Since 1992 I have been developing in Edinburgh a portfolio of collaborative clinical and laboratory research in breast cancer supported by peer reviewed funding. The focus has been on clinical trials of postoperative adjuvant irradiation, the assessment of the role of telemedicine in multidisciplinary decision making on primary treatment, and more recently this has included the role of carbonic anhydrase inhibitors in conjunction with radiotherapy in the pre-operative treatment of breast cancer and the development of real time biosensors of tumour biology to guide radiotherapy.
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1998-2009: £847,453 from Department of Health. Postoperative adjuvant irradiation for breast cancer in the elderly (Health Technology Assessment). PRIME trial.
Co-Chief Investigator (joint grantholder with Professor R Prescott, Edinburgh University) for a 6 year grant from the Department of Health (Health Technology Assessment) for a trial assessing the impact of postoperative adjuvant breast irradiation on the quality of life of women aged 65 or older at low risk of local recurrence after breast conserving surgery and adjuvant endocrine therapy. Co-grant holders: Professor D George (Glasgow University); Professor M Dixon (Edinburgh Breast Unit); Mr J Cairns (Aberdeen University) and Mr R Lindley (Edinburgh University).
2005-2010: £144,639 from Chief Scientist's Office for administrative support as Chief Investigator of PRIME 2 trial.
The PRIME 2 trial assesses the input on local control in 1000 patients from the omission of postoperative radiotherapy in low risk older patients managed by breast conserving surgery and adjuvant endocrine therapy.
Joint grantholders: Professor RJ Prescott (Edinburgh), Mr JM Dixon (Edinburgh), Professor A Rodger (Glasgow), Mr P Walsh (Inverness), Dr L Williams (Edinburgh)
2003-2006: £295,810 Breakthrough and Cancer Research UK Genetic Breast Cancer Trial. Funded in March 2004. Co-applicant with Dr J Mackay (Principal Investigator, Imperial College, London) and others.
The study assesses the role of taxanes in metastatic breast cancer in patients with BRCAI and BRCA2 mutations.
2005-2014: £2,121,597 Medical Research Council Health Service and Public Health Research Board.
Chief investigator of MRC SUPREMO trial - randomised international phase III trial assessing the role of postmastectomy radiotherapy in intermediate risk breast cancer, Co-grantholders Dr P Canney, Professor A Price, Professor J Bartlett, Dr G Thomas, Professor JM Dixon, Mr R Sainsbury, Dr M Denvir, Dr E Aird, Dr T McDonagh, Dr A Bowman and Dr J Thomas. The is run under the auspices of the Breast International Group (BIG 2-04) in collaboration with Anglo-Celtic Clinical Oncology Group, European Organisation for Research and Treatment of Cancer and Australia and New Zealand Breast Cancer Trials Group. There are biological, cardiac, quality of life and health economic substudies. Target accrual is 3700 patients over 4 years with 5 years of follow up. The trial was launched in Edinburgh on 17th June 2005 and opened for accrual on 7th June 2006.
2008 HK $1,000,000 from the William and Elizabeth Davies Foundation, Hong Kong to support the recruitment of 100 patients from a network of eight Chinese centres including Beijing and Shanghai into the MRC SUPREMO Trial.
RARECARE 2007 - 2010: 188,019 Euros from European Commission FP6 Programme
I am a co-grant holder for the University of Edinburgh with Dr Gemma Gatta (Chief Investigator) Cancer Epidemiologist, Istituto Tumori, Milan on a European Union Public Health programme 36 month grant proposal for €2,284,646 from 1/1/07 to (i) provide operational definition of rare cancers (ii) estimate the burden of rare cancers in Europe (iii) improve the quality of date on rare cancers (iv) develop strategies to exchange information on surveillance and treatment of rare cancers in Europe. I co-ordinate the work package on dissemination of the results for which I have received a grant of 188,019 Euros. Other work packages include Co-ordination of the project (Dr Gemma Gatta, Italy), Evaluation of the project (Professor Michel Coleman, UK), Definition and list of rare cancers (Dr Pancras Hogendoorn, The Netherlands), Health induction, Survival and Prevalence (Dr Riccardo Capoccacia, Italy) and Cancer Registry and Rare Cancers (Dr Carmen Martinez, Spain).
2007 - 2012: £184,839 from Cancer Research UK to cover salary and running expenses for Experimental Cancer Medicine Centre
I am co-grant holder for the Edinburgh Cancer Research Centre with Dr ARW Williams, Dr AJM Stevenson, Dr A Thomson, Dr BH Ramsahoye, Dr CD Gregory, Dr CM Abbott, Professor CMG Gourley, Professor DA Cameron, Dr D Brewster, Dr D McLaren, Dr FK Habib, Professor HAC Cubie, Professor J Bartlett, Dr J Thomas, Dr K Grigor, Dr KL Ball, Dr LA Stark, Dr L Forrester, Dr L Wall, Dr MM Wallace, Dr P Ghazal, Dr RA Goodlad, Dr RL Hayward, Dr S Guichard, Dr S Langdon, Dr SM Farrington, Dr T Riddick Dr T Sethi, Dr W Wallace, Mr AS McNeill, Professor JM Dixon, Professor AP Bird, Professor A Price, Professor DI Jodrell, Professor DJ Porteous, Professor D Melton, Professor H Campbell, Professor II Goryanin, Professor J Smyth, Professor MG Dunlop, Professor M Sharpe, Professor MT Fallon, Professor PJ Sadler, Professor R Millar, Professor R Procter, Professor SG Hillier, Professor TR Hupp.
1999-2002: £158,000 Scottish Office (Dept of Health) Scottish Founder mutations in BRCA1 and BRCA2 and modifiers of genetic cancer risk.
Co-grant holder with Professor. M Steel (Principal Investigator, St. Andrews University), Mr A Thompson (Dundee University), Ms E Anderson (Edinburgh University).
2004-2005: £28,400 from Robertson Trust. Study of genetic mutations in male breast cancer in collaboration with Professor M Steel, (St Andrews University), Professor A Wyllie (University of Cambridge) and Mr I Young (University of Edinburgh).
2003-2006: 919,609 Euros EUROCHIP 2 project on European health monitoring indicators for cancer. Joint grantholder with Dr Andrea Micheli (Principal Investigator, Milan).
The EUROCHIP 2 project builds on the EU funded EUROCHIP I project in which health monitoring indicators were agreed among 15 EU countries. It is collecting these indicators in all 25 EU countries. I chaired the Care and Treatment group.
1996-1998: £16,000 from the European Union (DGX111) on behalf of the British Oncological Association. Satellite broadcasting in Oncology.
Eurotransmed, medical television network provided satellite broadcasts in medicine and surgery from London to over 200 receiver sites in the UK and mainland Europe. A European Union grant was awarded to evaluate by questionnaire the educational value of 6 satellite broadcasts in oncology on behalf of the British Oncological Association. I was joint grantholder on behalf of the British Oncological Association in collaboration with the EORTC, European School of Oncology, and the University of Leeds. I wrote a summary of the evaluation for the project report to the European Union.
1996-1998: £42,000 grant from the Nancie Massey Trust. Optimisation of dose distribution within the intact breast in the management of early breast cancer.
Jointly with Dr A Redpath (Dept of Oncology Physics, Edinburgh).
Using compensators in two planes for tangential breast irradiation and three dimensional dosimetry based on multislice CT scans of the breast of women undergoing breast irradiation, we showed that it is possible to reduce the variation in dose distribution across the breast from 20% to as low as 5% (see publications).
1997-1999: £68,700 from the Robertson Trust (Glasgow) BRCA2 mutations and CYP17 polymorphisms in male breast cancer.
Principal grantholder (Robertson Trust Glasgow) (jointly with Professor M Steel (St. Andrews University), Professor A Wyllie (Cambridge University) and Professor M Hooper (Edinburgh University).
A study of mutations of the BRCA2 gene and polymorphisms of the CYP17 gene which codes for the P450 c17alpha enzyme involved in oestrogen synthesis among 64 male breast cancer patients treated in Edinburgh. Laboratory work was undertaken by Mr Ian Young, Surgical Research Fellow in the Molecular Medicine Centre, Edinburgh University.
1997-1999: £90,000 Scottish Executive Grant. Prospective audit of malignant spinal cord compression in Scotland.
Joint grantholder with Dr P Levack (Principal Investigator, Dundee), Dr R Grant (Edinburgh), Dr D Collie (Edinburgh), Professor R Rampling (Glasgow) and Professor A Munro (Dundee) for a prospective audit of malignant spinal cord compression in Scotland.
2001-2004: £1,277,149 grant from New Opportunities Fund for development of telemedicine platform for oncology services in SE Scotland and Tayside.
I was Chief investigator for the development and evaluation of a telepathology, teleradiology and teleconferencing platform for cancer services in SE, SW and Central Scotland (Fife, Lothian, Dumfries, Borders and Tayside). The project was funded in July 2001 over 3 years. I sat on the steering and executive committees for the project and supervised the project manager. Nested within the project was a randomised trial (TELEMAM) assessing the role of telemedicine in multidisciplinary decision making for breast cancer (see below).
2002-2005: £241,660 from Research and Development, Department of Health for evaluation of telemedicine in breast cancer management.
I was chief investigator of a project to evaluate the clinical and cost effectiveness of telemedicine in the conduct of multidisciplinary breast cancer clinics in SW and SE Scotland (Lothian, Dumfries and Fife). Co-grantholder is Dr J Brebner (Aberdeen), Dr G Fielding (Oxford), Dr R Maclean (New Jersey, USA), Professor R Prescott (Edinburgh), Mr U Chetty (Edinburgh), Professor M Dixon (Edinburgh), Mr A Walls (Dumfries), Mr G Neades (Edinburgh), Dr M Smith (Edinburgh).
I supervised the trial administrator and two research associates. After piloting of evaluation methodology and telemedicine equipment, assessment of the multidisciplinary decision making by telemedicine (linked to the Edinburgh Breast Unit) or standard 'in person' multidisciplinary discussions of patients from Dumfries and Fife started in March 2004. The trial started in March 2004 and was completed in April 2005 covering 473 patient discussions and exceeding the original target of 230 patient discussions for which the trial was powered. I was lead author of the report submitted to NHS Research and Development in September 2006.
Cancer Imaging and Adaptive Treatment Centre
I have taken the lead role in initiating innovation in service developments in cancer care - in particular the development of telemedicine facilities to aid multidisciplinary working in cancer care in southern Scotland and the development of an integrated centre for cancer imaging, radiotherapy planning and multidisciplinary team meeting facilities.
I initiated a proposal in December 2005 within the Directorate of Clinical Oncology for the development of a Centre for Cancer Imaging and Adaptive Therapy. This would provide an integrated template of cancer imaging (CT, MRI, PET) and advanced radiotherapy delivery systems and multidisciplinary cancer site specific meetings for service, teaching and research. The outline proposal was endorsed by Lothian Health and the University of Edinburgh in June 2006. I chair the steering committee which has drawn up a detailed specification of equipment and accommodation for the cancer imaging, radiotherapy planning and multidisciplinary working facilities in April 2008.
Next Generation Health Care
I am collaborating in an application to EPSRC with Professor David Harrison, Dr Simon Langdon, Dr Duncan McLaren and Professor Mike Dixon at the Edinburgh Cancer Centre in a project aiming to develop system-on-chip devices to measure key biological parameters in real time in conjunction with Professor Steve McLaughlin, Professor Anthony Walton and Professor Allan Murray (Department of Electronic Engineering, University of Edinburgh) and Professor David Argyle (Veterinary Oncology). The aim is to use the data to optimise the delivery of radiotherapy.
Bridging the Gaps (EPSRC)
I am a coapplicant with Professor David Harrison, Professor John Bartlett, Dr Duncan McLaren, Professor Mike Dixon at the Edinburgh Cancer Centre and Professor David Argyle from Human and Veterinary Oncology for an application for £460,249 submitted in September 2008 for an infrastructure grant from ESPRC to bridge the gaps between Engineering, Science and Human and Veterinary Medicine in the development of biosensors. The funding would support an e-learning programme developer to create educational materials in medicine relevant to physicists, chemists and engineers involved in developing biosensors for human and veterinary applications to study in vivo tumour biology in real time in oncology. The application is led by Professor Steve McLaughlin in conjunction with Professor Anthony Walton and Professor Alan Murray from the Department of Electronic Engineering and in collaboration with Dr Andrew Mount (Chemistry) and Professor Jason Crain and Professor Arthur Trew, School of Physics, University of Edinburgh.