The project looks at the correlation between demographic area and the impact it has on a sarcoma patient's diagnosis and routes into treatment pathways. It will also look at the link between poor diagnostic experiences and poorer treatment, rehab and follow-up, helping to provide evidence to shape future healthcare interventions to support earlier diagnosis of sarcoma.
Soft tissue sarcomas can be removed by surgery, but may return. All cancers are different which affects how they respond to treatment. A test is needed to predict which tumours will return and what treatments will prevent this.
Low oxygen levels in cancer, called hypoxia, make them harder to treat. Research has identified a gene signature to measure hypoxia in sarcomas. The signature needs testing in cells in a laboratory to make sure the signature is definitely measuring hypoxia in soft tissue sarcoma.
Soft tissue sarcomas are rare cancers commonly affecting the limbs. In most patients, treatment involves surgical removal of the cancer. Isolated limb perfusion (ILP) is a surgical technique that may be used when patients have a large tumours or had previous surgery. ILP delivers high-dose anti-cancer drugs to an affected limb whilst avoiding life-threatening side effects throughout the body. Research has found that adding cancer-killing viruses to ILP (OV-ILP) improved how long the treatment kept the tumour from growing, neither ILP or OV-ILP treatment prevent tumour spread.
Osteosarcoma tumours are affected by a variety of factors. One is the internal pressure of tumours, which is generally higher than the surrounding healthy tissue. This increased pressure is known to have an effect on drugs reaching the tumour. The increased pressure is also known to promote tumour growth and increases the risk of the tumour spreading.
This project looks at how this pressure is generated in osteosarcoma, how osteosarcoma cells respond to different pressures and what causes sarcoma cells with high internal pressure to grow and spread.
Pazopanib and regorafenib are drugs which are effective in the treatment of advanced soft tissue sarcoma. However, there are some patients who do not respond to treatment with these drugs and in other patients, the effect of the drugs can wear off as cancer develops resistance.
Patient experience is central to measuring the quality of care in the NHS, and government policy encourages the use of patient-reported outcomes (PRO) to facilitate patient-clinician communication. However, patients with sarcoma may have experiences which are not reflected accurately with standard or generic PRO measures (PROMs). The aim of this project is to develop a sarcoma-specific PROM (S-PROM) and a strategy to incorporate this into clinical practice.
Patients with inoperable or metastatic soft tissue sarcoma have a poor prognosis with overall survival rates (of approximately a year) when treated with current first line palliative chemotherapy. There has been no change in the standard of care for over 20 years. Improved outcomes could be achieved by identifying biomarkers that can select soft tissue sarcoma patients most likely to benefit from current and novel therapies.
Myxofibrosarcomas are cancers that most commonly develop in the limbs. Surgery is the main treatment but because of the way these cancers grow, it is a challenge to successfully remove them. Unlike other cancers that are easily visible to the surgeon, myxofibrosarcomas often infiltrate nearby tissues making it difficult to accurately assess how much cancer is present. There is a risk that some cancer is left behind after surgery, and this may result in a poorer outcome for the patient.