The PROSPECT-NE genome sequencing project will work with up to 800 cancer patients from across the North East and Cumbria over the next four years.  It will help develop ‘personal’ cancer treatments, find out how cancer is impacting on patients’ health and determine in advance if side-effects are likely from treatment.

Funded by an £892,000 contribution from the charity, the project is being delivered at the Royal Victoria Infirmary’s new Newcastle Molecular Pathology Node Proximity Lab - an exciting partnership between Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust.

Pioneering project

PROSPECT-NE links with the cancer drug trials undertaken by patients at the Sir Bobby Robson Cancer Trials Research Centre - at the Northern Centre for Cancer Care, Freeman Hospital - and today Sir Bobby Robson Foundation Patrons, Alan Shearer and Steve Harper, visited the Proximity Lab with Lady Elsie to find out more about the project.

They were joined by 68-year-old John Reid from Blyth, Northumberland, who has pancreatic cancer and is the first recruit to PROSPECT-NE.

Dr Alastair Greystoke, Senior Lecturer at Newcastle University and one of the Sir Bobby Robson Centre consultants running PROSPECT-NE, explains why genome sequencing is becoming so important to cancer treatment.

He said: “We know that cancer starts in our cells, which are the tiny building blocks that make up the organs and tissues of our body.  Each of us has about 10 trillion cells.

“Inside almost every cell is a copy of your genome, made of DNA. You can think of this as instructions for making and maintaining the cell.  It explains what kind of cell it is – for instance, is it a skin cell or a liver cell?  It also tells the cell when to grow, divide and die.

“Usually, cells divide to make new cells in a controlled way and that’s how our bodies grow and repair.  In cancer though, the tumour cells have developed a different genome to the healthy cells.  Comparing the normal and cancer genomes may give clues about ways to treat the cancer and that’s where genome sequencing comes in.”

Personalised treatment

Genome sequencing is a technique used to ‘read’ DNA, which is made up of four different chemicals represented by the letters A, T, C and G. Sequencing a human genome means finding the sequence of someone’s unique 3.2 billion letters of DNA one-by-one.

For some patients, knowing more about their genome may mean that a particular treatment can be recommended or even developed.

Dr Greystoke added: “We’re increasingly aware that every patient’s cancer is different.

“We want to determine the abnormalities that may be found in the tumours of our patients; this will allow us to choose which are the most promising clinical trials targeting specific tumours that we should try and bring to this region.

“We know from previous, more limited projects, that the tumour profiles of our patients in the North East may be very different from patients in the USA, or even in London.

“And we can now identify some of the individual abnormalities in a patients’ cancer, which may have allowed the cancer to form, grow and spread. In the future this may allow us to target tumours with treatments that have been tailored to that individual tumour profile.

“We’ve really only scratched the surface when it comes to understanding cancer and genes. Genomic sequencing is helping us unearth the secrets of cancer and to find new ways to beat the disease.”

Cancer drug trials

PROSPECT-NE is also finding out more about naturally-occurring substances in blood called biomarkers, which can help guide treatment for patients with cancer.

These include biomarkers that can tell us more about the tumour, such as any tumour cells, proteins or genetic material circulating around the body.

Dr Greystoke said: “We want to know if we can get more information from the blood about patients’ general health, to measure how the cancer is impacting on their body and maybe tell us if there is an increased chance of them experiencing side-effects from treatment.

“By testing blood biomarkers, we can see how they change over time and whether they can give us additional information about cancer and health.

“It’s a hugely important new area of research and we’re encouraged by the possibilities it offers. The reason we are performing this research is that we hope the results may benefit patients in the future.”

Patients taking part in PROSPECT-NE will be considering trials of new cancer drugs at the Sir Bobby Robson Centre and will have regular blood samples taken, undergo grip (strength) tests and general health reviews.

The number of cases of cancer in the North East and Cumbria is higher than the national average and the Sir Bobby Robson Centre sees around 450 new patients every year.

PROSPECT-NE has been specifically designed so that all of these patients are eligible and welcome to take part in research if they wish, making research more accessible for more patients in this region.

The PROSPECT-NE process

1.    Patient sees doctor at Sir Bobby Robson Cancer Trials Research Centre
2.    Consents to PROSPECT-NE
3.    Tumour sample prepared for sequencing at Newcastle Molecular Pathology Node
4.    DNA (genome) sequenced at NewGene Ltd at Centre for Life
5.    Tumour profile discussed by experts at Sir Bobby Centre
6.    If patient wants the results, these are fed back
7.    Patient sees Doctor at Sir Bobby Robson Cancer Trials Research Centre

Development of sequencing and analysis on this scale is new to the North East.  NewGene Ltd (at the Centre for Life) is developing a previously unavailable opportunity for research in the area.

The Sir Bobby Robson Foundation’s funding for this project will help maintain the Sir Bobby Robson Centre’s position as one of the country’s leading early phase trials units.  The money has been invested in essential personnel and skills development for biomedical scientists, and will enable genomic sequencing of 200 samples a year.

Alan Shearer, a Patron of the Sir Bobby Robson Foundation, says: “One of the first questions I asked today was, would you be able to do this research without funds from the Sir Bobby Robson Foundation?  And the answer was ‘no,’ so it’s all coming from Sir Bobby’s charity, which is just incredible.

“It’s a great day, and I’m sure they’ll have more of them, because everyone is determined to keep working hard to keep searching for answers.

“I’ve been walking around here with John, who’s the first person signed up to PROSPECT-NE.  It was a great pleasure to meet him and let’s all hope that he’ll benefit from taking part in this project.

“It’s hugely important to see where the money raised is being spent and it’s been fantastic to see the hard work that goes on behind-the-scenes.  Because you hear a lot about work funded, but until you actually see it for yourself, you don’t get a sense of just how technical it all is.  A lot of the science has been above my head but today’s been a real eye-opener.”

Steve Harper, also a Patron of the Sir Bobby Robson Foundation, says: “I’ve learned a bit about genome sequencing today, something I didn’t really know anything about.

“To see the detail that goes into treating people, all the way down to the level of individual DNA and then possible tailored treatments is incredible.  Hopefully it will improve rates of survival enormously.

“But just to be here in the labs, on the coalface with all the research and analysis, is incredible.  One minute I’m in a lab and looking at part of a lung and seeing what cancer actually looks like, in the next lab it’s being dissected and then you’re looking at it under a microscope.  It’s just been mind-blowing.

“People talk about the Sir Bobby Robson Foundation and the wonderful work it does thanks to generous donations but to actually see it has been amazing.

“I actually got a little bit emotional seeing the work here.  I really feel the benefit of seeing it all at first hand.  If I could speak on behalf of the people who are raising the money for the charity I’d say if you were also here you’d double your efforts.  It really is incredible.”