Grand Challenge Network+ in Proton Therapy

Lead Research Organisation: University of Manchester
Department Name: School of Medical Sciences

Abstract

In the UK one in two people are diagnosed with cancer during their lifetimes and of those who survive 41% can attribute their cure to a treatment including radiotherapy. Proton beam therapy (PBT) is a radical new type of radiotherapy, capable of delivering a targeted tumour dose with minimal damage to the surrounding healthy tissue. The NHS is investing £250m in two new "state of the art" PBT centres in London and Manchester. In addition, Oxford has attracted £110m (from HEFCE and business partners) for its new Centre for Precision Cancer Medicine, incorporating PBT.
This EPSRC Network+ proposal seeks to bring the EPS community together with clinical, consumer and industrial partners and develop a national research infrastructure and roadmap in proton therapy. It capitalises on ~£300m of government investment and affords an opportunity for those not directly involved in the new proton centres to be actively involved in the national research effort in this area. This project has the backing of NCRI Clinical and Translational Radiotherapy Working Group and NHS England and will work with the national Proton Physics Research and Implementation Group of the National Physical Laboratory. It also involves industrial stakeholders, consumer groups and international partners (including PBT centres in Europe and USA and CERN).
While PBT offers patients many advantages it also presents a wealth of technical challenges and opportunities where there is an unmet research and training need. This is where there the involvement of the EPS community is vital since this challenge in Healthcare Technologies requires expertise from across the EPS spectrum and maps on to themes in ICT, Digital Economy, Engineering, Mathematics, Manufacturing the Future, and the Physical Sciences and also finds synergies within quantum technologies. It directly maps onto the cross cutting capabilities identified in the Healthcare Technologies Grand Challenges. This is a highly multi-disciplinaryea at the frontiers of physical intervention, which achieves high precision treatment with minimal invasiveness. This Network+ is particularly timely; it will afford the UK the opportunity to develop a world-leading research capability to inform the national agenda, capitalising on existing research excellence and the synergies that can be developed by bringing the clinical and EPS areas together. It will also collaborate with existing doctoral training provision to train the next generation of leaders where a national need has been identified.
This proposed Network+ will create a national infrastructure to meet a national research and training need and will allow the UK community to work together in the multi-disciplinary field of proton research. This proposed Network+ will create a sustainable national proton beam infrastructure by drawing together sites where proton beams are already available (albeit at lower energies) and providing a route for the research community to access these facilities. As the new proton centres come on line they will add to this national resource and the centres will work together to provide a virtual national infrastructure for the UK, which by the end of the Network+ will be fully sustainable. The Network+ will also provide a route for those interested in the field but not requiring proton experiments to become involved. In addition, the Network+ will offer secondments ("Discipline Hops") into the clinical environment in both the UK and in PBT centres overseas. Working with NHS England the Network+ will develop a PBT training scheme. This will link the existing NHS provision with EPSRC Centres for Doctoral Training and allow equivalencies to be established and so provide a "fast track" to a skilled workforce and the next generation of leaders. The Network+ will also seek to engage with industry through joint research and secondments and with consumer groups, policy makers and the general public.

Planned Impact

This Network+ in Proton Therapy is designed to bring the EPS community together with clinicians and medical physicists working in hospitals, the major manufacturers in the field, consumer groups (patients, carers and charities), policy makers from NHS England and national and international leaders in the field. The Network+ will establish a sustainable national infrastructure for proton therapy research and allow the whole UK academic community to benefit from access to these facilities. It will also establish Pathfinder projects with industrial or international partners to initiate new research ideas and pump-prime collaborations. The Network+ will also develop a secondment scheme through "Discipline Hops" enabling the EPS community to work closely with the clinical, industrial and international communities.
Proton therapy is an emerging field of research requiring a multi-disciplinary palette of skills and capabilities and there are still many challenges to overcome. The EPS community has the skills to work in partnership with the proton therapy community to find innovative solutions to these challenges. This opens up a whole spectrum of opportunities for innovative research involving the EPS community working in partnership with the public and private sectors both nationally and internationally.
Consumer groups will be actively involved in this Network+ and will help to inform its direction. The ultimate aim will be better treatment and better patient outcomes, achieved by bringing together a wide-ranging and multi-disciplinary community and pump-priming collaborations (through Pathfinder projects, "Discipline Hops" and travel grants).
There will also be benefits through close collaboration with industry, taking EPS research up the technology readiness levels so that it can generate income for the UK economy and society. The fact the four of the worlds major manufacturers in this field want to be involved is testament to the importance they ascribe to this Network+. It is envisaged that this research will prove to be mutually beneficial and is likely to result in industrially sponsored research, knowledge exchange, patents, licensing agreements or spin out companies.
Likewise the involvement at a very senior level of NHS England demonstrates a serious commitment and undoubtedly this Network+ will play a part in informing government research strategy.
The Network+ will produce a vibrant energised community who will actively work together and start to train the next generation to do the same. Through working with NHS England and Health Education England we will address the skills shortage in this area and look at ways to establish equivalencies between the NHS clinical scientist training and that offered by EPSRC through its CDTs. This will help to address an area where there is a national need. In terms of timescale, some impacts will be realised on a short timescale and are likely to be developed as the UK proton therapy service ramps up, through informing treatment strategies and the clinical indications list. Other impacts will take longer to achieve and are likely to result in smaller compact devices, improved real-time imaging, adaptive treatment planning and detection. Impacts involving advanced materials and innovative manufacturing may take even longer. All of these activities will form the pipeline of innovation generated by this Network+, which has a strong industrial and clinical pull.

Publications

10 25 50
 
Title Bragg peak glass 
Description working with a glassblower on a glass sculpture to represent the Bragg peak and how different beams are brought togther during PBT treatment 
Type Of Art Artwork 
Year Produced 2018 
Impact this will form a piece of artwork in patient area of clinical PBT centre 
 
Title protons the play 
Description Story of proton therapy in Manchester from Rutherford to clinical treatment 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2019 
Impact story of how PBT came to Manchester 
 
Description Mechanistic mathematical models have been incorporated in to treatment plans to enable biological effects of proton therapy to be evaluated. This has been aided by research licenses for research version of clinical treatment planning Eclipse and Velocity being donated by Varian. fair market value $75k.
Patient information booklets developed with Brains Trust
The group hosted 5 summer placements in summer 2019
First UK RCT PBT clinical trial TORPEDO funded by CRUK and opened in 2020.
VM interface for patient demand software Malthus developed and has now been extended to cover patient waiting times funded by GM cancer
Proto-type for prompt gamma imaging for range verification developed
Framework agreement developed with Varian
Exploitation Route Patients using information booklets
clinicians and clinical scientists using biologically augmented treatment plans to inform and improve patient treatment
Government looking at equipment demand
Industry improving tumour targetting through better measurement of range and stopping powers
Work on patient screening for lung cancer using Malthus model now being extended nationally
Sectors Healthcare

URL https://brainstrust.org.uk/brain-tumour-support/resources/downloads/patient-guides/
 
Description Developing material with BrainsTrust on proton therapy which is being used to inform patients and carers about proton therapy. https://brainstrust.org.uk/brain-tumour-support/resources/downloads/patient-guides/ POSTnote for Members of Parliament on proton therapy published in 2019 In collaboration with CRUK ART-NET organised meeting for patients and carers to give views on proton beam therapy (PBT) clinical trials. RCT TORPEDO funded by CRUK started to recruit patients in 2019 Undertaking a report in collaboration with NHS-E to look at bringing doctoral training provision within NHS and research councils together. Public engagement activities with patients, carers, schools donors Radiotherapy and me videos now available BBC interview on FLASH radiotherapy Talked to patient groups on potential impact of FLASH radiotherapy Video on past 12 months for GM cancer conference Developing a master research agreement with Varian to develop a pipeline of research in to the clinic Working with a glassblower to produce art that emulates the Bragg peak with a display that will be used in patient waiting areas
First Year Of Impact 2017
Sector Healthcare,Government, Democracy and Justice
Impact Types Cultural,Societal,Economic,Policy & public services

 
Description Patient information booklets on PBT
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Training
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Workstream 4 CoChair NCRI CTRad
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact National body pioneering new developments in radiotherapy
 
Description Advanced Radiotherapy Network + (ARN+) extension
Amount £365,748 (GBP)
Funding ID ST/S005382/1 
Organisation Science and Technologies Facilities Council (STFC) 
Sector Public
Country United Kingdom
Start 09/2019 
End 09/2022
 
Description CRUK ART-NET
Amount £4,500,000 (GBP)
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2016 
End 08/2021
 
Description CRUK Major Centre
Amount £48,500,000 (GBP)
Organisation Cancer Research UK 
Department Manchester Institute
Sector Academic/University
Country United Kingdom
Start 04/2017 
End 03/2022
 
Description EC Research and Infrastructure
Amount € 5,000,000 (EUR)
Funding ID 730983 INSPIRE 
Organisation European Commission H2020 
Sector Public
Country Belgium
Start 03/2018 
End 02/2022
 
Description EMPIR
Amount € 2,000,000 (EUR)
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 05/2016 
End 04/2019
 
Description Equipment application
Amount £265,000 (GBP)
Organisation University of Manchester 
Department Manchester Cancer Research Centre
Sector Charity/Non Profit
Country United Kingdom
Start 09/2017 
End 10/2018
 
Description Manchester RADNET
Amount £16,500,000 (GBP)
Organisation Cancer Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2019 
End 09/2026
 
Description NIHR
Amount £100,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Biomedical Research Centre
Sector Public
Country United Kingdom
Start 10/2017 
End 09/2021
 
Description NIHR BRC
Amount £28,500,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Biomedical Research Centre
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2022
 
Description Responsive Mode
Amount £3,400,000 (GBP)
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 05/2018 
End 12/2021
 
Title Proton Therapy Research room in the clinical PBT centre at the Christie 
Description Research infrastructure to conduct research in proton therapy, funded by Christie Charity £5.6M 
Type Of Material Improvements to research infrastructure 
Year Produced 2019 
Provided To Others? Yes  
Impact The plan is to make this research infrastructure available via UKRI and CRUK grants. The facility has to pay its own costs so funding would need to be applied for via competitive grants 
 
Title Anonymisation of PBT overseas data and data from patients treated at The Christie with PBT 
Description Means to access anonymised patient data from PBT patients treated overseas and at the Christie. This allows real patient data to be used to validate models developed in BioProton and other UKRI grants 
Type Of Material Database/Collection of data 
Year Produced 2020 
Provided To Others? No  
Impact Means research outputs can be validated on real patient data 
 
Description MGH 
Organisation Eindhoven University of Technology
Department Medical Physics
Country Netherlands 
Sector Academic/University 
PI Contribution New collaboration to incorporate research undertaken by 2 current PhD students and a new PhD who will work directly with MGH. MGH are providing software licenses free of charge and the software developed will be incorporated in to TOPAS which is used internationally. The PhDs have now visited but there is an ongoing collaboration with weekly telephone conferences. 1 publication in Nature Scientific Reports and 4 further publications in the process of being submitted
Collaborator Contribution software licenses, hosting PhDs at MGH expertise
Impact Software now incorporated in Open Access Software Topas n-Bio; 1 publication and 4 further publications being written; Workshop to be held in Belfast in April 2018 (all workshop places filled). Active ongoing collaboration.
Start Year 2016
 
Description Malthus on Azure cloud 
Organisation Microsoft Research
Country Global 
Sector Private 
PI Contribution Uses Malthus model for radiotherapy demand
Collaborator Contribution Access to Microsoft cloud allowing us to demonstrate a cloud based solution of our radiotherapy demand model
Impact The research is going to feature in a short film of Microsoft's research collaborations, will be published and demonstrated at conferences world wide
Start Year 2017
 
Description NPL2 
Organisation National Physical Laboratory
Country United Kingdom 
Sector Academic/University 
PI Contribution Proton Physics Research Implementation Group (PPRIG) Hosts annual international workshop
Collaborator Contribution Costs of hosting the annual workshop, experience and expertise
Impact Presentations can be found below http://www.pprig.co.uk/pprig/meetings/pprig-proton-therapy-physics-workshop-dec-2016.html
Start Year 2016
 
Description Patient Reported Outcomes 
Organisation Leeds Teaching Hospitals NHS Trust
Country United Kingdom 
Sector Public 
PI Contribution Funding from Network which also links in to CRUK ART-NET grant to develop patient reported outcomes for proton therapy
Collaborator Contribution CRUK ART-NET funds post at University of Leeds
Impact Electronic patient reported outcomes for mobile phone or tablet. Able to be used for different types of radiotherapy for a range of patient ages.
Start Year 2017
 
Description Patient Reported Outcomes 
Organisation University of Leeds
Country United Kingdom 
Sector Academic/University 
PI Contribution Funding from Network which also links in to CRUK ART-NET grant to develop patient reported outcomes for proton therapy
Collaborator Contribution CRUK ART-NET funds post at University of Leeds
Impact Electronic patient reported outcomes for mobile phone or tablet. Able to be used for different types of radiotherapy for a range of patient ages.
Start Year 2017
 
Description PhD studentship 2 
Organisation Eindhoven University of Technology
Department Medical Physics
Country Netherlands 
Sector Academic/University 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Description PhD studentship 2 
Organisation Massachusetts General Hospital
Country United States 
Sector Hospitals 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Description PhD studentship 2 
Organisation University of Manchester
Department School of Physics and Astronomy Manchester
Country United Kingdom 
Sector Academic/University 
PI Contribution brings together research at MGH, The Christie and University in modeling DNA damage and repair and incorporating it into a commercial software
Collaborator Contribution experience and expertise, software licenses and funding for 50% of PhD
Impact multidisciplinary incorporating Geant 4 DNA into TOPAS nBio. We are in the process of developing this in to treatment planning and have had preliminary discussions with Varian to obtain software license free of charge.
Start Year 2017
 
Title RCT TORPEDO 
Description TORPEO RCT has been developed and is funded by CRUK, it started recruiting patients in Feb 2020 
Type Therapeutic Intervention - Radiotherapy
Current Stage Of Development Refinement. Clinical
Year Development Stage Completed 2018
Development Status Under active development/distribution
Impact First UK RCT in PBT 
URL https://www.ncri.org.uk/ncri-blog/the-journey-of-torpedo-the-uks-first-proton-beam-therapy-clinical-...
 
Description BBC interview of FLASH radiotherapy 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact media interview for BBC on Flash proton therapy as part of CRUK RADNET launch
https://www.bbc.co.uk/news/uk-england-manchester-50289393
Year(s) Of Engagement Activity 2019
URL https://www.manchesterbrc.nihr.ac.uk/news-and-events/manchester-scientists-lead-way-next-generation-...
 
Description Charity events for patient groups and carers 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Have participated in about 3 charity events per year for charitable donors patients and carers
Year(s) Of Engagement Activity 2017,2018
 
Description Cyclotron installation The Christie 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Installation of cyclotron in to Christie proton therapy centre
Year(s) Of Engagement Activity 2017
 
Description Film on proton therapy for GM cancer conference 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Film "what we have achieved in the last 12 months" which was shown during GM cancer conference. I also spoke at this conference
Year(s) Of Engagement Activity 2019
URL https://gmcancer.org.uk/greater-manchester-cancer-conference-2019/
 
Description Launch 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact First of the Network launch events
Year(s) Of Engagement Activity 2016
URL http://protontherapynetwork.com/
 
Description One day workshop on FLASH radiotherapy: Transforming Radiotherapy in a FLASH 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact One day workshop organised with NCRI CTRad to inform UK researchers about Flash radiotherapy
Year(s) Of Engagement Activity 2020
URL https://www.eventbrite.co.uk/e/transforming-radiotherapy-in-a-flash-tickets-84136780375#
 
Description POST Note 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact POST note for members of the House of commons and Lords
Advances in Cancer Treatment
Year(s) Of Engagement Activity 2019
URL https://researchbriefings.parliament.uk/ResearchBriefing/Summary/POST-PN-0598
 
Description PTCOG 58 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Largest conference ever held on particle therapy attracted over 1355 people to a 5.5 day event in Manchester and contributed over 2.5M to the local economy
Year(s) Of Engagement Activity 2019
URL https://ptcog58.org/
 
Description Presentations at House of Commons 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation to politicians at House of Commons by at least 1 PGR from the group
Year(s) Of Engagement Activity 2017,2018
 
Description School Visit (Oldham) 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Talk on Proton Therapy for national Science week
Year(s) Of Engagement Activity 2016
 
Description School visit (Withington) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact School visit to 6th form to talk about proton therapy
Year(s) Of Engagement Activity 2016
 
Description Spotlight event on proton therapy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Talk on proton therapy and the building of the Manchester facility
Year(s) Of Engagement Activity 2016
 
Description radiotherapy and me 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact event to listen to patients experience of radiotherapy
Year(s) Of Engagement Activity 2019
URL https://publicprogrammes.co.uk/radiotherapy-and-me