International Clinical Trials Day: The Wales Cancer Trials Unit goes global

James Lind (1715-1794) - the father of modern clinical trials. Image from Wikimedia Commons

May 20^th was International Clinical Trials Day, first established in 2005 to raise awareness of the importance of clinical trials.

To recognise this, Gareth Griffiths, Scientific Director of the Cancer Research UK Wales Cancer Trials Unit – one of our seven pioneering trial units around the UK –  tells us about the international importance of his Unit in running world-class clinical trials.

But first, a bit of history…

The first clinical trial

20^th May was chosen to mark the first recorded controlled clinical trial back in 1747, when a Scottish naval surgeon called James Lind carried out a clinical trial on sailors with scurvy. He gave a number of sailors either cider, vinegar, seawater or oranges and lemons in addition to their normal rations.

Lind found that the sailors who received 2 oranges and a lemon every day recovered from scurvy, providing the first hard evidence that citrus fruits in the diet prevent scurvy. James Lind published his findings and as a consequence the British Navy began to supply their ships with limes to prevent scurvy – hence the old nickname “limeys”.

Although the techniques may have moved on since Lind’s time, clinical trials remain the gold standard of scientific evidence for the effectiveness of treatments for diseases such as cancer.

Clinical trials in cancer

Most cancer trials fall into one of three ‘phases’, depending on their size and aims. This diagram explains the difference:

Introducing the Wales Cancer Trials Unit

The Wales Cancer Trials Unit, based within the Cardiff Cancer Research UK Cancer Centre, is an All-Wales clinical trials unit carrying out studies of new cancer drugs and different ways of giving chemotherapy, surgery and radiotherapy. The Trials Unit recruits cancer patients from hospitals across Wales via the Wales Cancer Research Network nurses, funded by the Welsh Government and Cancer Research UK.

Furthermore, the Unit not only carries out clinical trials in Wales and the rest of the UK but also internationally, and the results from the trials provide evidence to justify new, better treatments for the cancer patients of Wales and beyond.

Here are just a few examples of the pioneering clinical research going on at the Unit:

International clinical trials in leukemia

The Unit is running an important Cancer Research UK-funded clinical trial in leukemia called AML17, led by Professor Alan Burnett at Cardiff University. This large-scale trial is looking at a number of new drugs to treat acute myeloid leukemia in younger people and needs to recruit thousands of patients.

The trial started recruiting in Wales and the rest of the UK but has recently opened to patient recruitment in Denmark and New Zealand. When the results come out in about two years’ time they could change the way this disease is treated around the world.

International trials in Welsh Hospitals

The Wales Cancer Trials Unit worked with Professor John Wagstaff at Swansea University to open a trans-European kidney cancer clinical trial in the UK called SURTIME. This is a study looking at when to give surgery, either before giving the cancer drug sunitinib (Sutent) or later on after drug treatment has started, to see which timing is most effective at treating the disease.

Led from Brussels, the trial was originally only open to patients in mainland Europe. But Cancer Research UK funded the Wales Cancer Trials Unit to open SURTIME to cancer patients in Wales and the rest of the UK. This has resulted in a truly international collaborative trial which will help to find the best treatment for kidney cancer patients.

Building international collaborations

Some cancers are rare (for example, salivary gland cancer) and there aren’t enough patients in any one country to run trials big enough to properly investigate new treatments.

Cancer Research UK has spearheaded an initiative with the US’s National Cancer Institute and the European Organisation for Research and Treatment for Cancer (EORTC) to investigate how the UK, US and other European countries can work together to recruit enough patients for trials in rare cancers.

As a result of this International Rare Cancers Initiative, more trials in rare cancers should become available to Welsh and UK cancer patients in the future. And because of my involvement in this initiative, I’ve been invited onto the United States National Cancer Institute International Planning Committee representing Cancer Research UK. This group is looking to create a network of countries across the world, including countries in Europe, North America, South America, China and Japan, kick-starting an exciting new era of international clinical trial collaboration.

The most important people are the patients

Although clinical trials units like the one in Wales are an essential part of the process, life-saving cancer trials simply wouldn’t be possible without the patients who volunteer to take part.

Nearly one in five cancer patients in the UK now take part in clinical trials – more than anywhere else in the world – and their involvement is shaping the new treatments of the future. By contributing to this vital work they are helping us make huge progress towards beating cancer, and we owe them a huge debt of thanks.

Gareth Griffiths, Cancer Research UK Wales Cancer Trials Unit

• To find out more about cancer clinical trials running in Wales and throughout the rest of the UK, have a look at the clinical trials database on the CancerHelp UK website.