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Author: Louise Stanley

Scientists discover new pathway that prevents bowel cancer treatment from working

Written by Louise Stanley on . Posted in Cancer outcomes, Experimental medicine.

Leading scientists at BHP founder-member the University of Birmingham have discovered a previously unknown pathway that prevents specific drugs from working in patients with bowel cancer.

The research findings pave the way for increasing the number of bowel cancer patients who can be successfully treated, say the scientists.

Bowel cancer, also called colorectal cancer, affects the large bowel, which is made up of the colon and rectum. It is the fourth most common cancer in the UK, with over 42,000 people diagnosed with bowel cancer every year in the UK. It is also the second biggest cancer killer, with 16,000 people with bowel cancer dying in the UK every year.

The University of Birmingham-led research involved the study of 184 tumour samples and medical records of bowel cancer patients participating in the COIN trial, as well as research carried out in mice, cell cultures, and a laboratory model for pre-malignant colorectal cancer.

Co-senior author Andrew Beggs, Professor of Cancer Genetics & Surgery at the University of Birmingham, explained: “About 60% of bowel cancers are sensitive to drugs called anti-EGFR inhibitors which work by blocking a key pathway in these cancers.

“However, despite this, in cancers that should be sensitive to them, these drugs only work in patients about 50% of the time.”

Co-senior author Dr Fedor Berditchevski, also of the University of Birmingham, added: “Scientists have previously found that if bowel cancer patients have a mutation in a gene called RAS, the anti-EGFR inhibitors will not work.

“However, our research has now discovered a new pathway involving a tetraspanin protein called TSPAN6 that is frequently inactive in bowel cancer patients and this makes these drugs less effective. Crucially, our research also shows that if this pathway is active in a patient’s cancer then the drug will work, irrespective of whether they have a mutation in RAS or not.”

First author Dr Regina Andrijes, a Postdoctoral Fellow at the University of Birmingham, concludes: “This is the first time a tetraspanin protein has been shown to be directly involved with bowel cancer. Our research findings show that this new pathway could act as a biomarker for treatment with anti-EGFR drugs in bowel cancer, increasing a patient’s chance of survival and the number of patients who could benefit from these drugs who previously would not have.”

The researchers are now set to undertake a clinical trial of using this marker to better identify patients for anti-EGFR treatment.

The study, published in the Proceedings of the National Academy of Sciences (PNAS), was carried out in collaboration with fellow BHP member University Hospitals Birmingham NHS Foundation Trust, working with Semmelweis University in Hungary, and Assiut University in Egypt.

High-profile appointee to lead Birmingham’s Precision Health Technologies Accelerator

Written by Louise Stanley on . Posted in Birmingham Health Partners.

The University of Birmingham has announced the appointment of an experienced academic and industrial pharmaceutical professional to the position of Managing Director of its new Precision Health Technologies Accelerator (PHTA).

Professor Luigi ‘Gino’ Martini joins PHTA Ltd – a wholly-owned subsidiary of the University that will operate the new facility – from the Royal Pharmaceutical Society (RPS) where he has held the role of Chief Scientist for more than three years. With extensive experience in oncology, rare and infectious diseases, and drug development, Gino also brings expertise in policy development and external advocacy to his new appointment in Birmingham.

Gino’s career began with Senior Scientist roles at Scherer Drug Delivery Systems and SmithKline Beecham, before joining GSK – initially as Drug Delivery and Strategic Technologies Manager – rising to Senior Directorships across a 10-year stint.

An experienced academic, Gino was formerly Professor of Pharmaceutical Innovation at King’s College London, as well as undertaking visiting professorships and PhD supervision alongside his industry roles. Prior to his appointment at the RPS, he held senior development and advisory positions with Shire Pharmaceuticals and Roche.

PHTA will be dedicated to the rapid development and translation of innovative therapies and technologies from concept to clinical evaluation. By creating new opportunities for businesses and entrepreneurs to grow and commercialise their ideas, it will enable advanced drugs, diagnostics and devices to reach patients more quickly. This signature facility will be the focal point of the forthcoming Birmingham Health Innovation Campus (BHIC) development, providing up to 6,000sqm of innovation, co-creation and incubation space within BHIC’s Phase 1 building.

Commenting on his appointment, Gino explained: “I see the PHTA as a place where innovators in health and life sciences will have global impact. I am a great believer in catalysing innovation through creating hubs where like-minded individuals can converge, connect and – in its simplest terms – ‘try things out’.

“COVID-19 has shown us that hybrid and multidisciplinary models of working really do work and this is my vision for the PHTA – an ecosystem which benefits from co-location of experts and budding entrepreneurs which also crosses boundaries and taps into skillsets and best practice of other UK regions. It’s an incredibly exciting time to be joining the project and forging these connections.”

Professor Tim Jones, University of Birmingham Provost and Vice-Principal, commented: “Through Birmingham Health Partners we have an established track record in collaborating with industry partners at start-up, scale-up, and global levels. The Precision Health Technologies Accelerator is the next stage in the journey towards cementing our position as a leader in the translation of research and innovation in health and life sciences.

“Gino’s leadership will be pivotal in achieving this aim, drawing on his considerable experience in both the pharmaceutical industry and in research-intensive academic environments. We are delighted to welcome him to Birmingham.”

Set to open in late 2023, BHIC is ambitious 10-acre, £210m development delivered through a long-term collaboration between the University of Birmingham, as landowner, and experienced investor-developers Bruntwood SciTech. It will be the only science park in the region dedicated to health and life sciences, offering premium laboratory, office and incubation facilities to companies specialising in medtech, precision medicine and digital healthcare.

As one of only six national Life Sciences Opportunity Zones, BHIC is attracting significant new inward investment to the region. This includes significant investment of up to £14m from the Greater Birmingham and Solihull Local Enterprise Partnership (GBSLEP) which will support the design and fit-out of the state-of-the-art PHTA facilities.

AI to improve treatments for people with multiple long-term conditions

Written by Louise Stanley on . Posted in Health inequalities, Inflammation and chronic disease.

The NIHR has awarded £2.5 million for new artificial intelligence (AI) research led by the University of Birmingham. The study will use AI to produce computer programmes and tools to help doctors improve the choice of drugs for patients with clusters of multiple long-term conditions.

Called the OPTIMAL study (OPTIMising therapies, discovering therapeutic targets and AI assisted clinical management for patients Living with complex multimorbidity), the research aims to understand how different combinations of long-term conditions – and the medicines taken for these diseases – interact over time to worsen or improve a patient’s health.

The study will be led by Dr Thomas Jackson and Professor Krish Nirantharakumar at the University of Birmingham and carried out in collaboration with the University of Manchester, University Hospitals Birmingham NHS Foundation Trust, NHS Greater Glasgow & Clyde, University of St Andrews,and the Medicines and Healthcare Products Regulatory Agency. Both the University of Birmingham and University Hospitals Birmingham are founding members of BHP.

An estimated 14 million people in England are living with two or more long-term conditions, with two-thirds of adults aged over 65 expected to be living with multiple long-term conditions by 2035.

Dr Thomas Jackson, Associate Professor in Geriatric Medicine at the University of Birmingham, said: “Currently, when people have multiple long-term conditions, we treat each disease separately. This means we prescribe a different drug for each condition, which may not help people with complex multimorbidity, which is a term we use when patients have four or more long-term health problems.

“A drug for one disease can make another disease worse or better, however, presently we do not have information on the effect of one drug on a second disease. This means doctors do not have enough information to know which drug to prescribe to people with complex multimorbidity.”

Krish Nirantharakumar, Professor in Health Data Science and Public Health at the University of Birmingham, added: “Through our research, we can group such people based on their mixes of disease. Then we can study the effects of a drug on each disease mix. This should help doctors prescribe better and reduce the number of drugs patients need. This will lead to changes in healthcare policy which would benefit most people with complex multimorbidity.”

The research is one of a number of studies being funded by the NIHR’s Artificial Intelligence for Multiple Long-Term Conditions (AIM) call, which is aligned to the aims of the NHSX AI Lab, that combine data science and AI methods with health, care and social science expertise to identify new clusters of disease and understand how multiple long-term conditions develop over the life course.

The call will fund up to £23 million of research in two waves, supporting a pipeline of research and capacity building in multiple long-term conditions research. The first wave has invested nearly £12 million into three Research Collaborations, nine Development Awards and a Research Support Facility, including the University of Birmingham-led study.

Improving the lives of people with multiple long-term conditions and their carers through research is an area of strategic focus for the NIHR, with its ambitions set out in its NIHR Strategic Framework for Multiple Long-Term Conditions Research.

Professor Lucy Chappell, NIHR Chief Executive and chair of the AIM funding committee, said: “This large-scale investment in research will improve our understanding of clusters of multiple long-term conditions, including how they develop over a person’s lifetime.

“Over time, findings from this new research will point to solutions that might prevent or slow down the development of further conditions over time. We will also look at how we shape treatment and care to meet the needs of people with multiple long-term conditions and carers.”

To date NIHR has invested £11million into research on multiple long-term conditions through two calls in partnership with the Medical Research Council, offering both pump-priming funds and funding to tackle multimorbidity at scale.

AI identifies patients with heart failure that respond to beta-blocker treatment

Written by Louise Stanley on . Posted in Early diagnosis and detection, Health inequalities, Inflammation and chronic disease.

Researchers at BHP founder-member the University of Birmingham have developed a new way to identify which patients with heart failure will benefit from treatment with beta-blockers.

Heart failure is one of the most common heart conditions, with substantial impact on patient quality of life, and a major driver of hospital admissions and healthcare cost.

The study involved 15,669 patients with heart failure and reduced left ventricular ejection fraction (low function of the heart’s main pumping chamber), 12,823 of which were in normal heart rhythm and 2,837 of which had atrial fibrillation (AF) – a heart rhythm condition commonly associated with heart failure that leads to worse outcomes.

Published in The Lancet, the study used a series of artificial intelligence (AI) techniques to deeply interrogate data from clinical trials.

The research showed that the AI approach could take account of different underlying health conditions for each patient, as well as the interactions of these conditions to isolate response to beta-blocker therapy. This worked in patients with normal heart rhythm, where doctors would normally expect beta-blockers to reduce the risk of death, as well as in patients with AF where previous work has found a lack of effectiveness. In normal heart rhythm, a cluster of patients was identified with reduced benefit from beta-blockers (combination of older age, less severe symptoms and lower heart rate than average). Conversely in patients with AF, the research found a cluster of patients who had a substantial reduction in death with beta-blockers (from 15% to 9% in younger patients with lower rates of prior heart attack but similar heart function to the average AF patient).

The research was led by the cardAIc group, a multi-disciplinary team of clinical and data scientists at the University of Birmingham and fellow BHP founder-member University Hospitals Birmingham, aiming to integrate AI techniques to improve the care of cardiovascular patients. The study uses data collated and harmonized by the Beta-blockers in Heart Failure Collaborative Group, a global consortium dedicated to enhancing treatment for patients with heart failure.

First Author Dr Andreas Karwath, Rutherford Research Fellow at the University of Birmingham and member of the cardAIc group, added: “We hope these important research findings will be used to shape healthcare policy and improve treatment and outcomes for patients with heart failure.”

Corresponding author Georgios Gkoutos, Professor of Clinical Bioinformatics at the University of Birmingham, Associate Director of Health Data Research UK Midlands and co-lead for the cardAIc group, said: “Although tested in our research in trials of beta-blockers, these novel AI approaches have clear potential across the spectrum of therapies in heart failure, and across other cardiovascular and non-cardiovascular conditions.”

Corresponding author Dipak Kotecha, Professor & Consultant in Cardiology at the University of Birmingham, international lead for the Beta-blockers in Heart Failure Collaborative Group and co-lead for the cardAIc group, added: “Development of these new AI approaches is vital to improving the care we can give to our patients; in the future this could lead to personalised treatment for each individual patient, taking account of their particular health circumstances to improve their well-being.”

The research used individual patient data from nine landmark trials in heart failure that randomly assigned patients to either beta-blockers or a placebo. The average age of study participants was 65 years, and 24% were women. The AI-based approach combined neural network-based variational autoencoders and hierarchical clustering within an objective framework, and with detailed assessment of robustness and validation across all the trials.

The research was presented this week at the ESC Congress 2021, hosted by the European Society of Cardiology – a non-profit knowledge-based professional association that facilitates the improvement and harmonisation of standards of diagnosis and treatment of cardiovascular diseases.

Birmingham Health Partners plays key role in report calling for Government reform of regulation of medical devices

Written by Louise Stanley on . Posted in Birmingham Health Partners.

Experts within Birmingham Health Partners (BHP) have significantly contributed to a new independent report calling on the UK Government to reform the regulation of medical devices.

Lessons learned from issues around the regulation of diagnostic tests for COVID-19 which led to many substandard tests on the market, and opportunities for the UK to update the way it regulates medical devices now that it has left the EU, form part of the insights outlined in four reports by leading scientists from BHP.

BHP is a strategic alliance between the University of Birmingham, the West Midlands Academic Health Science Network, Birmingham Women’s & Children’s NHS Foundation Trust, and University Hospitals Birmingham NHS Foundation Trust, with members collaborating to bring healthcare innovations through to clinical application.

BHP’s Centre for Regulatory Science and Innovation was commissioned by the Regulatory Horizons Council (RHC), to produce four reports which have formed part of RHC’s ‘Report on Medical Devices Regulation’ calling for action from the government for regulatory reform of medical devices.  RHC is an independent expert committee that identifies the implications of technological innovation, and provides government with impartial, expert advice on the regulatory reform required to support its rapid and safe introduction.

The BHP reports were based on a combination of literature reviews, semi-structured interviews, a multidisciplinary stakeholder workshop and a post-workshop survey.  Stakeholders involved included leading experts from a range of policy and industry organisations such as the National Institute for Health and Care Excellence (NICE), Innovate UK, the Association of British HealthTech Industries (ABHI) and the British In Vitro Diagnostic Association (BIVDA), as well as patient and public contributors.

The reports produced by the BHP team focused on four critical areas defined through cross-stakeholder consultation undertaken by the RHC:

      • Report 1 – details a study examining lessons learned from COVID-19 in relation to regulations of in vitro diagnostics (IVDs – medical devices intended for use in diagnosis of disease or other conditions), and sets out the regulatory challenges such as the development of substandard diagnostic COVID-19 tests and lack of availability of reliable information during the pandemic. The report also sets out a series of recommendations on how the government could increase efficiency in test development and distribution in the event of a future infectious disease outbreak.
      • Report 2 – details a study consulting on the mitigations for the move to the United Kingdom Conformity Assessed mark from July 2023, as a result of the end to the use of the EU CE mark for medical devices. The cost and complexity of complying with the new UK regulation to medical device companies means companies may prioritise non-UK markets, potentially reducing availability and choice of medical devices for UK healthcare.
      • Report 3 – details a study looking at alternative routes to market for medical devices, probing the UK’s unique opportunity post-Brexit to update the way it regulates medical devices to promote patient outcomes, stimulate innovation, and ensure that the UK remains at the forefront of the global life sciences sector.
      • Report 4 – summarises ideas and evidence around the opportunities and risks for future UK regulatory reform of medical devices in four key areas: patient and public access to high quality medical devices; international investment and innovation; patient and user safety; and global standing in regulation of the life sciences sector.

Reports author Xiao Liu, a leading post-doctoral researcher at the University of Birmingham and an ophthalmologist at University Hospitals Birmingham NHS Foundation Trust, said: “With the UK’s exit from the EU, Europe’s transition of its regulatory framework, and the global urgency of the COVID-19 pandemic, now more than ever we need to identify how we can reform regulation so the UK can encourage international investment, innovation and improve safety of medical devices.”

Reports author Melanie Calvert, Professor of Outcomes Methodology and NIHR Senior Investigator at the University of Birmingham, and Director of the Birmingham Health Partners’ Centre for Regulatory Science and Innovation, added: “Among our findings is a clear need to build a patient-centred regulatory system that accelerates innovation, captures outcomes that matter to patients, protects patient safety and has increased patient engagement in medical device development and regulation.  We are proud to have made such a significant contribution to RHC’s report and we hope it will lead to wide-ranging reform of the regulation of medical devices.”

In the foreword of RHC’s report, Sir Bruce Keogh, Chair of Birmingham Women’s and Children’s NHS Foundation Trust which is part of BHP, says: “This report from the Regulatory Horizons Council is a timely call for action.  Importantly this report is firmly patient-centred: accelerating innovation, assuring safety, and increasing engagement of patients with the process of development and regulation.  The opportunities are enticing. Effective implementation of the recommendations will bring tangible economic benefits and enable our patients to benefit from the very best of UK and global innovations more rapidly than at present.”

Recommendations within RHC’s report are centred on:

      • Building a regulatory system for medical devices that works for patients
      • Increasing capacity to address present needs and emerging opportunities
      • International leadership and partnership in medical devices
      • Using medical devices as a template to help enable regulatory innovation that improves patient safety, system efficiency and UK growth
      • Building resilience and preparing for future threats

A spokesperson for the Regulatory Horizons Council (RHC) said: “We are very grateful to Birmingham Health Partners for the stakeholder engagement and four reports they produced, which provided a useful evidence base for our recommendations.”

ENDS

      1. Lessons learned from COVID-19 in relation to IVD regulations – https://www.birminghamhealthpartners.co.uk/wp-content/uploads/2021/08/Lessons-learned-from-COVID-19-in-relation-to-IVD-regulations.pdf
      2. Mitigations for the move to the UKCA mark from 01 July 2023 – https://www.birminghamhealthpartners.co.uk/wp-content/uploads/2021/08/Mitigations-for-the-move-to-the-UKCA-mark-from-01-July-2023.pdf
      3. Alternative routes to market for medical devices – https://www.birminghamhealthpartners.co.uk/wp-content/uploads/2021/08/Alternative-Routes-to-Market-for-Medical-Devices.pdf
      4. Opportunity and risks around future UK regulatory reform of medical devices – https://www.birminghamhealthpartners.co.uk/wp-content/uploads/2021/08/Opportunities-and-risks-around-future-UK-regulatory-reform-of-medical-devices.pdf

New Birmingham-Roche collaboration targets new treatments for inflammatory bowel disease

Written by Louise Stanley on . Posted in Clinical trials, Inflammation and chronic disease.

A new £850k collaboration between Birmingham Health Partners (BHP) and global biotechnology leaders Roche is set to improve both diagnosis and care of patients with inflammatory bowel disease (IBD) by investigating promising biomarkers and inflammatory mechanisms in the search for new treatment targets.

IBD affects around 250,000 people in the UK in the form of ulcerative colitis and Crohn’s disease, and is characterised by an imbalance in gut bacteria which causes debilitating damage to the intestines.

Current treatments, which target the body’s immune response, are ineffective for the majority (around two-thirds) of patients, meaning many of them eventually have to undergo invasive surgery. These diseases affect mainly younger people of working age, and as the precise cause is not yet fully understood, there is a pressing need to identify non-surgical therapies which can improve quality of life.

As host to the largest IBD clinic in Europe, BHP founder-member University Hospitals Birmingham NHS Foundation Trust (UHB) will lead the new active translational research collaboration with Roche scientists, alongside BHP colleagues at the University of Birmingham’s Institute of Cardiovascular Sciences (ICVS) and Microbiome Treatment Centre. Newly-diagnosed IBD patients will be seen weekly at new clinics across sister UHB sites Queen Elizabeth Hospital Birmingham and Heartlands Hospital.

This unique patient cohort will provide invaluable biological samples taken before they begin treatment – allowing researchers to investigate biomarkers identified by Dr Asif Iqbal of ICVS. Dr Iqbal’s team will study disease pathology including the role of immune cells, the microbiome and metabolome in driving the various inflammatory mechanisms associated with IBD.

Professor Tariq Iqbal, Consultant Gastroenterologist at UHB and Director of the Microbiome Treatment Centre at the University of Birmingham explained: “IBD is an underfunded disease area and the potential benefits to patients which will arise as a result of this collaboration are likely to be lifechanging for many. Those participating in the trial will help build the first clinical resource of its kind from which we aim to promote earlier diagnosis and more effective treatments.

“Cross-discipline collaboration, facilitated by BHP, will be crucial in unlocking these advances as we tap in to expertise in specialties such as genomic sequencing as well as the University’s Microbiome Treatment Centre.”

Dr Asif Iqbal commented: “This project will demonstrate the power of combining basic science with translational clinical research for patient benefit. Through identifying targets in immune cells which drive this chronic inflammatory disease, we hope to develop a range of novel therapeutics.”

The collaborative research award of £844,163 from Roche funds two combined IBD projects from March 2021 to January 2023. UHB is aiming to recruit 60 patients to the study.