New horizons in the management of advanced colorectal cancer

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Stivarga Prescribing Information

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Stivarga Prescribing Information

Sheela is a Consultant Medical Oncologist specialising in gastrointestinal cancers and cancers of unknown primary within the Gastrointestinal Unit at the Royal Marsden Hospital.

She completed medical training at Charing Cross and Westminster Medical School and specialist oncology training at The Royal Marsden. She undertook laboratory-based research at The Institute of Cancer Research, supported by an academic grant, examining the prognostic and predictive value of genomic profiling of tumour biopsies in oesophagogastric cancer.

Her main clinical interest is the sequencing of all modalities of treatment using the multidisciplinary team to achieve the best overall outcome for patients whilst aiming to improve or maintain quality of life and consider the patient’s wishes and ambitions.

She is The Royal Marsden’s lead for cancers of unknown primary. Her research interests include clinical trials with novel therapies in GI cancers and she is the Principal Investigator and Chief Investigator on a number of national and international trials with novel agents and immunotherapy.

She serves on the committees for the UK National Cancer Research Institute (NCRI) Colorectal Cancer and Anal-Rectal Clinical Study Groups and is an active member of the International Rare Cancers Initiative (IRCI). She serves on the European Society of Medical Oncology (ESMO) educational faculty for GI tumours. She sits on a number of national and international trial management groups and data monitoring committees.

Sheela is an active contributor to international research through peer-reviewed journals and conferences and has given invited lectures globally. She is a strong advocate for collaboration nationally and globally.

Professor Gary Middleton is a Medical Oncologist who specialises in lung cancer and colorectal cancer. He has many years of experience in patient treatment, and also in development of novel clinical trials.  Appointed to a chair of Medical Oncology at Birmingham in 2013, he has built up a strong clinical and translational research programme. Gary is Chair of the Experimental Cancer Medicine Centre Network, Director of the Birmingham ECMC and Lead for the Birmingham CRUK Clinical Academic Training Programme. A key interest is in stratified approaches to patient treatment, and Gary has a strong presence in UK stratified medicine clinical trials. He is Chief Investigator for the National Lung Matrix Trial, a multi-centre, multi-arm, molecularly stratified clinical trial programme for UK patients with lung cancer (Nature, 2020).  He is Translational Lead for the DETERMINE trial which seeks to understand the impact of the genomic, transcriptional and immunological context on which the targeted mutation is inscribed on outcome with genotype-matched targeted therapy (Ann Oncol, 2023). A fundamental part of this work is to uncover the mutational, epigenomic and inflammatory processes that promote the development of oncogene addicted cancers. He is also interested in stratification approaches for immunotherapy and leads on the ANICCA trial, a phase II study in high class II expressing microsatellite stable colorectal cancer, a study directly translating the clinic work from his laboratory programme exploring the determinants and dynamics of class II expression in cancer (Cancer Res Comms, 2023). One particular area of active study is myeloid derived suppressor cells and tumour associated macrophages, which suppress tumour-specific immune responses particularly in liver metastases and the lab has developed a suite of human models to understand how best to target these to improved ICB outcomes in patients with liver metastases. The discovery of novel predictors of checkpoint blockade toxicity is a particularly key area of current research and the group have recently published data showing a pre-treatment lack of Bregs (regulatory B Cells) in patients developing severe immune related adverse events (irAEs) in lung cancer patients (Nat Comms, 2022). We are currently exploring the underlying failure of this induction and have developed clinical grade assays to interrogate Breg status as clinically useable predictive biomarker for the development of severe immune-related Adverse Events.

Alice Dewdney is a consultant clinical oncologist at Weston Park Hospital in Sheffield and is the lead for colorectal cancer. She completed an MD in the role of biomarkers in the neoadjuvant treatment of rectal cancer at the Marsden and has maintained an active interest in colorectal clinical trials, she is the sub speciality lead for CRC for the NIHR in Yorkshire and Humber and co-lead for oncology on the Yorkshire and Humber Bowel Cancer improvement project (YCR BCIP) working to improve outcomes across the region.

Paul Ross is a Consultant Medical Oncologist at Guy’s & St Thomas’ and King’s College Hospitals.  He specialises in hepatobiliary pancreatic (HPB) and colorectal cancers.  He has served on national groups including: NCRI Upper GI Cancers Clinical Studies group, its hepato-biliary sub-group; NCRI CRC adjuvant and advanced disease group; NHSEs Chemotherapy Clinical Reference group; Association of Cancer Physicians.  His research interests are focused around pharmacogenomics, interventional oncology and clinical trials.

Paul trained at the Royal Marsden Hospital and Institute of Cancer Research.  His Research was awarded the Association of Cancer Physicians McElwain prize and an American Society of Clinical Oncology Merit award.

Lennard is an accomplished Oxford University cancer physician and our national senior advisor for the cancer vaccine advance in the UK. He is a research scene setter with a successful track record in delivering strategic national health mega projects. Combing academic expertise with effective project management and a strong background in healthcare, Lennard has made significant contributions in achieving projects for healthcare systems, industrial partners, government and those affected by cancer.

He is an Associate Professor at the University of Oxford where he is aligning strengths in vaccinology and cancer neoantigen prediction to lay the path to bespoke mRNA cancer vaccines. He is a founder of a number of research programmes including the UK Covid cancer programme, and delivery lead for the NHS-Galleri study and the UK Lateral flow Moonshot.

He has received numerous awards, including the National ACP McElwain Prize for work during the pandemic, and the IAP’s 21 Outstanding Young Physicians award, given to individuals under the age of 40 who have made outstanding contributions to the field. He has a strong track record of academic achievements, with over 50 publications in the highest impact journals, including the Lancet and JAMA.