Author: Louise Stanley

Researchers at BHP founder-members University Hospitals Birmingham (UHB) and the University of Birmingham, in collaboration with Kings College London (KCL), are leading a new study which aims to better understand the factors that influence how well older people recover from cancer treatment, as well as finding ways to keep the body strong.

While age is a known risk factor for developing cancer, in some people, treatments – including chemotherapy, immunotherapy, surgery, and radiation therapy – can trigger processes that resemble ageing.

The Resilience Breakthroughs in Older people Undergoing cancer proceDures (REBOUND) study is examining how key ‘hallmarks’ of ageing – the biological processes that naturally occur as we get older – are affected following treatment for bowel cancer in people aged 65 and over.

By understanding how the body responds to cancer treatment, researchers aim to develop new interventions that could prevent or reduce ageing-related changes and improve the number of years patients then spend in good health. The ultimate goal is to help older people with cancer remain active and continue doing the things that matter most to them.

Researchers will be analysing DNA for age-related changes; examining gut bacteria from stool samples; and assessing changes in blood and fat cells, with samples being collected at multiple timepoints before, during, and after surgery. These biological findings will be compared with tests of memory, thinking, strength, and muscle function, alongside information from medical records.

The study aims to recruit 172 participants aged 50 years and older who are scheduled to undergo bowel cancer surgery at UHB, Guy’s and St Thomas’ NHS Foundation Trust, or King’s College Hospital NHS Foundation Trust.

At UHB, recruitment is taking place across two of its hospitals: Queen Elizabeth Hospital Birmingham (QEHB) and Solihull Hospital. Study visits are undertaken flexibly in clinical environments, at the NIHR/Wellcome Trust Birmingham Clinical Research Facility, or within participants’ own homes, depending on works best for each individual.

The study opened to recruitment in Autumn 2024, and to date, 58 patients have been enrolled.

Ken Cox, 82 from Tamworth, who took part in the study last year, said: “I was diagnosed with bowel cancer in January 2025 and had surgery at Solihull Hospital in March. I heard about the study at the time of my diagnosis and wanted to take part as a way of giving something back.

“The team visited me at home to carry out the tests, which made things much easier. Everyone was absolutely wonderful and easy to talk to. I’d like to think this research will help others in the future, and I would encourage people to take up the opportunity if they can.”

Professor Thomas Jackson, Consultant in Geriatric Medicine and General Internal Medicine at UHB and Professor in Geriatric Medicine at the University of Birmingham said: “This is really important work that couldn’t be done without the support of patients agreeing to be in the study. We want to understand how the biology of ageing changes when older people have significant events, such as major surgery, and why some people recover well, and others don’t. With this understanding, we can identify ways of improving recovery in everyone and maximising the benefits of cancer treatment.”

The project is a collaborative effort bringing together clinicians specialising in the care of older people, surgeons, and scientists with expertise in ageing and complex data analysis. It is supported by the Dynamic Resilience programme, funded by Wellcome Leap and the Temasek Trust.

The most detailed atlas of tumour cells from the deadliest form of pancreatic cancer has been developed by an international team of researchers, highlighting how tumour cells change their behaviour depending on their surroundings – and how this leads many promising treatments to fail in standard lab tests.

The research was a collaborative effort led by the BHP founders-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, working with pharmaceutical company Bristol Myers Squibb. Published in Cell Reports, their findings describe the most detailed spatial map to date of pancreatic ductal adenocarcinoma (PDAC).

In the study, tumour samples from 39 untreated pancreatic cancer patients were analysed using cutting-edge spatial transcriptomics technologies, allowing researchers to see which genes are active in cells and exactly where those cells are located in the tumour. This approach generated a massive dataset – comprising hundreds of thousands of spatial measurements and more than half a million individual cells – creating a comprehensive ‘atlas’ of pancreatic cancer tissue.

Pancreatic cancer remains one of the hardest cancers to treat, with few effective therapies and a five-year survival rate in the single digits. A major reason is the disease’s complexity: cancer cells are embedded in a dense, hostile tissue environment filled with scar-like material, low oxygen, and supportive cells that help tumours survive. 

Dr Shivan Sivakumar, co-senior author from the University of Birmingham and consultant medical oncologist at University Hospitals Birmingham said: “This spatial atlas is expected to serve as a foundational resource for the research community, and may accelerate the development of treatments for a disease that has long resisted progress.

“By integrating spatial biology with functional genetic screening, we have created a roadmap for discovering therapies that target pancreatic cancer more effectively – especially combination treatments designed to disrupt both cancer cells and the environments that protect them.

“The findings suggest that environmental factors play a much greater role in tumour cell development in the pancreas, and identifies new intermediate tumour subtypes and highly proliferative cancer cells which together provide a more vivid picture of this deadly cancer.”

Dr. Konstantinos Mavrakis, Executive Director and Head of Discovery Biosciences Oncology at Bristol Myers Squibb and co-senior author of the publication emphasised the importance of scientific collaborations: “This study underscores how important it is to use real-world patient data to better understand the underlying causal human biology of a specific cancer type such as pancreatic cancer.”

Key findings:

• Cancer cell identity depends on location. The study confirmed known pancreatic cancer subtypes, commonly called classical and basal-like, but showed that these identities are strongly shaped by the tumour’s local environment. In particular, aggressive basal-like cancer cells were consistently found in regions with low oxygen and dense fibrotic tissue.
  
• A hidden cancer state comes into focus. Researchers discovered that an ‘intermediate’ tumour subtype is not just a mix of known states, but a distinct cancer cell identity. This finding clarifies long-standing confusion in pancreatic cancer classification.
  
• Tumours contain a small but powerful growth engine. A previously underappreciated group of highly proliferative cancer cells was identified, marked by intense cell-division activity. Although relatively rare, these cells may disproportionately drive tumour growth.
  
• Context hides critical vulnerabilities. The team used CRISPR gene-editing screens in cancer cells grown under realistic conditions such as low oxygen or inside living tumours. This revealed genetic weaknesses that are invisible in standard laboratory cultures, and may explain why many drug targets that look promising in the lab fail in patients.
  
• Common lab models miss key disease features. Widely used mouse and cell-line models captured some aspects of human pancreatic cancer but often failed to reproduce the most aggressive tumour states and their surrounding environments. This highlights the need for better preclinical testing strategies.