OCH focuses on key areas to develop new capabilities and collaborations, and to enhance existing areas of expertise from the current basic and translational research base across to clinical practice.
An avalanche of new therapies is radically transforming the therapeutic landscape for diseases and disorders of the blood. The majority of these drugs are only available through clinical trials because approval for use in the NHS can take many years. Patient recruitment to trials is therefore very good. As haematological diseases are relatively rare we have focussed on securing regional referrals and have expanded our clinical trial capability. A decade ago no Phase I/II clinical trials were performed in Oxford. Now Haematology works closely with Oncology’s Early Phase Clinical Trials Unit (EPTU). To deliver Phase III, the Late Phase Haematology Unit was started in 2009, run by Dr Jaimal Kothari. The number of trials is currently over 80. Over the last five years, Oxford consultants have become leading members of national clinical trial groups and are now developing Oxford-led Phase I/II trials. These investigator-initiated, commercially and academically funded trials allow hypotheses to be tested and provide invaluable biological samples for Oxford research laboratories.
Camellia is a clinical trial investigating a treatment for acute myeloid leukaemia.
Oxford has the UK’s largest biobank of myeloid disease samples. They are collected under a National Cancer Research Institute (NCRI) approved biobanking study, MDSBio. Viable cells from thousands of marrow samples have been collected from ~50 hospitals. One example of the work with these samples is the study of clonal structure within leukaemic stem cell (LSC) and non-LSC populations from sequential samples from patients pre- and post-therapy in leukaemias. Sample banking will be a key activity supported by the OCH. We are planning to expand the biobank to include samples from other patient groups. The aim is to provide samples for a broader range of clinical studies in haematological diseases, engage with a wider set of clinicians and researchers, ultimately improving outcomes for patients.
Engagement with commercial partners is key to realising the aims of the OCH. Oxford haematologists have relationships with various biopharmaceutical companies. A current clinical trial with Forty Seven Inc is based on studies from Oxford and Stanford on a therapeutic monoclonal antibody against CD47, a universally expressed leukaemia antigen. Dr Karthik Ramasamy runs industry funded clinical trials in myeloma. Oxford has a strong relationship with Celgene in the US and Europe. Clinical Fellowships via the Oxford University-Celgene Programme have been highly successful. We work with OxStem Oncology, a spinout from the University Department of Chemistry (Professors Davies and Russell), on screening novel compounds for stem cell therapies.
Stem cell transplantation
Haemopoietic SCT is the only routine stem-cell based therapy. It provides new haemopoiesis after chemoradiotherapy and can be curative. Allo-SCT is one of the most widely used, successful immune-based therapies against cancer. OCH will take advantage of Oxford’s haemopoietic stem cell biology and cellular immunology programmes to deliver new programmes that could make a significant contribution to understanding immune mechanisms and improving SCT outcomes. Oxford is now part of IMPACT, a partnership committed to improving the outcomes of stem cell transplantation through the delivery of clinical trials across the UK.
Our academic clinical training programme has expanded significantly in recent years, with 12 fellows currently who are clinically active. Following Dr Lynn Quek’s award of the first Clinical Fellowship on the joint Oxford University-Celgene Programme, Dr Sarah Gooding continues to build on this success with her Clinical Fellowship. Funds have been awarded to Allied Healthcare Professionals in the nursing, pharmacy and laboratory haematology teams.