Trinity College Dublin’s network of ‘the best minds in Ireland’ studying oesophageal cancer

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The AllCaN Grant Programme was created as part of (the Irish research charity) 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.

The first of these AllCaN Grants will focus on oesophageal cancer; funding innovative research to improve early detection and outcomes for patients with, or at risk of, developing the disease. Ireland and the UK have the highest incidence of oesophageal adenocarcinoma worldwide.

The reality of oesophageal cancer in Ireland
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 even less at 19% (NICR). Northern Europe, and specifically the UK and Ireland, are where the highest incidence rates of oesophageal adenocarcinoma (OAC) are reported.

School of Medicine researchers leading the way
Breakthrough Cancer Research is investing €1 million into the Oesophageal AllCaN Programme grant (2023-2027) with additional collaborative funding and support coming from CROSS and the Oesophageal Cancer Fund. Successful awardees receive a €1 million investment that will see researchers, clinicians, patients, and industry work together to significantly improve Irish cancer survival rates.

The grant has been awarded to an all-Ireland network of the best minds in Ireland working in this area, led by Professor Jacintha O’Sullivan, School of Medicine and Trinity St. James’s Cancer Institute and co-led by Prof. Helen Coleman (Queen’s University Belfast) and Professor Juliette Hussey, Discipline of Physiotherapy, School of Medicine.

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.

This extraordinary collaboration 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. The identification of, and improved treatments for people with oesophageal cancer and Barrett’s oesophagus, could therefore significantly control the progression of the disease.

The importance of cross border collaboration
This unique cross-border collaboration of researchers across two health jurisdictions will enable for the first time the 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.

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.

Professor Jacintha O’Sullivan, Professor in Translational Oncology at the School of Medicine and Trinity St James Cancer Institute, who is leading AllCaN said:

“The new all-island collaborative structure will provide research-led innovation addressing key gaps in knowledge across the oesophageal cancer patients journey from cancer prevention, diagnosis, treatment to survivorship This will led to new cancer prevention strategies, lifestyle interventions and identify those at risk of disease progression and identify new treatment approaches for these patients.”

Professor Juliette Hussey, Professor of Cancer Rehabilitation and Survivorship, School of Medicine who will lead research in the area of improving physical performance, physical activity and body composition in people with Barrett’s Oesophagus and people after surgery for oesophageal cancer said:

“We will examine a number of dietary and exercise interventions to help modify risk factors and improve overall physical and mental health. The results from these studies will generate new knowledge to inform overall management and lead to novel approaches and developments in clinical practice.’

Professor John Reynolds, Professor of Surgery and Head of Department, St. James’s Hospital and Trinity College, said:

“Reducing mortality from oesophageal cancer will be achieved mainly by both prevention and early diagnosis of cancer in the most at-risk population, the common condition of Barrett’s oesophagus, and this collaboration of clinical and scientific expertise in an all-island consortium creates a powerful new structure towards tackling this objective.”

Professor Maeve Lowery, Professor of Translational Cancer Medicine, Trinity College, Consultant Medical Oncologist St. James’s Hospital and Academic Director of the Trinity St. James’s Cancer Institute, said:

“The all-island consortium is a wonderful opportunity to combine excellence in clinical care with ground- breaking research to ensure the best outcomes for Irish patients with oesophageal cancer.”

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.”

Orla Dolan, CEO of Breakthrough Cancer Research said:

“AllCaN is a game changer for low survival cancer research on the island of Ireland. The inaugural project will bring everyone working on, or living with, oesophageal cancer in Ireland together to take on the key challenges, with the aim of doubling survival in 20 years. Ireland is leading the way in new innovations for this disease, but we are still only moving the needle by single digits. We need bold new ideas and significant investment to back them. This collaboration aims to generate actionable intelligence to reduce the number of people who develop oesophageal cancer and improve the treatment and survival of those who do.”