Much of the research that takes place into cancer is called clinical research. This involves designing or identifying a medication or intervention that may improve the diagnosis or treatment of a disease. This idea is then repeatedly tested or developed through research and clinical trials. Before a medication or intervention is licensed and given to patients it will have been tested using a variety of methods. These tests will determine the safety and effectiveness of the intervention or medication. New medications or interventions need to be practical, cost effective and appropriate.
The process of clinical research is long, and many new discoveries or ideas don’t make it to the licensing stage. Research also relies on funding and on patients and volunteers taking part. The page below describes the research process that takes place to find and develop interventions or medications for cancers including pancreatic.
1. Discovery and early research
Research into new medications or interventions (such as scans or surgeries) for a disease normally begins with research scientists. They may work in a university or private lab trying to understand a disease and the processes which cause it. They will look at the cells involved in the disease to understand how they work and what kind of medication or intervention may disrupt or kill the disease itself or any cells that are not working properly.
Once this is understood, scientists can look at new or existing methods for medicines and interventions. These can come from natural products such as plants, existing medications and interventions or new man-made products, designed using computer models.
2. Preclinical trials
Potential candidates for medicines or interventions in a disease are tested using computer models, cells and animals in pre-clinical testing.
Computer models can provide a prediction of how a new intervention will work and cell models can confirm this using live cells that make up animal or human bodies. However, these tests are outside of the complex environment of the body and therefore cannot be relied upon as the only evidence.
Animal models are sometimes used in place of humans to limit the amount of harm that can be caused to humans during clinical trials and to see if the intervention works as well as predicted. Often, mice are used for research, they are mammals like humans. However, tests in mice cannot give the same effect as those in humans and often differences are observed between the two.
3. Clinical trials
Clinical trials are medical research studies where an intervention or treatment is offered to people to test how well it works compared to the current standard. Trials are carried out because the benefit of a treatment or intervention is currently unknown. It may be better, the same, or sometimes not as good as standard treatments.
Depending on how far through the testing process a drug is depends on the kind of trial you may be asked to take part in. Clinical trials usually have up to three phases, and information gathered in each phase helps researchers decide whether the study can move on to the next phase and the best way to do so. In phase one and two clinical trials, the intervention is received by everybody taking part (single armed trial). The third phase can involve comparing to existing treatment, a placebo (such as a sugar pill) or no treatment.
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4. Licensing and approval
If a medication or intervention passes all of these tests it can be licensed and investigated as a potential treatment to be used by the NHS. Each country within the UK have organisations which advise the NHS on the best ways to diagnose, treat and manage diseases. They look at how cost-effective new interventions are and what the benefits will be to patients.
Once an intervention is in use, it will be monitored to make sure that it is safe and working as predicted. If this is a medication then an instruction leaflet should be provided with information about dose, the way the medicine should be taken and any side effects. Doctors will be able to report any concerns they have about the medication for further investigation and clinical trials will continue to either examine issues with the medication or find new uses for it.
Pancreatic Cancer Action and clinical research
Pancreatic Cancer Action funds clinical research into the early diagnosis of pancreatic cancer. We currently fund the research of PHD students and seed fund other projects.
An initial PCA funded trial has recently been awarded £2.17 million by Cancer Research UK to investigate the links between pancreatic cancer and diabetes. Specifically, the project aims to distinguish between type 2 diabetes that develops in adulthood and type 3c diabetes caused by pancreatic cancer.