David is aiming to better personalise treatment to individual cancer patients by providing additional genetic information to doctors treating patients. Currently, cancer patients are ‘staged’ using a system known as ‘TNM’, which is based on the location of tumours in the original (primary) location, nearby lymph nodes and distant organs (metastases). However, TNM staging does not always allow doctors to distinguish the most aggressive cancers from those that are more benign. By better identifying those tumours that are more likely to spread, treatment could be better personalised to individual patients.
The team around David have sequenced the DNA of patients with metastatic Oesophageal Cancer and compared the results from the primary and numerous secondary tumours. Using this approach David and his team are able to track how the cancers spread from the oesophagus to local lymph nodes and to distant organs. This provides a clearer picture of how the cancers spread and of which mutations may make tumours more aggressive. It is hoped that understanding the mechanisms by which cancer spreads, assays which more effectively stage a cancer can be derived and thus patients could make more informed decisions about treatment options.
This project was made possible by the PHOENIX autopsy study, which was set up by Ayesha Noorani, and the OCCAMS study, which is led by Rebecca Fitzgerald, with funding from the MRC and Cancer Research UK.