Kingston Upon Thames

Researchers are studying Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer with about a 50% five-year survival rate across all stages. Patients with early-stage (I & II) disease have better outcomes. When symptoms suggest HNSCC, patients may be referred urgently through a suspected cancer referral pathway, which includes specialized neck lump clinics. The study focuses on improving early diagnosis using a sensitive next generation sequencing (NGS) assay that detects circulating tumor DNA (ctDNA) in the blood, which could speed up cancer detection and treatment, especially in secondary care settings. The study evaluates an ultra-sensitive NGS assay capable of detecting HPV DNA and other genetic changes in ctDNA from patients with non-metastatic locally advanced head and neck cancer. This liquid biopsy blood test offers a faster turnaround (1-2 weeks) compared to traditional methods. The test is designed to be used alongside existing referral pathways and aims to reduce delays caused by inter-hospital transfers. The study seeks preliminary data on the assay's sensitivity and specificity to support future research. Participants undergo blood sample collection during their clinic visits, particularly when referred for ultrasound-guided fine needle aspiration (USFNA) in neck lump clinics. Researchers will measure how well the NGS assay detects ctDNA over one year. The study also monitors the patient journey through the cancer pathway to assess if the liquid biopsy can reduce delays and improve early diagnosis. The total participation time depends on follow-up within the one-year outcome measurement period.

Researchers are studying how to improve the accuracy of MRI scans in identifying early-stage rectal cancer and significant rectal polyps. Early-stage rectal cancers grow partially into the bowel wall and can often be treated with local procedures that preserve the bowel, avoiding major surgery and its risks. Many patients are currently over-treated due to inaccurate MRI staging, leading to unnecessary major surgery or radiotherapy. The study focuses on a new MRI reading method called PRESERVE that has shown higher accuracy in identifying early rectal cancers suitable for local excision. The study involves training radiologists across 20 hospitals in the PRESERVE MRI reading method to better stage early rectal cancers and significant polyps. MRI scans are recommended before removal of rectal polyps that are 20mm or larger or have features suspicious for cancer. Radiologists will be trained to use the PRESERVE system to improve diagnostic accuracy and help guide treatment choices, aiming to increase the number of patients offered organ-preserving surgery. Participants will be monitored by comparing MRI reports before and after the radiologist training over one year. Researchers will measure the impact of the training on the accuracy of tumor staging and whether more patients receive local procedures instead of major surgery. This study will help determine if the new approach can be widely adopted to improve patient outcomes and preserve quality of life.

Researchers are evaluating the real-world effectiveness of nemolizumab for treating moderate-to-severe atopic dermatitis (AD) in adolescents and adults. This study is a prospective, multicenter, non-interventional trial that aims to measure treatment outcomes through physician assessments and patient-reported outcomes over approximately 12 months. The goal is to understand how nemolizumab works in routine clinical practice, focusing on physician evaluations and patient experiences at Month 6. Treatment with nemolizumab is determined solely by the participant's physician before joining the study, with no extra visits, procedures, or lab tests beyond standard care. The study does not define a specific visit schedule; instead, visits follow routine medical practice to collect data systematically. A sub-study in Germany and the UK will have participants complete daily questionnaires on itch severity, sleep disturbance, and pain from Day -1 to Day 14 remotely, without requiring clinic visits. Participants will be involved in routine clinical visits where physician assessments and patient-reported outcome measures will be gathered. Key outcomes measured include the Investigator Global Assessment (IGA) and the Peak Pruritus Numerical Rating Scale (PP NRS) at Month 6. The study observes participant responses and safety under normal care conditions, with data collection lasting about a year to evaluate nemolizumab's effectiveness in everyday treatment settings.

Researchers are investigating colorectal cancer (CRC) patients with newly diagnosed stage I, II, and III cancers to evaluate whether mutations in circulating tumor DNA (ctDNA) can predict disease relapse earlier than current methods. This study includes two parts: Part B focuses on analyzing tumor tissue, serial blood samples, and clinical data to detect minimal residual disease (MRD) and predict relapse, while Part C is a randomized study comparing ctDNA-guided adjuvant chemotherapy to standard care in high-risk stage II or III CRC patients post-surgery. In Part B, the study collects serial blood samples from patients who have undergone potentially curative surgery to detect and quantify ctDNA, aiming to identify MRD and predict relapse. Part C randomizes patients after surgery into two groups: one receiving standard adjuvant chemotherapy and the other receiving ctDNA-guided chemotherapy, where those testing ctDNA negative may have chemotherapy reduced. The goal is to assess if ctDNA-guided treatment can safely reduce chemotherapy use without compromising disease-free survival. Participants will undergo tumor tissue collection, blood sampling at multiple time points, and clinical assessments over several years. Researchers will monitor ctDNA levels and clinical outcomes, measuring disease-free survival up to 3 to 6 years. Safety and treatment effects will be evaluated, with follow-up visits to track relapse and treatment response. Total participation includes long-term monitoring for relapse prediction and chemotherapy guidance.

Researchers are investigating the impact of a 12-week online peer support program designed specifically for family caregivers of individuals with Motor Neurone Disease (MND) who are at risk of becoming or currently technology-dependent. Caregivers in this role face significant psychological distress due to the progressive and debilitating nature of MND and the complexities of managing assistive technology. The study aims to determine how this virtual support affects caregivers' psychological health and burden, with a focus on reducing anxiety and depression. Participants will be randomly assigned to either receive access to the online peer support program or continue with usual care. The program includes private messaging through audio, video, or text, weekly live chats, asynchronous discussion forums, and access to informational resources. The intervention lasts for 12 weeks, during which caregivers can connect with peers who share similar experiences and challenges. During the study, researchers will collect data on caregiver demographics, caregiving impact, psychological wellbeing using tools like the Hospital Anxiety and Depression Scale (HADS), and program usage. Usability and acceptability of the program will be assessed through interviews and monitoring of participant engagement. The main outcomes measured are changes in anxiety and depression at 6 and 12 weeks. The study plans to enroll 154 participants to ensure sufficient data despite expected dropout, ultimately providing insight into how online peer support may benefit caregivers nationally and internationally.