Oesophageal Cancer requires very specific and painstaking research. The OCF supports a variety of institutions that are on the very cutting edge of that research, helping to find innovative new treatments for patients in the areas of Early Diagnosis, Treatment and Survivorship.
The research has tangible, lifesaving results. For example, nowadays patients with certain types of diagnosis and at certain stages, may be able to avoid invasive surgical procedures as part of their treatment – a breakthrough that would have been unheard of just 10-15 years ago.
When deciding which of the many cancer research projects to fund, we at the OCF look through individual programme and project grant applications in clinical and translational research, in the field of Oesophageal Cancer. Clinical research can be aimed at any aspect of the disease spectrum, including epidemiology, prevention, diagnosis, assessment and staging, and management of Oesophageal Cancer.
Public health awareness and epidemiological studies are of great interest to us as well as studies which investigate symptom palliation and quality of life, especially if those studies are national collaborative studies with better reflect the national profile of the OCF’s fundraising.
How Effective Has OCF Funding Been To Date
Barrett’s Oesophagus Registry and Bio Bank - Through a large programme grant funded by the OCF in 2009, that still continues today, we saw the creation of the first ever national Barrett’s Registry in Ireland, directed by Professor John V. Reynolds, Upper GI Consultant, St. James’s Hospital. Apart from the goal of increasing the early diagnosis of Oesophageal Cancer, this registry helps improve services and information for patients. It also allows Consultants to see if changes in the management of patients should be altered. In parallel with the registry, is the development of the first ever Barrett’s Oesophagus National Bio Bank where tissue and blood samples are collected with patients’ consent, used for research studies. This Bio Bank infrastructure supported by The Oesophageal Cancer Fund, has enabled students and researcher to apply to funding bodies to conduct further research using this collected material, to great success. Through this OCF-funded programme, collaborations have been formed with leading international groups in Barrett’s Oesophagus and Oesophageal Cancer.
OCF has funded the National Barrett’s Oesophagus Registry and Bio Bank since 2009, in 2020 Precision Oncology Ireland joined with OCF to jointly fund this programme.
The Barrett’s Oesophagus Registry, is a database that was established to meet our aim of combating Oesophageal Adenocarcinoma (OAC) through early detection. To date, over €1.6 million in funding has gone towards keeping the Registry alive, employing five full-time Registry personnel and linking five national hospitals: St. James’s, St. Vincent’s, Beaumont, Mater Misericordiae, Dublin and Mercy Hospital, Cork. Since 2009 over 8,500 patients have been recorded on the Barrett’s Registry. Though not cancerous, Barrett’s Oesophagus is a condition that is frequently a precursor to full-scale Oesophageal Cancer.
The Registry helps the medical professionals identify at-risk patients earlier and track their progress using endoscopies and bioscopies. Cellular changes such as dysplasia and or cancer can be diagnosed much earlier, meaning Oesophageal Cancer can be addressed in its early and most treatable phase.The data manager records and monitors a range of follow-up data for all Registry patients across all five hospital sites. Barrett’s patients who show progression in their disease are offered Radio Frequency Ablation (RFA) therapy, a highly effective Halo procedure that eradicates diseased tissue and allows healthy new tissue to regenerate.
The Barrett’s Oesophagus Registry is now part of the UK Radio Frequency Ablation Registry that covers 26 hospitals of which St. James’s Hospital Dublin is the third largest contributing centre. OCF donations also fund a National Barrett’s Bio Bank that operates in tandem with the National Barrett’s Registry. Tissue and blood samples from consenting Barrett’s patients are collected, stored and used for vital patient-focused research that is helping medical professionals to better understand what factors drive progression to Oesophageal Cancer. A number scientific studies which have utilised this national biobank have been submitted for publication.
Other Examples of Research Funded
Neo Aegis Clinical Trial ending 2022 - Currently OCF is one of the funders of the Neo Aegis Clinical Trial. The Neo Aegis Clinical Trial is a is a major, international clinical trial led from Ireland by Clinical Trials Ireland that has recruited 377 people with Oesophageal Cancer, a third of whom [136 (34%)] are based in Ireland.
The trial seeks to establish the best available treatment for patients presenting with advanced but potentially curable Oesophageal Cancer, and compares chemotherapy alone combined with surgery against a combination of chemotherapy and radiation therapy prior to surgery.
The study has cemented two ‘standard of care’ treatment options for Oesophageal Cancer as ‘equivalent’, thereby keeping treatment options open and viable for patients with Oesophageal Cancer depending on regional and national networks.
Importantly the outcomes have been excellent in both treatment arms. This result is particularly important bearing in mind the differing availability of treatment options in different regions nationally and internationally.
The findings of the The Neo Aegis Clinical Trial were presented in 2021 at the world’s most prestigious and competitive clinical cancer research conferences (ASCO 2021), which will pave the way for a publication in one of the world’s most eminent medical journals.
Development of patented medical devices for the minimally invasive electroporation assisted ablation of internal cancers. (Grant fund from the OCF). This funded project was led by Dr Declan Soden and involved the development of patented medical devices for the minimally invasive electroporation assisted ablation of internal cancers..
The project involved the co-ordination of CCRC engagement with an EU-funded Cancer Network of Excellence, which provided collaborative links with 20 leading EU cancer centres. (Grant fund from the OCF). This research received Irish Medicines Board approval to commence a Phase I trial using a new endoscopic system to treat Colorectal Cancer (November 2009) and Lung Cancer (April 2011). Awarded Innovation of the Year award for 2011 based on Lung Cancer work. Awarded Pfizers Innovation through Teamwork award – 2014
An Investigation Into the Impact of Impaired Gallbladder Function on the Development Of Barrett’s Oesophagus and Oesophageal Cancer. This study compares gallbladder function in patients with Barrett’s Oesophagus, adenocarcinoma, and controls. Oesophageal adenocarcinoma is associated with gastroesophageal reflux, but the mechanisms responsible for this are unknown. Bile components are implicated, and so impaired gallbladder function may contribute to duodenogastric reflux (DGR) and harmful GORD. More information can be found here;
Multiple Primary Oesophageal Cancer Tumours - The Oesophageal Cancer Fund funded a project examining the long term importance of follow up on patients with Oesophageal Cancer. The importance of follow up has increased due to better survival rates. Concluding that patients require advice and surveillance on the long term effects of surgery of the Oesophagus. More information can be found here;
Badcat - The aim of the Badcat research was to provide consensus recommendations, based on up-to-the-minute medical literature, to assist clinicians in making decisions about the management of low grade dysplasia, high-grade dysplasia and early Oesophageal Adenocarcinoma in Barrett’s Oesophagus patients. More information can be found here
Studying The Effects Of Pre-operative Chemoradiotherapy On Oesophageal Cancer. The aim of this collaborative study was to evaluate the effects of a certain type on chemoradiotherapy on a phenomenon called Vascular Endothelial Growth Factor (VEGF), the levels of which are raised in the serum of patients with Oesophageal Carcinoma. More information can be found here;
Cork Cancer Research Centre - Research funded by the OCF delivered positive initial results when native Dr Declan Soden, who led the project, revealed some very promising indicators after early trials of a new technology. The tech, which was developed at the Cork Cancer Research Centre has now completed an OCF-funded trial, Phase I, for use in the treatment of Oesophageal Cancer specifically.
The system Dr Soden and his colleagues developed is a world first in the treatment of Oesophageal Cancer, by which a short burst of electrical energy is delivered directly to the tumour via an endoscopic device. This energy burst makes the tumour "leaky" and allows for greatly improved take-up of chemotherapy.
In previous clinical studies with this technology in other cancers – colorectal and skin cancer– they have seen excellent results, even in those previously unresponsive to chemotherapy or radiotherapy.
Dr Soden is very hopeful that this technology advance will help greatly in improving Oesophageal Cancer patients’ quality of life. “OCF fundraising has allowed us to bring a new endoscopic outpatient treatment to patients," he said. "As a result of this support we have started treating patients in a clinical trial with excellent results so far.” "Improving patients’ quality of life is our goal," he continued, "and the OCF has enabled us to bring this new treatment to the patients that need it most.
The OCF has had a tremendously positive impact in raising awareness of Oesophageal Cancer, connecting survivors and in supporting innovative research.” We must point out that there’s still a long road ahead.
In data provided by the National Cancer Registry, Dublin has seen almost a doubling in Oesophageal Cancer diagnoses over the last 20 years, with major increases also observed in North Tipperary, Wexford and Waterford. Internationally, the reported incidence of Oesophageal Cancer in the western world has risen over four-fold in the last 30 years. "The OCF could not do this without the generosity and support of the public. They receive no other funding and rely entirely on public support throughout the year," said Dr Soden. "
