The Molecular Diagnostics Theme is focused on improving medicine by better classification of disease, allowing more accurate prediction of patients’ prognosis and better prediction of how they will respond to different treatments. This will help to offer the most suitable treatments to patients with cancer and other diseases.
Molecular Diagnostics Theme Lead, Prof Paresh Vyas
Our work is divided into four sub-themes, each within the general area of molecular pathology:
1 – Precision Biomarkers
2 – Cancer genomics for patient benefit
3 – Experimental pathology
4 – Predicting disease progression
Sub-theme 1: Precision Biomarkers
Dr David Church
Advances in technology mean that we now have an unprecedented ability to identify the molecular alterations that drive cancer growth and spread. While many of these alterations are likely to be associated with differences in prognosis or probability of treatment benefit, current analytical methods are inadequate to confirm this in cases where the alteration is uncommon, or in cases where multiple alterations are present. In the Precision Biomarkers sub-theme, we will develop new statistical methods to address this challenge. Our aim is to realise the potential of new technologies to refine care for patients with cancer, and in so, doing reduce both under- and over- treatment. In addition to improving cancer care, the methods we seek to develop should be applicable to other disease types, and thus help to achieve the ambition of Precision Medicine more broadly.
Dr David Church on precision biomarkers
Sub-theme 2: Cancer Genomics for Patient Benefit
Dr David Wedge
Genomics England has sequenced DNA from 20,000 cancers within the NHS. We are analysing the resulting data from colorectal, endometrial and testicular cancers to find out what makes some cancers more aggressive and resistant to treatment. This will enable doctors to personalise treatment to individual patients.
Tumours contain millions of cells, each of which may have a different set of mutations. We are using novel sequencing technologies to look in detail at how individual cells behave within tumours. This will enable us to predict how individual tumours will respond to different treatments.
Sub-theme 3: Experimental Pathology
Prof Clare Verrill
The Experimental Pathology subtheme focuses on translational cellular pathology research and is a novel collaboration with the engineering team based at the Big Data Institute. Cellular Pathology (Histopathology) is a discipline involving evaluation of tissue sections under a microscope and was highlighted within the UK Government’s Industrial Life Sciences Strategy (2017) as being ripe for innovation. Much of the workflow is manual and assessment of samples involves parameters which are unchanged for decades. This subtheme aims to bring novel technologies into the workflow, with a particular emphasis on computational pathology; bringing digital reporting into clinical practice and establishing libraries of slide images that are used to build novel artificial intelligence algorithms to improve workflow or enable correlation with molecular changes within tumours. The subtheme also provides core laboratory and biobanking support including: histology, immunohistochemistry, tissue microarray construction, whole slide imaging and image analysis.
Sub-theme 4: Predicting disease progression
Dr James East
For many diseases a large proportion of patients will be a low risk of developing a serious complication of their disease becoming uncontrolled over time. It is therefore important to be able to pick out those few patients who are at risk of a poor outcome. This will save the lower risk patients unnecessary investigation, treatment or surveillance, and focus our resources on those at highest risk. As an example, we will attempt using genetic analysis of precancerous polyps and stem cells to separate patients with bowel inflammation (ulcerative colitis) into those at high and low risk of severe inflammation or bowel cancer. Those at higher risk might get more intensive checking the bowel with colonoscopy or need to consider early surgery.
Dr James East on predicting disease progression
Dr James East on FIT Bowel Cancer Screening programme
In addition to our specific work plans, our role is a cross-cutting one. We will work with, and assist several other Oxford BRC themes, including Multi-Modal Cancer Therapies, Gastroenterology and Mucosal Immunity, Genomics Medicine, Haematology, Health/Wealth/Innovation and others.
This reflects the central role that molecular pathology plays in many disease types. Improvement in our field will enhance the care of a very broad range of patients.