clinical trials can be successful for some patients, outcomes can vary from case to case. More information about taking part in clinical trials can be found here.