Pioneering breast cancer clinic established in Cambridge opens in Great Yarmouth

A ground-breaking breast cancer treatment programme, funded by Cancer Research UK, that could potentially save thousands of lives has opened in the James Paget University Hospital NHS Trust.

Patients who join the Personalised Breast Cancer Programme (PBCP), which was pioneered at Addenbrooke's Hospital in Cambridge, have their DNA read like a barcode, with the whole genome of their tumour sequenced and the results returned to inform treatment planning.

The news means now more people in the East are set to benefit from personalised treatment, as the ground-breaking breast cancer study is expanded. The James Paget Hospital is the fifth site in the East and the sixth site to be opened nationally following on from the implementation of the programme in Cambridge, Ipswich, Colchester, Norwich and Oxford.

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Recruiting started in March and the first patient was seen at the new clinic in April this year. So far, nearly 1800 patients have been enrolled in the study. Results are returned within six to 12 weeks, enabling patients to have a more precise and personalised cancer treatment.

Beccy  with Professor Jean Abraham (l-R Jean, Beccy)placeholder image
Beccy with Professor Jean Abraham (l-R Jean, Beccy)

For many, results have confirmed they were receiving the best treatment available for their disease, whilst over a third have had a change in clinical management.

Professor Jean Abraham, who leads the PBCP from Cambridge University Hospitals NHS Foundation Trust, explained that for every patient on the programme DNA and RNA readouts from their tumour cells are compared with those of their healthy cells to study which genetic mistakes are causing the disease, and which weaknesses could be targeted with cancer drugs.

Dr David Maskell is overseeing the study at the James Paget University Hospital NHS Trust. He said: "We are thrilled to now offer our patients the chance to participate in this exciting project which is at the forefront of genome sequencing for breast cancer, ultimately aiming to develop better cancer treatments and more personalised medicine.

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Every year, around 5,700 women -as well as a small number of men- are diagnosed with breast cancer in the East of England, whilst around 1,100 women in the region die from the disease. **

Beccy Sleighplaceholder image
Beccy Sleigh

Dr Maskell added: "The results also identify whether the patient has any inherited genetic faults that increase the risk of breast cancer or could cause toxic side effects to chemotherapy.

"The DNA will be analysed from the same routine biopsy and blood tests, meaning that in most cases there are no more tests or appointments than usual and no delays in starting treatment. The results are discussed by a team of geneticist and clinicians, with a report prepared for the patient.

"Longer term, this study may help us to predict which patients will or won’t benefit from a particular treatment. It leads us to much more effective and personalised care which increases survival rates and reduces the side effects of treatments."

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Professor Abraham, Oncology Consultant at Cambridge University Hospitals NHS Foundation Trust and Professor of Precision Cancer Medicine at the University of Cambridge said:“The beauty of this sequencing project is we get the data faster and can act on it. The benefits are various and depend on the stage of the cancer. If it’s at an advanced stage, the genetic information we get from the whole genome might push us towards a different treatment or you might find a specific mutation that means the patient could take part in a certain clinical trial. Some tumours have clustered regions of excessive amounts of mutations. These tumours are said to be hypermutated. Hypermutations are thought to respond better to immunotherapy and so we can push for an immunotherapy trial. Ultimately, these findings can help direct clinicians to using more novel and targeted drugs that have the best chance of helping individual patients.

James Paget University Hospitalplaceholder image
James Paget University Hospital

Professor Abraham, who is based at Cancer Research UK's Cambridge Centre, added: “A lot of patients won’t see their treatment plan change, but it might offer hope and faster access to the most appropriate treatment if there’s a relapse. Having the genetic information of the tumour will give us a better idea of what to do should a patient relapse. It becomes an armoury of knowledge, and it could reveal weakness we can target. That can be very reassuring to patients. In addition, establishing an individual doesn’t carry any high-risk hereditary genes is a relief to both the patient and their family.”

Beccy Sleigh, 43, from near Newmarket, was diagnosed with breast cancer in June 2017. She took part in the PBCP at Addenbrooke’s Hospital in Cambridge and her results ensured she received the best possible treatment, helping her get clear of the cancer in six months.

Beccy said: “I found out through the PBCP that my cancer was linked to a faulty BRCA1 gene. The treatment I received focused on certain aspects of my diagnosis that were specific to me – this is massively important."

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Thirty years ago, Cancer Research UK scientists were at the forefront of the discovery of the BRCA genes. This landmark breakthrough is revolutionising how BRCA-driven cancers are treated through trials like the PBCP – helping to save and improve the lives of more people like Beccy

Beccy added: "Knowing where my cancer came from can help members of my family in future, whilst it also means I can make informed decisions about my future. I decided to have my ovaries and tubes removed because of the increased risk and not wanting to go through potential treatment again. Without us taking part in these trials, we wouldn’t have all this knowledge to improve cancer survival rates.”

The pilot phase of the PBCP began in November 2016. It was a collaboration between Cancer Research UK and Addenbrooke’s Charitable Trust, with over 250 patients from the Addenbrooke’s Breast Unit taking part and becoming the first NHS breast cancer patients to have whole genome sequencing of their tumour as part of their routine treatment in a clinically impactful timeframe. A further £1 million of funding from Cancer Research UK, plus more from The Mark Foundation for Cancer Research, was announced in 2018 to enrol a further 2,000 patients.

Professor Abraham and her precision breast cancer research team will move into Cambridge Cancer Research Hospital (CCRH) when the new specialist hospital for the East of England opens on the Cambridge Biomedical Campus. The new hospital will change the story of cancer, breaking down barriers between the laboratory and clinic, and enabling patients to benefit from the latest innovations in cancer science.

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Beccy added:“Having research and hospital space all under one roof is just brilliant. People can get answers sooner, the clinical trials will happen quicker and ultimately patients like me will be in the best place to receive the best care possible.”

For more information go to www.cambridgecancer.org.uk.

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