A multidisciplinary approach to cancer research in Manchester

Professor Robert Bristow has championed a team science approach to all research activity taking place across Manchester since he became the University Professor of Cancer Studies and Director of the Manchester Cancer Research Centre (MCRC) in 2018. This approach, which sees experts in different fields work together on a single research question, is yielding exciting results. Professor Bristow explains why he sees this approach as transformative to the cancer research environment.

Multidisciplinary science is a key aspect of team science and brings the best ideas from different scientific areas, all focused on one specific cancer question.

That's exciting because in our busy day-to-day approaches to our own research, we don't necessarily have time to think about the big questions or developments occurring in other disciplines. These include the best new ideas coming in from engineering, physics or chemistry, and creating the opportunity to work together with these experts to bring the best solutions to some of the most complex questions in cancer research.

These new ideas positively disrupt our thinking in the cancer realm. It allows us to look at old problems through a new and exciting lens. It's an invitation to other disciplines that says: 'You are one of the new disciplines that we need to be working with closely to pull this problem off with pace and scale. Come and help solve this question with us.' That's a new way of doing things.

The best teams will always be multidisciplinary because the best ideas will come from that mix of different expertise and accepting that others may have solutions to your problems that you have not yet thought of.

Setting the question

Ensuring the questions are set appropriately is at the heart of good multidisciplinary science.

When we think about setting up the multidisciplinary science teams, it's crucial that we identify the clinical need. The clinical need must be spelt out for the tumour type, and what the specific need is to be explicitly understood from the outset to ensure that you properly identify the disciplines that you need to bring in and collaborate with you.

That level of granularity is needed to ensure successful collaborations.

Making it work

Increasing the focus on a particular problem, such as 'why do certain patients get certain inflammatory side effects following radiotherapy while others don't?', self-selects specific researchers who are interested in the problem from their own unique perspective.

These might include experts in the different physics pertaining to photon versus proton radiotherapy, or experts in germline genetics who might wonder whether a radiotherapy sensitivity gene is involved, or a non-cancer expert in immune biology or inflammation who may see their work mirrored in a cancer side-effect.

By placing the questions that are important to patients out to the science community, this allows a much more granular approach and brings multiple disciplines to bear on specific questions.

Ambitious projects

A project that typifies our multidisciplinary team science approach is our ambition to understand which patients, when undergoing bone marrow transplant, are going to acquire acute graft versus host disease, which develops after the transplant.

Here, the body starts to see itself as something foreign and creates an inflammation against itself, which can affect kidney and liver function and the acquired blood cells after transplant and, ultimately, can lead to a 50% chance of death.

If we knew which patients were more likely to develop this, we could start to think about novel treatments to reverse the effects. Using state-of-the-art approaches with CyTOF and SWATH-MS proteomics, our team of clinicians and basic researchers are trying to develop an assay to detect this side effect early, and offer new treatments to improve survival after transplant.

Cancer and graphene

One of the exciting multidisciplinary projects involving engineers is one we're working on with Professor Kostas Kostarelos from the prestigious National Graphene Institute. He is a world leader in nanotechnologies, and is collaborating with our early cancer detection researchers to develop new cancer risk signatures.

Kostas and his team have created nanoparticles that can trap proteins as they circulate through the body. In patients with the earliest beginnings of cancer, these nanoparticles may detect novel cancer-specific proteins to herald the development of certain types of cancer.

The specific proteins detected within the blood might then give us an early signal as to who is most at risk for an aggressive cancer, and provide earlier treatment to attain better cure rates.

This is a much more sensitive technique for picking up circulating proteins than other approaches, so it's literally small nanoparticles mopping up novel proteins from people who are, or are not, at risk from cancer and comparing those signatures by shaking out the protein mop at the end of the day.

We hope these technologies will grow to involve multidisciplinary scientists within the UK and USA within the next two years.

One Manchester

Manchester is already an exemplar of teamwork thanks to the MCRC itself. The MCRC represents the University's cancer beacon, and is a research cancer centre bringing together the strengths of our university, The Christie and other Manchester trusts, and CRUK (including the CRUK Manchester Institute and Major Centre). This unique partner collaboration doesn't exist anywhere else in the world, and its ethos trickles down into the creation of our unique research projects.

What's exciting about the 'one Manchester' approach is the success in developing new multidisciplinary science teams, with more than £25 million of new research funds accrued in the last year alone.

Providing a research environment for team science is added value for the individual research programme. This recent track record of success has led other researchers and patients to think: 'How can I be part of a team?'. We've been using our Town Hall meetings to provide the opportunity for people to think about the ideas early on and then to develop them.

What's been impressed clearly upon me are the numbers of people wanting to take part in team science.

Instigating change

At the beginning of a Town Hall meeting, we state our goal: to step-change the outcomes for patients in Manchester through the best research that is activated within the NHS.

We've been given a major challenge with the devolved healthcare system in Manchester. Already, a systems healthcare approach exists to bringing together all the trusts in Manchester to streamline and harmonise our NHS clinical pathways for every cancer type.

As researchers, we ask ourselves: 'How can we develop research methods to impact on more than three million people in the aligned clinical care pathways of the Greater Manchester Cancer Plan?'.

When we take this attitude and collaborate with the commissioners in the NHS, this then becomes one of the most powerful ways of reaching the greater population with our research programmes and technologies.

Working together

That we have an MCRC sets the stage for powerful partnerships to direct against the increasing incidence and complexity of cancer detection and treatment in our populations. We aim to drive very best science from our CRUK and other science funders across the whole of the University, and link this with the very best state-of-the-art treatments at The Christie.

This provides us with an opportunity to conduct research in early detection or personalised treatments at a pace and scale unlike that in any other healthcare system.

The collaborative and multidisciplinary Town Halls provide a new and exciting way to conduct added-value research. For those who've always done research on their own, it's an opportunity to be involved in bigger projects and projects that move more quickly towards their clinical ambitions. The Town Halls are really designed for impact in this unique way.