The first Breakthrough Cancer Research All-Ireland Cancer Network (AllCaN) programme grant is focused on Oesophageal Cancer research

The AllCaN Grant Programme was created as part of Breakthrough Cancer Research’s new 5-year research strategy (Making More Survivors), to support and facilitate knowledge sharing between exemplary teams in institutions across the island of Ireland, who are taking on less survivable cancers.

Oesophageal Cancer is one of the biggest cancer challenges with a 5-year survival rate of just 24% in the Republic of Ireland (NCRI) – only 1 out of every 4 people diagnosed will survive 5 years.  In Northern Ireland, the survival rate is less at 19% (NICR). Northern Europe, and specifically the UK and Ireland, are where some of the highest incidence rates of oesophageal adenocarcinoma (OAC) are reported.

The AllCaN – Oesophageal Programme grant was awarded to an all-Ireland network led by Prof. Jacintha O’Sullivan (Trinity St. James’s Cancer Institute, TSJCI), and co-led by Prof. Helen Coleman (Queen’s University Belfast) and Prof. Juliette Hussey (TSJCI).  The collaboration links six major academic institutions across the island of Ireland – Trinity College Dublin, Queen’s University Belfast, University College Cork, Royal College of Surgeons in Ireland, University College Dublin, and University of Galway – along with their associated hospitals, the National Cancer Control Programme and the Belfast Health and Social Care Trust.

John Clarke, Dr Frances Drummond, Prof Helen Coleman, Prof Jacintha O’Sullivan, Prof Juliette Hussey, Orla Dolan, Dr Richard Turkington

The first of these AllCaN Grants, AllCaN – oesophageal cancer, which is funding innovative research to understand cancer development, improve early detection and outcomes for patients with, or at risk of, developing the disease was launched on World Cancer Day, February 4th, 2023 in QUB, Breakthrough is investing €1 million into the AllCaN – Oesophageal Programme grant (2023-2027) with additional collaborative funding and support coming from CROSS and the Oesophageal Cancer Fund.

This unique cross-border collaboration will enable the sharing of data and learnings for the first time.  They share decades of collective experience in Oesophageal

Cancer and Barrett’s oesophagus (a significant risk factor for oesophageal cancer). People with Barrett’s oesophagus have biological changes in their food pipe (oesophagus) which puts them at a higher risk of developing Oesophageal Cancer.  For the first time this collaboration will enable sharing of data from the Northern Ireland and Republic of Ireland Barrett’s oesophagus registries (over 34,000 patients) to answer important epidemiological studies using one of the largest platforms available worldwide for studying this disease.

Identification of, and improved treatments for people with Oesophageal Cancer and Barrett’s oesophagus, could significantly control the progression of the disease.

With AllCaN, it will be possible to identify if potential inequalities exist across demographics, healthcare systems and patient outcomes and how lifestyle factors and medications influence reflux symptoms and progression. Lifestyle interventions will be tailored to reduce symptoms and improve quality of life (including mental health and wellbeing). The collaboration with industry will help ensure that discoveries that could help identify people at risk of progressing to Oesophageal Cancer or who will benefit from a particular treatment, progress quicker into the clinic.

John Clarke who was diagnosed with Barrett’s oesophagus at age 33 and is a Public Patient Involvement (PPI) representative for AllCaN spoke about the possibilities of the all-Ireland Barrett’s oesophagus registry. ‘I am unlucky to have Barrett’s oesophagus, but I am lucky to know I have it.  Awareness is the key with any condition. The sooner found the better. To have an all-Ireland cancer register is unbelievable. The possibilities it opens are endless. Imagine the day we can tell everyone with oesophageal cancer that there’s a lifestyle plan or treatment that will contain and control the disease and enable them to live with it and improve their quality of life.’

The Research:

INVESTIGATING THE EFFECT OF CALCIUM ELECTROPORATION ON THE INFLAMMATORY MICROENVIRONMENT AND CROSSTALK TO IMMUNE CELL ACTIVATION ACROSS THE BARRETT’S-DYSPLASIA-ADENOCARCINOMA DISEASE SEQUENCE

Lorraine Smith

Lorraine Smith is the first PhD student appointed to the All-Ireland Cancer Research Network (AllCaN) Programme.  Lorraine, working in the lab of Prof Jacintha O’Sullivan in the Trinity St James Cancer Institute will investigate a new treatment called electroporation which involves applying electrical pulses to cells, making them more responsive to therapies. This treatment is already in clinical trials for numerous cancers and early results are very positive. This project will investigate the science behind the treatment: how does it affect the cells treated and can it activate the immune system?

AllCaN Project Collaborators

Scientific Collaborator(s): Dr John Mackrill, and Dr Sharon McKenna.

Clinical Collaborator(s): Prof. John Reynolds, Prof. Dermot O’Toole, Dr Narayanasamy Ravi

Industry Partner(s): Mirai Medical (Dr Declan Soden)

THE IMPACT OF CELLULAR METABOLIC PATHWAY MANIPULATION ON INFLAMMATORY-DRIVEN BARRETT’S OESOPHAGUS (BO)-TO-OESOPHAGEAL CANCER (OAC) TRANSITIONING, AND THE POTENTIAL ROLE FOR THE HDL PROTEOME AS A NON-INVASIVE IMMUNE-METABOLIC BIOMARKER OF DISEASE PROGRESSION.

Pousali Chatterjee

Ms. Pousali Chatterjee is the second PhD student appointed by the All-Ireland Cancer Research Network (AllCaN) Programme. Pousali is working under the supervision of Dr. Fiona McGillicuddy and Prof. Helen Roche at UCD to answer the research question; Can we improve the identification of survivors who most need dietary support using personalised biomarkers, and is it visceral adiposity or dietary saturated fatty acids that augment the risk of transition from Barrett’s Oesophagus (BO) to oesophageal cancer (OAC)?

Inflammation plays an important role in driving a transition from a pre-cancerous state (Barrett’s Oesophagus) to a malignant oesophageal cancer (OAC) state. Pousali aims to explore the effects of the fuel sources available to the cells on the subsequent mounting of cellular inflammation and growth rate. The fuel sources available to the cells (sugar or fat) will dictate the type of metabolism the cells undergo (glycolysis = breaking down glucose or fatty acid oxidation = burning of fat). Thus we will control cellular metabolism by regulating the fuels delivered to the cells. This will give greater insights into how dietary composition may contribute to disease transitioning in humans. In parallel, we will measure the proteins attached to ‘good cholesterol’ (HDL) particles as a new biomarker of inflammation in humans at risk of OAC, and the degree to which exercise intervention in high-risk individuals can reduce inflammation.

AllCaN Project Collaborators

Scientific Collaborator: Prof. Stephen Pennington

Clinical Collaborator: Prof. Carel le Roux

EXPLORING BARRIERS AND ENABLERS TO THE IMPLEMENTATION OF NOVEL CAPSULE SPONGE TECHNOLOGY IN PRIMARY CARE.

Dr Órla Carney

Dr Carney is an All-Ireland Cancer Research Network (AllCaN) MPhil candidate based in Queens University Belfast. This project, as part of work package 1,  will focus on the barriers and enablers to the implementation of novel capsule sponge technology within primary care. It will look at general practitioner views on the current management of gastroesophageal reflux disease and referral processes in both Northern Ireland and the Republic of Ireland. I aim to explore GP perspectives using semi-structured interviews to ascertain any concerns or difficulties in current management and whether the use of capsule sponge in primary care could improve pathways in general practice for earlier diagnosis of Barrett’s oesophagus or oesophageal cancer.