by ecancer reporter Clare Sansom

Monday was designated “surgery day” at the NCRI, and the afternoon program featured two sessions about improving cancer surgery through clinical trials.

The first of these was a workshop covering all aspects of planning clinical trials with surgery, including tips for successful grant applications and advice for engaging surgeons in trials involving radiotherapy.

Two trainee surgeons, Andy Torrence from the University of Birmingham and Julie Cornish from the University of Cardiff, described innovative new schemes known as Research Collaboratives through which trainees design and deliver research in their discipline with the help of a mentor.

There are currently almost 30 trainee-led collaboratives in the UK, each centred on either a region or a sub-discipline, and they are already delivering successful trials.

The linked session that followed highlighted research partnerships between surgeons and oncologists that are improving surgical procedures.

First to speak was Jane Blazeby of the University of Bristol, who explained the difference between pragmatic clinical trials and the explanatory ones that are common in surgery.

A pragmatic clinical trial is one designed to test whether an intervention works in practice and improves patient outcomes; it involves a large number of centres and patients and can cope with local variations in clinical management and surgical procedures.

Blazeby explained that surgeons, who typically have little experience with these trials, find pilot studies helpful, and described one such pilot in oesophageal cancer, the ROMIO trial comparing open and keyhole surgery in oesophageal cancer.

The other studies described in this session concerned so-called “window trials” of pre-operative chemotherapy in breast cancer and organ-sparing surgery in early stage rectal cancer,

The day ended with the presentation of the prestigious Cancer Resarch UK prizes for 2013 by the chair of the selection panel, Nic Jones.

Four prizes were awarded in total; the Future Leaders prize was shared by two exceptional young researchers, Nitzan Rosenfeld of the Cancer Research UK Cambridge Institute and Ivan Arel of the Manchester Institute.

The Translational Research prize was awarded to an interdisciplinary group of fourteen scientists led by Paul Workman of the Institute of Cancer Research and Laurence Pearl of the University of Sussex, for their work on the structure and mechanism of the chaperone Hsp90 and its role in cancer.

And the Lifetime Achievement award went to Bruce Ponder, the Cancer Research UK Cambridge Institute director.

Ponder then gave his award lecture, a tour de force covering his forty-year career working mainly at the forefront of cancer genetics.

Ponder had come to this research area fairly late, after clinical training and a few years investigating cancer as a breakdown of tissue organisation.

His first major success in genetics was the linkage of medullary thyroid cancer to chromosome 10, which led to a test for genetic susceptibility to this rare disease.

In the late 1980s he moved on to study breast cancer; the international consortium he established  in breast cancer genetics led directly to the discovery of BRCA1 and BRCA2.

Later still he was involved in the first genome-wide association scans (GWAS).

Results from these, however, have been disappointing: for example, even with GWAS we have been able to explain less than 20% of the genetic variation in breast cancer risk.

Ponder ended his lecture by suggesting that combining genes into networks might help explain some of this missing heritability of breast cancer,