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Leeds Cancer Centre, UK June 2013.

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Presentation on theme: "Leeds Cancer Centre, UK June 2013."— Presentation transcript:

1 Leeds Cancer Centre, UK June 2013

2 Leeds Cancer Centre Provides comprehensive cancer services for
750,000 population of Leeds 2.7 million population of Yorkshire Supra-regional services for 5.4 million population of Yorkshire-Humber

3 Leeds Cancer Centre Cancer services co-located at St James’s University Hospital St James’s Institute of Oncology – clinical care / trials Opened in 2008, £220 million development 3rd largest cancer centre in the UK (66,000m2, 350 beds) Leeds Institute of Molecular Medicine – laboratory research £21M development, opened 2005 >7,000m2 building linked to existing research laboratories

4 St James’s Institute of Oncology
11 floors, 12 wards, patient hotel Excellent transport links (airport 20 minutes) Unites Non-surgical oncology (including TYA cancer) State of the art imaging and radiotherapy Specialist Cancer Surgery Haematology Clinical pathology Cancer registry Protected research beds

5 UK cancer incidence, 2009

6 Leeds Cancer Centre Comprehensive cancer services
Surgery, chemotherapy, radiotherapy Radiology and pathology Clinical research Academic research 24 site specific multi-disciplinary teams Common cancers - breast, colorectal, lung Intermediate cancers – gynaecology, urology, upper GI, H&N Others – liver, CNS, melanoma, skin, thyroid Haematological malignancies

7 Multi-disciplinary teams
Site-specific teams basis of cancer care Weekly meeting to review all new and relapsed cases Leeds and Yorkshire Central, specialist review of all radiology, pathology Electronic transfer of radiology Working towards digital pathology Patients managed according to clinical guidelines Guidelines agreed across Yorkshire Cancer Network Site specific teams subject to annual peer review Measures defined by National Cancer Action Team Would omit this slide, this detail can soon be delivered verbally if necessary

8 Our workload 12,500 new cancer diagnoses in Yorkshire each year
6,500 radiotherapy patients 90,000 fractions of radiotherapy 5,000 cycles of chemotherapy 120 bone marrow transplants 11,700 elective NSO admissions 3,500 acute NSO admissions Significant specialist surgery workload

9 Leeds Cancer Centre 430 consultants 1240 nurses 100 radiographers
Including: 31 clinical oncologists 24 medical oncologists 22 haematologists 33 histopathologists 42 radiologists 70+ surgeons 35 general surgeons 4 thoracic surgeons 5 gynaecology surgeons 12 urology surgeons 4 head and neck surgeons 8 plastic surgeons 6 neurosurgeons 1240 nurses 100 radiographers 60 medical physicists 20 allied health professionals Includes dieticians occupational therapists physiotherapists speech and Language therapists social workers

10 Cancer surgery First class Service Delivery incorporating state of the art technologies Robotic Surgery Laparoscopic Surgery

11 Chemotherapy Comprehensive range of chemotherapy services
Intravenous / Oral Intra-peritoneal / Intra-vesical / Intra-arterial Rapid access to modern drugs Modern cytoxic chemotherapy drugs Targeted therapies

12 New agents targeting the VEGF Pathway
Antibodies inhibiting VEGF (e.g. bevacizumab) Antibodies inhibiting VEGF receptors Soluble VEGF receptors (VEGF-TRAP) Small-molecules inhibiting VEGF receptors (TKIs) (e.g. PTK-787) Ribozymes (Angiozyme)  Permeability VEGF VEGFR1 FLT1 Cation channel VEGFR2 KDR P– – P – P P– – P P– – P P– P– P– – P – P Migration, permeability, DNA synthesis, survival Angiogenesis Lymphangiogenesis

13 Radiotherapy Linear accelerators Brachytherapy unit
10 NHS, 2 research 4 Planning CTs Brachytherapy unit State of the art technology Image guided radiotherapy Intensity-modulated radiotherapy Volumetric Modulated Arc Therapy Stereotactic radiosurgery unit UK lead in stereotactic body radiation World first clinical use of Agility (beam shaping device) and use with SABR technique – October 2012

14 Haematology Supra-regional service (3.8 million)
Treats both adults and TYA 43 beds, +ve pressure hepa-filtered Bone marrow transplantation 50 allografts, 55 autografts On-site stem cell harvest National lead for PNH Prof Peter Hillmen Strong research record Myeloid – Dr David Bowen Lymphoid – Prof Pete Hillmen Myeloma – Prof Gordon Cook

15 Paediatric and adolescent cancer
Designated treatment centre for 3.8 million population Paediatric oncology Paediatric haematology Teenage and Young Adult Bone marrow and stem cell transplantation Services located at Leeds General Infirmary 3 in-patient wards, 25 beds Dedicated day care unit and out-patient clinic One of the most active research centres in UK National leadership roles throughout International leadership in TYA and cancer survivorship

16 Clinical Informatics PPM Clinical outcomes
All cancer diagnoses since 1990 ChemoRx and RadioRx since 1995 All clinic letters, MDT reviews since 2002 Clinical outcomes Early morbidity/mortality Overall survival Open-source EHR in development Trust-wide clinical portal Links to primary care SystmOne and EMIS

17 Pathology Standard light microscopy plus antibodies
Molecular phenotyping HER2 over-expression in breast cancer EGFR mutations in lung cancer K-Ras mutations in colorectal cancer Part of CR-UK Stratified Medicine Programme Aiming to deliver Next Generation Sequencing Cancer Genome in 4 hrs for $1000

18 Clinical trials - Recruitment
Strong clinical trial recruitment across LTHT 33% of all patients recruited to trials 10% of patients recruited to randomised controlled trials Large, dedicated trial support team Nurses, co-ordinators, data clerks, administrative/finance Leadership profile Colorectal cancer; ovarian cancer; breast cancer

19 Clinical trials - Leadership
Chief Investigator on large international phase III trials ICON3 – Dr Tim Perren, NEJM, 2011 FOCUS2 – Prof Matt Seymour, Lancet, 2011 EMBRACE – Prof Chris Twelves, Lancet 2011 CR07 – Prof Sebag-Montefiore, Lancet 2009 Leeds Clinical Trials Unit Prof Julia Brown Co-ordinating centre for phase 1 Myeloma UK Network NCRN – national co-ordinating centre for cancer research Prof Matt Seymour

20 Cancer Research UK Clinical Centre
Director – Prof Tim Bishop Formal partnership between University of Leeds, LTHT, Cancer Research UK 4 core programmes Genetics and epigenetics of cancer Targeted therapies Early phase and randomised prospective clinical trials Biomarkers and pathology Aims to harness the scientific power of Leeds-based cancer researchers in order to deliver improvements in cancer therapy at local, national and international level. 

21 Leeds Institute of Molecular Medicine
Director Prof Peter Selby Level 9 - Genetics; Molecular Gastroenterology Level 8 - Neurosciences Level 7 - Experimental Cancer Therapeutics Level 6 - Experimental Haematology Level 5 - Targeted Cancer Therapies Level 4 - Cancer Pathology, Tumour Biology Level 3 - Support services

22 Radiation research Prof David Sebag-Montefiore
Dedicated research facility Collaboration with Elekta UK consortium with Elekta Christie, Manchester Marsden, Sutton International consortium Netherlands Cancer Institute Princess Margaret (Toronto) Algemeines Krankenhaus (Vienna)

23 Imaging Research Leadership in both PET and MRI
Dr Andrew Scarsbrook Prof David Buckley Involvement with CR-UK Large portfolio of oncology projects (>150) Dedicated research PET/CT machine

24 Surgical research Led by Prof David Jayne Surgical Technologies
Stratified Surgery TISSUE-DEVICE INTERACTIONS INTRA-ABDOMINAL PLATFORMS BIOSENSORS FLUORESCENCE-GUIDED SURGERY INTRACORPOREAL ROBOTICS I have put this back in as this is really ground breaking stuff from a surgical oncological perspective – all of this is being developed by david Jayne in conjunction with world class biotechnical University of Leeds departments

25 Surgical research MRC/EME/NIHR ROLARR Trial
Robotic vs Laparoscopic Rectal Cancer £1.2m over 5 years Pan-World randomised control trial Intraoperative fluorescence for Stratified colon cancer surgery MRC/EME/NINR GLiSten Trial £1m over 3 years Multicentre UK randomised controlled trial Fluorescence guided surgery

26 Any questions ?

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