PreventionTreatment The age-old search for innovative cures for Cancer continues at a new clinic

At Hammersmith Hospital’s newly-opened oncology outpatients clinic, clinician scientist Dr David Pinato speaks of the “beauty” of creating new cures for cancer and giving hope to patients who are out of options.

Also, a leading oncology consultant at Imperial College Healthcare NHS Trust, clinical reader at Imperial College London and a key member of the NIHR Imperial BRC Surgery and Cancer Theme, Dr Pinato leads a team of doctors, nurses and researchers offering brand new treatments as part of a suite of clinical trials. The patients they recruit from across the UK and all over the world are often the first to receive these cutting-edge treatments.

New treatments, tried and tested technologies

Among the most exciting new therapies being trialled are some of the mRNA-based drugs that may have the potential to treat a variety of cancers by preventing them from spreading through the body.

These “innovative” new therapies use similar technology to the COVID-19 vaccines, which were accelerated during the pandemic following years of extensive research, to protect millions of people worldwide.

“It’s very innovative because it could enable their body to do the work and block the cancer directly. These treatments work by helping the body create defences against specific proteins that help aggressive cancers to grow more quickly,” said Dr Pinato.

“The idea with this kind of technology is to inject patients with a series of precise and often personalised instructions in the form of mRNA that might facilitate the immune system’s ability to recognise and clear the cancer better.

“This approach is very innovative because it will enable the patient’s body to do the work and block the cancer directly.”

This new approach differs from current targeted treatments, where antibodies that block cancer growth are made in a lab and given to a patient via infusion. The latter comes with the risk of allergic reactions or that a patient’s immune system might kill the new antibodies.

Trials at the cutting-edge of medical science

Clinical trials at the Trust are supported by the National Institute of Health and Care Research (NIHR) – it awarded the Imperial Biomedical Research Centre (BRC) £95m in 2022 to continue providing essential infrastructure to run clinical trials like this.

However, with treatments as new as those being trialled at this clinic, researchers are not always certain what potential side effects could later arise.

“It’s exciting but it can also be daunting for us, and of course for the patient,” “Imagine as a clinician you’re using a drug that’s maybe never been used before and you might not know what the side effects will be.

“A lot of the time my job is literally facing the unknown, navigating without a compass. But there is a lot of beauty in it. And I’m surrounded by young clinicians who come here to learn how to use cancer medicines for the first time. It’s an interlinked journey of learning, patient care and research, and it’s actually quite unique” said Dr Pinato, whose research is also supported directly by the NIHR Imperial BRC.

Immunotherapy for liver cancer

Another experimental therapy being trialled by the Trust and Imperial College London is a new form of immunotherapy against liver cancer, as Dr Pinato explains. “We are amongst the first centres that have been trying to use immunotherapy to treat liver cancer. Usually immunotherapy is used as a way to boost the patient’s immune system when, unfortunately, the cancer has spread outside the liver.”

This can increase the length of time a patient has to live but not cure them. “Whereas we’re trying a different approach, funded in collaboration with pharmaceutical companies and partnered with Imperial College London, to use the immunotherapy in a patient before they have surgery to remove a tumour so that you improve the chances of them being cancer-free forever.”

Callan’s story

The new outpatient unit at Hammersmith Hospital welcomes patients receiving a range of experimental trial therapies. One patient who has been taking part in a clinical trial is Callan Rogers, a mountain climber and mixed martial arts fighter who has also been sharing the story of his cancer journey with his thousands of TikTok and Instagram followers.

Diagnosed two years ago with cancer that has spread to his lung, Callan has experienced multiple rounds of different chemotherapies. Some treatments were sparing enough to let him continue his fitness regime, but others left him feeling “stripped of everything” – without enough strength to walk and in too much pain to eat. A round of blood stem cell high-dose chemo saw his body weight plummet from 82kg to 54kg in two weeks.

But when he began the trial, Callan said his appointments were a “breath of fresh air”. He now feels “proud” to have played a part in enabling the discovery of cutting-edge cancer treatments that could save lives.

“It’s been a breath of fresh air because it’s been a great change of pace. They really look after me. I actually feel quite happy when I do come to the hospital now,” he said.

“For a while everything was quite daunting, I was nervous, anxious.

“I’ve started realising I have more to offer. Doing chemo you feel like you’re going through the motions a bit and feeling negative. Now it feels like I can actually help people. And I’ve been posting about it on social media.”

Callan continued: “Sometimes you don’t realise how much you can be helping people.

“I had a message from someone saying their husband had decided to go ahead with one of the [trial] treatments I’ve done in the past because they saw me post about it, when the alternative was no treatment at all.

“So yes I am quite proud of myself. Not every day, you have fluctuations, but some days I think to myself ‘Yes this is the future of treatment’.”

Patients today driving solutions for tomorrow

The trials can only happen thanks to the generosity of the patients who agree to participate despite being told there are potential risks, and that the chances of success aren’t certain.

Dr Pinato said, “There’s something I always tell my patients when they have reservations, it’s that this is the only chance of us having new treatments or even the treatments we have today. They were only researched maybe six months ago, or a year ago, or 10 years ago – today’s medicines were yesterday’s research.

“Sometimes you don’t realise how much you can be helping people.” – Callan Rogers, patient

“A lot of people come here for that sense of altruism, that sense of something bigger. But unfortunately, when treatments haven’t worked, that residual sense of gratitude and having enabled change is the strongest driver.”