The director’s cut: How Dr Catherine Elliott sees the future of cancer research

Firstly, welcome to CRUK! What have been your first impressions about the cancer research community?

Thank you! I have had a fascinating couple of months since starting with CRUK. I’ve met researchers and operations teams across the UK – hearing about their work and meeting many of them face to face has been really energising after months of online meetings.

Their passion and commitment to meet the challenges in improving cancer outcomes has been amazing to see. Of course, it has also been an incredibly difficult time for everyone throughout the pandemic, with the challenges of working from home, interruptions to research programmes and reductions in funding.

I’m also very aware, not least from my own clinical work, of the huge impact of the pandemic on clinical research and those involved in clinical services.

The pandemic has impacted so many areas of research, but clinical research has been hit particularly hard. What can we do to get back on track?

I really want to make sure we listen to those affected as to what the impact has been and what they need to get back on track. And we must work with many other partners – the pandemic has highlighted just how effective research can be when it is coordinated and prioritised.

We need to recognise the ongoing pressures on clinical services, and work with the NHS across the UK to ensure that research has a high priority alongside service resumption.

We also need to understand and support measures to address the pressures on the NHS R&D teams that are essential to set up and deliver research in clinical environments.

And finally, we need to appreciate the inordinate pressures our clinical research teams have faced, not least in providing clinical services above and beyond their usual work over the last years. Many will also have been dealing with challenges of childcare and other caring during the pandemic. We need to work with their host organisations to help them fully return to their clinical research careers.

You have had an impressively varied scientific career – tell us a little about your own research background.

I began my research work at the University of Edinburgh, during my obstetrics and gynaecology training.

I did my doctorate there, looking at how labour starts (it really is a fascinating process), focusing on the inflammatory pathways that lead to it, and how they can be damped down to stop preterm labour, and triggered to help induction of labour. This involved both lab work and clinical studies, as well as many nights waiting to collect samples on labour wards. I developed this work further during my years as a Clinical Lecturer at Imperial College, London.

Mentoring can be a really effective way of bolstering a research career – what are your thoughts on how we can help this, and have you had any notable mentors in your career?

I agree – research careers are hugely rewarding, but also extremely challenging at times. It can sometimes feel like there are insurmountable hurdles, as I found when combining clinical training in an acute speciality with academics and a young family. Effective mentorship can really help navigate these challenges. As can support in planning for career progression, as in developing other skills, like managing people or negotiating our commitments.

I have been really lucky, especially later in my career, to have had several really supportive mentors who have been brilliant role models as well as generous in giving me honest and positive support and critique.

Sometimes people may be in environments where they do not have a mentor who can relate to their circumstances and funders can help by creating networks for connection as well as working with universities to provide training and support for these relationships. Mentors also need mentors to learn how to be effective in this role.

What are you most passionate about when it comes to research?

I am really passionate about connecting the amazing complexity of discovery science with the needs of patients and the daily challenges seen by their clinicians. I also think it is incredibly important that we as funders and researchers continue to explain and explore progress in science with the wider public.

I’ve also always been very interested in medical law and ethics. I undertook a Masters in this, with a dissertation on the impacts of human tissue legislation on medical research and I’ve continued to be intrigued by how our frameworks for ethics and law respond to progress in medical research and innovation.

What role do you see for funding organisations in terms of guiding, as well as just funding, the direction of science?

This is an area where I think funders can bring a lot of value. Funders, such as CRUK, have teams of incredibly smart and committed people who have a very wide view across the spectrum of relevant research. And we also have the privilege of being able to work with leaders across this span to develop a co-ordinated approach to meeting a vision.

We also connect with patients and the public and so can bring that understanding of what our supporters are looking for when they so generously donate. As funders, we also understand the range of approaches we can bring to maximise value from investment – from networks, to response mode, to infrastructure – and which to adopt to meet a particular goal.

Does curiosity-led research still have a role to play in an environment that is so goal directed?

Absolutely – without question. Without curiosity driven, discovery-based work we would not have the future pipelines that lead to patient benefit. We need to understand the complex, interconnected mechanisms that underly cancer development and progression in order to be able to identify new targets for more directed research.

We also need to be open to ideas from other fields and disciplines which can shed light on our own areas of focus. In parallel, cancer research is part of the whole panoply of discovery science and will have benefits for many other areas of human disease, for example the translation of cancer vaccine work into the effective approaches to Covid-19 vaccines.

Positive research environment is becoming a hugely important part of the way we want to conduct science… what do you see as the main things we need to improve to ensure this?

I think it is so important to be clear on the values we expect in the research environments we fund, and also to ensure there are effective ways to assess whether these are being put into practice.

We also need to ensure that within our own teams and organisation we model these. For me this includes integrity, transparency and ensuring that everyone has an equal opportunity to progress on their own merits regardless of their background or any other characteristics. We have made a lot of progress, but I think there is more to do to ensure that we proactively support positive, energising and inclusive places to conduct research.

There are large scale changes to implement at organisational level, but also every individual, particularly those of us in leadership roles, needs to be conscious of the impact our behaviour has on others and strive to ensure that our impact is positive.

How important is core funding to fostering a research environment that encourages experimental approaches and exploring bold new ideas?

I think this is really important – core funding enables CRUK to support world leading facilities and research teams with capacity to innovate and take risks. Without such funding it is very difficult to run large and complex facilities, for example for DNA sequencing, advanced microscopy or data analysis. Core funding provides security for the highly trained specialists who run these and means researchers are in the right environment to let them think big and take their research to the next levels.

Large scale core funding, such as CRUK Institutes have, also coalesces teams who work across disciplines and without boundaries, with more security of funding to develop innovation and take risks which in turn attracts global leaders to such environments.