NIHR | Manchester Biomedical Research Centre
Our Research: Cancer Precision Medicine

Treatment selection and monitoring of treatment response

Using liquid biopsy to match the right patients to the right trials and develop new treatments.

Cancer precision medicine has the potential to improve outcomes for patients in Greater Manchester and beyond, but significant challenges must be overcome before this approach can become part of everyday clinical practice.

Through our research we are:

  • Developing and applying simple blood tests to identify patients who are most likely to benefit from an early clinical trial, working in collaboration with Manchester’s NIHR/CRUK Experimental Cancer Medicine Centre.
  • Expanding our existing laboratory protocols for monitoring patient response to treatment and testing patient-derived cell cultures (samples) to inform the development of new therapies

When cells inside tumours die, they shed tiny amounts of DNA into the bloodstream, called circulating tumour DNA (or ctDNA), where it can be sampled and analysed.

We have recently established a ctDNA assay/test to aid clinical decision making, selecting the most appropriate available Phase I trial for our patients.

We are developing protocols for testing patient tumour-derived cell cultures (biopsy, ascites, circulating tumour cells) to validate treatment response in real time, and to support studies of likely emergent drug resistance mechanisms in a laboratory setting.

This work will benefit from The University of Manchester’s biomarker expertise.


Progress to date:

  • We have published a manuscript reporting the use of ctDNA to guide patient selection onto clinical trials at the Christie NHS Foundation Trust
  • The story of Dave Kearney was profiled on North West tonight, demonstrating part of the journey of a patient in a clinical trial at the Christie.
  • We initiated a clinical trial in melanoma to determine whether ctDNA profiling can be used to switch treatments earlier, before disease progression, and benefit patients.
  • We have generated and characterised a ‘living biobank’ of advanced ovarian and breast cancer cell cultures, to test new drugs that may work in the clinic.
  • We are optimising experimental workflows to generate liquid biopsy-derived preclinical models of lung and colorectal cancer, that will allow us to investigate mechanisms of drug resistance.

Future work:

  • We will start a new clinical trial in melanoma that will use ctDNA to detect post-surgery disease relapse earlier, to help speed up initiation of new treatments.
  • Using improved molecular and computational techniques, we will increase the sensitivity and specificity of our ctDNA tests to provide better results earlier.
  • Using our advanced cell cultures we will develop new tests and investigate new therapies, that will be available to patients at the Christie NHS Foundation Trust.