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Cancer clinical trials within the Welsh context – where do we go next?

How can Wales develop a global reputation as a leader in cancer clinical trials? Professors Richard Adams and Steve Knapper share their thoughts on how this could be achieved.

We are fortunate to have research leaders who lead on national and international trials, and an engaged community of healthcare professionals with potential to head up the ground-breaking trials of tomorrow.

Cancer clinical trials can help us improve outcomes for patients. For instance, trials may explore the best way to catch cancer earlier, increasing the chances of cure, or help us examine new ways to treat patients with more advanced incurable disease.

Trials allow us to question what we do now; what should we change and how can we test new ideas and treatments to prove that they are better for the next generation of patients? They form an important part of the cancer research landscape in Wales and will be an integral component of the new cancer research strategy (CReSt).

The Welsh context

There are unique elements in Wales that are important to recognise in terms of how we deliver cancer care. We have a very mixed, rural and urban population, and diverse social and economic influences which can all affect cure rates and survival. It can also affect the way we deliver treatment and who might be recruited into trials. In this respect, cancer trials have another opportunity in Wales to really highlight the best ways forward for all.

There are two clear strategic strands that we wish to understand and improve within the Wales Cancer Research Strategy, which are: 

  • How can we engage more patients from across Wales in clinical trials, that will help us identify ways to improve cancer care?
  • How do we support the future leaders in healthcare to develop new trials that meet the needs of the Welsh population and global populations? Our health system is subtly different to the rest of the UK, and in certain areas it is importantly different. If we want to assess something new, we need to assess it in the Welsh context. 

There are many challenges in achieving these aims which require a structured, efficient approach and some difficult choices. A focus on catching cancer earlier through screening and detection studies, for instance, has potential to be rolled out across areas of Wales that are more socioeconomically and geographically challenged. Whilst, trying to deliver very complex trials such as those delivered by the Experimental Cancer Medicine Centre in Cardiff across Wales can be more challenging

World-leading innovation

In developing our future clinical research leaders, we are focusing on how to make Wales a leader in developing new ideas. We have a fantastic academically led clinical trials unit in Cardiff, which is supported by Health and Care Research Wales. Here the research team work with people from across Wales and beyond to develop and deliver national and international trials. 

We believe we are in a strong position to develop research ideas using patients’ voices, and those of clinicians, technicians and scientists to develop the trials of the future. We need to find those future leaders to develop the ideas that we think will make a difference to patients in Wales. 

We need to understand how best to nurture the next generation of leaders who will generate the next group of trials. That’s a difficult process because it is a lot of extra work for people to undertake. However, if we give people some dedicated research time, we can really move things forward.

We also need to ensure that the voices of the cancer community are heard loud and clear. These are the people who have had cancer or who have known people with cancer. Listening to the lay research partners who contribute to our work should be at the top of the CReSt agenda.