Q&A with Prof Ruth Plummer, Director of the Sir Bobby Robson Cancer Trials Research Centre (SBRU), Northern Centre for Cancer Care, Freeman Hospital

Can you briefly explain your current job focus, what your day looks like?

My job focus is working with the trials team on SBRU to help develop new anti-cancer drugs for our patients.  I am a clinical academic but spend more than 50% of my time clinically based, also working with colleagues in NCCC to treat patients with skin cancer with standard therapies – all the treatments we use have been developed over my period as a consultant and we recruited patients to the pivotal trials so I see the benefits of research for patients every day!  However the focus of my work is the early phase trials where we work out dose and check the safety of potential new anti-cancer drugs.

What were your primary research interests before the pandemic?

Early phase cancer trials, with the complete range of potential active agents from small molecule inhibitors to novel cellular therapies.

What impact has COVID-19 had on your role and to your research work?

We were very fortunate on SBRU in that we have remained open and recruiting to trials throughout the pandemic.  This was unique in early phase cancer units in the UK and down to the flexible planning R&D put in place with stratification of studies and then the potential phased closure depending on service pressure from COVID-19.  I am aware that the other Experimental Cancer Medicine Centres across the UK lobbied NIHR to adopt a “1b prioritisation” for early cancer studies nationally for the restart of research – so NuTH was ahead of the curve!

All of our IMP studies offer potential treatments to patients with no therapeutic options, so the majority of our trials fell into this category 1b and remained open.  We did pause recruitment to our translational studies, where we ask patients to donate research samples only, so we did not ask vulnerable patients to come up to the hospital unnecessarily.

Given the uncertainties of outcomes with early phase trials, both in terms of side effects and also potential toxicities informed consent is absolutely key to what we do.  We did spend a lot of time talking to our patients about the number of visits and risks to them of going on a study in the pandemic, and suggested to some delaying recruiting to a trial with very intense visit numbers.  I have always found I learn a huge amount from our patients, and had my concerns about this put firmly into place by one of our patients who politely pointed out he was “trying not to die of cancer” while I sorted out getting him on the trial.  So we got on with sorting out those visits!

What has the atmosphere been like in your team over the past few months?

It was been generally very positive although obviously all staff were concerned about all the uncertainties and the knowledge that coming to work might put them and their families at risk of coronavirus infection.  Despite this everyone has been working to deliver their roles within the team so that we have been able to continue to offer trials to patients and comply with the safety data collection which is key for the studies and our reputation as one of the UK most active early phase cancer units.

How have you and the team adapted to working since the pandemic?

As ever, I have seen the “can do” attitude from the team as we have tried to adapt to the various guidelines from the government as they came out – to help with social distancing the office based staff worked flexibly from home or in early and late shifts, and with support from IT we sorted our remote access to allow this. We have also seen flexibility from sponsors and regulators to allow us to do some follow up visits by telephone and some safety bloods locally so we did not ask patients to travel unnecessarily.  We recruit patients from right across the Northern Region, and sometimes beyond, so this flexibility has been great (and we hope will continue post-COVID!)

“As ever, I have seen the “can do” attitude from the team”

How important is research into helping tackle COVID-19?

Research into COVID-19 is clearly really important, as we need as a country to be able to open up and resume a more normal life, but particularly for our cancer patients as the majority of them come into the highly vulnerable group and have been shielding throughout this period – with visits to the hospital often the only time out of the house.  It is clear this has had a huge impact on them and their families so we need a vaccine to control spread, and a treatment for those unfortunate enough to get this disease.  A number of us on the unit have volunteered for the vaccine study – so seeing research from the other side too.