Research is an important part of a large sarcoma service, and so we run many clinical trials. These investigate new drugs that may be useful in sarcoma, or new ways of giving established treatments such as surgery, chemotherapy or radiotherapy. We can also have trials trying to find out more about sarcomas, by asking patients if we can use a sample of their tumour and/or a blood test to learn more about how these cancers develop. All our patients are given the opportunity to take part in any clinical trials for which they are suitable if they wish.
Clinical trials are a very important part of cancer treatment. They allow us to learn about new drugs and treatments, and how they should fit in with current treatments, in a controlled way. They also help us to learn how best to use the treatments that we have. Clinical trials are important for patients as it allows them to try new drugs or treatments that they couldn't otherwise access. At UCLH we run a large number of clinical trials for both bone sarcomas and soft tissue sarcomas. We have a team of clinical trial practitioners, a paediatric cancer research nurse, and a data manager to run the studies and oversee patients while they are taking part in studies.
Clinical Trials Practitioners/Research Nurses
- Sarah Taylor
- Chloe Walding
- Swad Timbo
- Tara Searle
- Sarah Maziliauskas
AFATINIB FOR CHORDOMA: A phase II, single arm, multi-centre trial evaluating the efficacy of Afatinib as first-line or later-line treatment in metastatic or unresectable chordoma
DeFI Study: A randomized, double-blind, placebo-controlled, phase III trial of Nirogacestat versus placebo in adult patients with progressing desmoid tumours/aggressive fibromatosis
E7389-G000-213 (BOLD): A phase I/II single-arm study evaluating the safety and efficacy of Eribulin Mesilate in combination with Irinotecan in children with refractory or recurrent solid tumours
E7080-G000-230 (OLIE): A multicenter, open-label, randomized phase II study to compare the efficacy and safety of Lenvatinib in combination with Ifosfamide and Etoposide versus Ifosfamide and Etoposide in children, adolescents and young adults with relapsed or refractory Osteosarcoma
ESPRIT: ESP1/SARC025 Global Collaboration: A phase I study of a combination of the PARP inhibitor, Niraparib and Temozolomide or Irinotecan in patients with previously treated, incurable Ewing sarcoma
GSK 3377794: Open-label phase Ib/IIa clinical trial to assess the safety, tolerability and antitumor activity of genetically engineered NY-ESO-1 specific (c259) T cells (GSK3377794) in combination with anti-cancer agents including Pembrolizumab in HLA-A2+ participants with NY-ESO-1 and/or LAGE-1a positive relapsed and refractory Synovial Sarcoma
HGUS EORTC 62113: A randomised double-blind phase II study evaluating the role of maintenance Cabozantinib in high grade undifferentiated uterine sarcoma (HGUS) or response to Doxorubicin +/-Ifosfamide or in metastatic first line treatment
ICONIC: Improving outcomes through collaboration in osteosarcoma
IMRIS: A phase II study of intensity modulated radiotherapy (IMRT) in primary bone and soft tissue sarcoma
INTRIGUE: A phase III, interventional, randomised, multicentre, open-label study of DCC-2618 vs sunitinib in patients with advanced gastrointestinal stromal tumours after treatment with imatinib
Kindred Study: The international sarcoma kindred study: a global multi-site prospective cancer genetics study
KCP-330-020 (SEAL): A phase II/III multicentre, randomised, double-blind study of Selinexor (KPT - 330) verus placebo in patient with advanced unresectable differentiated liposarcoma
RAPPER: Radiogenomics: Assessment of polymorphisms for predicting the effects of radiotherapy
REDUCE (EORTC 1762): Reduced dose-density of denosumab for maintenance therapy of unresectable giant cell tumour of bone: a multicentre phase II study
rEECUr: International randomised controlled trial of chemotherapy for the treatment of recurrent and primary refractory Ewing sarcoma
SMPaeds: Stratified medicine paediatrics: genomic characterisation of relapsed paediatric cancers for diagnostics and stratified therapy
SPEARHEAD 1: A phase II single arm open-label clinical trial of ADP-A2M4 SPEAR™ T cells in subjects with Advanced Synovial Sarcoma or Myxoid/Round Cell Liposarcoma
SSG XXII: A phase III prospective, multi-centre, open-label, 2 arm study for evaluation of 2 durations of adjuvant treatment with the tyrosine kinase inhibitor Imastinib Mesylate of operable gastrointestinal stromal cells tumour (GIST) with a high risk for recurrence
Sometimes there may be other trials open - it is always worth asking your doctor.
ALT-GIST: A randomized phase II trial of Imatinib ALTernating with Regorafenib compared to Imatinib alone for first line treatment of advanced gastrointestinal stromal tumour (GIST)
ANITA: A phase II multicenter study comparing the efficacy of the oral angiogenesis inhibitor Nintedanib with the intravenous cytotoxic compound Ifosfamide for treatment of patients with advanced, metastatic soft tissue sarcoma after failure of systemic non-oxazaphosporine-based firstline chemotherapy for inoperable disease
ANNOUNCE 2: A phase Ib (open label)/phase II (only) randomized, double-blinded study evaluating the efficacy of Gemcitabine and Docetaxel with or without a human anti-PDGFRa monoclonal antibody (Olaratumab) in the treatment of advanced soft tissue sarcoma (Academic)
Bone Sarcoma CTC study: Optimisation of circulating tumour cell detection in bone sarcomas
CaboGIST EORTC 1317: Phase II study of Cabozantinib in patients with metastatic gastrointestinal stromal tumour (GIST) who progressed during neoadjuvant, adjuvant or palliative therapy with Imatinib and Suntinib
CASPS: A phase II trial of Cediranib in the treatment of patients with alveolar soft part sarcoma (CASPS). This trial is testing a new drug Cediranib that has already shown promising results in a small number of patients with alveolar soft part sarcoma. Cedirinib works by inhibiting growth of blood vessels in tumours.
CREATE: a cross-tumoral phase II trial exploring Crizotinub (PF-02341066) in patients with advanced tumours induced by casual alterations of ALK and/or MET
EE 2012: an international randomised controlled trial for the treatment of newly diagnosed Ewing's sarcoma family of tumours
EZH202: A phase II, multicentre study of the EZH202 inhibitor Tazemetostat in adult subjects with INI1-negative tumours or relapsed refractory synovial and epitheliod type
GOG-0277: A phase III randomised trial of Gemcitabine plus Docetaxel followed by Doxorubicin versus observation for uterus-limited, high grade uterine leiomyosarcoma
HOPE: Phase I/II study of Lenvatinib in children and adolescents with refractory or relapsed solid malignancies and young adults with osteosarcoma
Paragon: a phase II study of aromatase inhibitors in women with potentially hormone responsive recurrent/metastatic gynaecological neoplasms
RMS 2005: A protocol for non-metastatic rhabdomyosarcoma. This study is investigating the use of chemotherapy in the treatment of children and teenagers with rhabdomyosaroma that has not spread around the body
VIT 0910: International randomized phase II trial of the combination of Vincristine and Ironotecan with or without Temozolomide (VI or VIT) in children and adults with refractory or relapsed rhabdosarcoma
The 100,000 Genomes Project
This flagship project to sequence 100,000 genomes of patients affected with cancers and other rare diseases is now closed to recruitment and work has started to analyse the data in the Genomics England Research Environment. This major UK initiative is funded by the National Institute for Health Research, NHS England, The Wellcome Trust, Cancer Research UK and the Medical Research Council. Over 1,000 patients with sarcoma have been recruited from across UK, of which 600 have been recruited from London Sarcoma Service. The UK collection of sarcoma genomes now makes up the largest repository worldwide and will continue to grow as all patients with sarcoma will have access to whole genome sequencing of their tumours from early next year. This is because NHS England has agreed to fund whole genome sequencing of sarcoma from patients across the UK. Dr Fernanda Amary, Consultant Pathologist, is leading and co-ordinating the clinical pathways and implementing this for the London Sarcoma Service.
More information can be found on the Genomics England website https://www.genomicsengland.co.uk/about-genomics-england/the-100000-genomes-project/
The Sarcoma Genomics England Clinical Interpretation Partnership (GeCIP), led by Professor Adrienne Flanagan of the London Sarcoma Service, brings together sarcoma researchers and clinicians in the UK to process, analyse and interpret the genomics data generated by the 100,000 Genomes Project. Key partners in the genomics working group include scientists from the Francis Crick Institute, University College London, University of Birmingham and the Wellcome Trust Sanger Institute.
The genomic datasets from sarcoma participants will allow the team to discover genomic mutations (CNVs, SNVs, SVs, indels) contributing to the tumour initiation, development, evolution and intra-tumour heterogeneity. Additional ongoing research studies, led by various Sarcoma GeCIP members, to decipher the transcriptomic and epigenomic landscape of these sarcoma samples from the 100,000 Genomes Project will further contribute to a comprehensive understanding of the recurrent genetic driver mutations in a range of sarcoma subtypes and help to identify and better define the different tumours.
Dr Nischalan Pillay, Honorary Consultant Pathologist at RNOH and Cancer Research UK clinician scientist is a member of the team co-ordinating the analysis of the sarcoma genomes. Dr Pillay’s lab is focussed on unravelling the complex genetics of some sarcoma subtypes for clinical benefit (https://www.ucl.ac.uk/cancer/research/department-pathology/sarcoma-biology-and-genomics). Recently Dr Christopher Steele in the Pillay lab developed a novel method to extract biologically and clinically useful information from the genomes undifferentiated pleomorphic sarcomas which was published in Cancer Cell (https://www.cell.com/cancer-cell/fulltext/S1535-6108(19)30097-2). Ms Shadi Hames, a PhD student funded by Sarcoma UK (Sayako Grace Robinson fellowship) will work with Dr Steele to apply this method to the sarcoma genomes sequenced by GEL which has many other sarcoma subtypes. She will also be investigating the genetic determinants of immune evasion in sarcoma which is of clinical importance due to the rapid advances being made in the immunotherapy field.
Tom Prince Osteosarcoma Research Project
The project, led by Prof. Adrienne Flanagan and funded by the Tom Prince Cancer Trust, has contributed enormously to the 100,000 Genomes Project. The funds are being used to generate a comprehensive multi-omic data set for the samples submitted to the 100,000 Genomes Project. These generous funds are also being put towards the purchasing a digital slide scanner and will be based at the Royal National Orthopaedic Hospital. Digital pathology data linked with genetic and clinical data will provide a powerful resource for researchers and clinicians to improve classification of the disease and a greater insight into tumour behaviour.
Improving outcome through Collaboration in OsteosarComa (ICONIC)
The Bone Cancer Research Trust is funding this multidisciplnary cohort study to collect data and samples of all newly diagnosed patients with sarcoma across the UK. This complements and adds value to the Tom Prince Osteosarcoma Research Project and other research projects.
Genomics of Malignant Peripheral Nerve Sheath Tumour (GEM) Consortium
This philanthropically-funded project is led by Dr David Miller – Boston Children’s Hospital, Harvard. Adrienne Flanagan and Nischalan Pillay and the RNOH pathologists are major contributors to the study which involves an in-depth integrated genetic, transcriptomic and epigenetic data analyses from these neoplasms in order to understand the basic biology of this disease with the aim of identifying prognostic and therapeutic markers.