September is Blood Cancer Awareness Month- Meet Haematologist Consultant Graham Collins
Graham Collins is a consultant Haematologist and lymphoma lead for the Thames Valley Lymphoma MDT. He has trained in medicine at Cambridge and St Bartholomew’s and the Royal London Hospitals. Dr Collins completed his Specialist haematology training in Oxford where he also completed a DPhil in molecular biology of the Reed-Sternberg cell.
He currently chairs the UK NIHR Hodgkin study group and T-cell working group where academic trials are devised and developed for these lymphoma subtypes.
Graham is a full time clinician but with an interest in lymphoma trials and is based at the Churchill hospital.
There are many subtypes of lymphoma but Graham is primarily interested in Hodgkin lymphoma, T-cell lymphoma and aggressive B-cell lymphoma. Hodgkin lymphoma is the commonest cancer in teenage and young adults. It is highly curable, but the treatment can have lasting side effects such as increased risk of second cancers and heart disease. Hodgkin lymphoma has an exuberant microenvironment and as such, immunotherapy drugs such as PD1 inhibitors, work very well in this condition. However currently their use is restricted to the uncommon patients with multiply relapsed disease. Graham is interested in investigating the use of these agents earlier in the treatment pathway (including in front line treatment) as a way of reducing the chemotherapy and radiotherapy burden patients currently endure.
Graham has designed, and is running, 2 investigator-initiated trials using immunotherapy in Hodgkin lymphoma. One (called AVENUE) is in the front line setting, investigating whether initial using of a PDL1 inhibitor may lead to better chemotherapy responses, enabling future trials to assess chemotherapy de-escalation strategies. The second (ANIMATE) is investigating the use of a different immunotherapy drug in relapsed disease. Together with his team he is also incorporating translational studies to understand better how these drugs work in Hodgkin lymphoma (as Reed-Sternberg cells down-regulate MHC class 1, it is probably not via CD8+ T-cells) and to better predict the patients most likely to benefit. Intelligent incorporation of immunotherapy agents in the front line (or early relapse) setting in Hodgkin promises to reduce the chemotherapy and radiotherapy burden for patients which should reduce acute, and associated later toxicities. There may of course be additional toxicities which need to be monitored over long term.
Graham is working with members of the WIMM to develop the translational projects, including members of Prof Cerundolo’s lab and Prof Vya’s lab. Nationally he is collaborating with a number of colleagues to deliver on the trials.
Graham has obtained most of his funding through competitive applications to pharma companies. He also receives support from the Haematology and Stem cell theme of the Oxford BRC, and the CRUK ECMC centre.