Pioneering research into rare cancer is making a difference
A professor who is ranked the highest in the world in his field is celebrating after receiving a prestigious award for his pioneering research into a rare type of cancer.
Professor of Thoracic Oncology, Dean Fennell, has won an international Pioneer Award for his innovative work around treating mesothelioma – an incurable lung cancer usually caused by asbestos – with personalised therapy.
This award, issued by The Mesothelioma Applied Research Foundation (MARF), recognises individuals who are pioneering scientific advances in mesothelioma research and treatment.This accolade comes just a few months after Professor Fennell was awarded the Senior Investigator Award research medal by the global International Mesothelioma Interest Group (IMIG), recognising his accumulation of work over the last couple of years.
In this Meet the Citizen, Professor Fennell talks us through his journey to becoming an expert in his field and what most inspires and challenges him.
How does it feel to have won these prestigious awards?
It’s a real honour to be recognised. However, I feel these prizes are a testament to the teamwork that led to our recent achievements. It’s not just me but a whole team effort that goes into accomplishing these things.
Tell us about your journey to becoming an expert in mesothelioma
It’s been a 20-year journey so far, the most important part of which has been the clinical aspects and helping patients afflicted with mesothelioma. It was around two decades ago that I first saw patients with this disease while I was working at St Bartholomew’s Hospital in London. I was working for and being mentored by a lung expert there, Dr Robin Rudd, who was very active in clinical trials at the time. He was very accommodating and I was able to not only gain clinical experience in treating lots of patients with mesothelioma in a specialised clinic, but also get involved in the execution and publication of clinical trials. My academic career started in pharmacology with an interest in drug mechanisms. I then completed my medical training and PhD as an MRC fellow at University College London (UCL). After qualifying as a consultant I was awarded a clinician scientist fellowship from Cancer Research UK (CRUK), which allowed me to integrate my medical and scientific expertise. I did two of those fellowships back-to-back, which allowed me to develop my group and establish myself, and move towards developing new drugs for mesothelioma by testing them in laboratories and trying to understand how they work.
Is it something you were passionate about from a young age?I’ve been passionate about pharmacology since my teens and had a deep interest in understanding how molecules in drugs could somehow interfere with complex biology.
My interest in cancer came much later during my clinical practice after seeing how much of a widespread problem the disease was, and mesothelioma particularly struck a chord because there seemed to be a massive unmet need and the treatments at the time were very poor. When I started seeing patients, we didn’t have any licensed therapy at all; there was virtually nothing except trials. As a researcher I saw this as a challenge and felt as though I could really make a difference.
Did you have a burning desire to try and help people suffering?When I saw what this cancer was doing to people and their families, I had a strong desire to help them. I was motivated by the fact that I could potentially make a difference to people’s lives. My drive and passion comes from seeing what patients have to deal with.
What is the most satisfying aspect of your role – and the most frustrating?
The most satisfying aspect is easy: seeing the results of a clinical trial in which patients live longer. Seeing that our work has changed the lives of patients for the better is a rewarding feeling. Thankfully we are now in a position where we’re seeing this more frequently, particularly with some of the newer immunotherapy drugs.The most frustrating part is that it has become more complex to carry out translational research, partly due to contractual frameworks which can be a bottleneck. As the cancer is a rare kind, it’s also particularly challenging to secure large-scale funding.
Tell us about your breakthroughs in research you’ve been involved withI’m really pleased to have been involved in a number of breakthroughs over the years, right up until a couple of weeks ago.
One of the earliest ones was a 20-year bench to bedside drug development path which was the first ever positive phase III trial of a targeted therapy for people with mesothelioma. Back in 2006, I published with a colleague the identification of a metabolic alteration in mesothelioma that we targeted in the clinic. Many years later, after a number of trials, I was again co-senior author on the pivotal trial publication in which we showed that this drug could significantly improve survival in the most aggressive form of the mesothelioma. This breakthrough was reported earlier this year. In the early 2000s some of the work that I started at St Bart’s eventually led to a positive randomised clinical trial of a chemotherapy drug that we now offer on the NHS.
The other big thing we’re doing is seeing how we can personalise medicine for patients with mesothelioma, which is a trend that has been emerging in oncology over the last 20 years. The idea is that a ‘one-size fits all’ method is not the best approach to treating mesothelioma; each patient is different and these differences need to be recognised in how we treat them. We’re just now getting to grips with the genetics of mesothelioma and harnessing this knowledge to help us treat patients appropriately according to their biology. We’ve completed a clinical trial, called MiST (Mesothelioma Stratified Therapy), which was the first of its kind in the world. Our focus was to identify personalised treatment pathways for patients with relapsed mesothelioma, by identifying which patients are likely to get the greatest benefit from different types of drug therapies, using cancer genetics to lend insights.
Where do you see your research going over the next few years?
I’d like to think we’re just at the beginning. Personalised therapy is such an important area of development for all drugs in different cancers. If you can give the right drug at the right time to the right patient, you are really on to a winner. I’m pleased to say we’re beginning to see new drugs coming through that I think could make a real difference to people’s lives.
We have a challenge with mesothelioma which is that the genetics of personalised therapy and how we target the cancer is challenging – it’s a different biology compared to other common cancers. However, things are starting to change. We’ve recently started a new platform clinical trial which we’ll hopefully kick off with the first study in the new year, so I’m feeling very optimistic.
Finally, what is it like having contact with people with mesothelioma?
The challenge you have as a physician is that when you run out of the standard treatment options, there is nothing standing between the patient and death. The most important thing that I can do, as a clinical trialist, is to offer an experimental treatment that will hopefully extend the life expectancy as well as quality of life of those patients. I get the most satisfaction from serving my patients in many cases by actually developing the trials myself.
Ultimately, it all comes down to extending my patients’ life span and chances of survival – like extending a runway for an aeroplane to land. My hope for the future is that we can continue to get more of these promising drugs licensed and make them available on the NHS for everybody, not just the few trial patients we treat.