Upper Gastro-Intestinal surgeon receives major national research funding for translational science

AUGIS member, Tim Underwood, has achieved the notable accolade of becoming the first surgeon to be awarded an Advanced Clinician Scientist Fellowship by Cancer Research UK.

Tim, Professor of Gastrointestinal Surgery at the University of Southampton, trained in London and Wessex. He completed a PhD in molecular biology and took an NIHR Clinical Lectureship in Surgery in 2008. In 2011, he was awarded a Medical Research Council Clinician Scientist Fellowship. He became a Cancer Research UK & Royal College of Surgeons of England Advanced Clinician Scientist Fellow in April 2017.

He leads a programme of research which studies the role of the tumour microenvironment in the development and progression of cancer. Other areas of interest include the metabolic regulation of gene expression in oesophageal malignancy and the influence of exercise on the response to therapy, including surgery.

The award of £1.4 million will be used to support his group’s study of cancer ecosystems. Advanced technology is used to evaluate cellular interaction in oesophageal cancer; including genome-wide expression profiling of single cells using nanolitre droplets and the generation of multicellular organoid models. Through investigation of the molecular determinants of the response to chemotherapy, Tim anticipates that new therapies which target the tumour microenvironment will be developed, enhancing the efficacy of conventional treatments. He believes that the time is right for a radical change in cancer management, with surgery being personalised to individual patients based on the specific genetics of their own tumours and the host response to cancer.

For the majority of solid organ tumours, surgery is central to the chance of a cure, yet basic scientific research relating to surgery has often been overlooked in favour of studies pertaining to chemotherapy or radiotherapy. At present, many patients do not survive despite radical multimodal therapy.

Tim anticipates that his research could improve outcomes with directed multimodal therapy in selected patients. He foresees the potential to increase the chance of cure from oesophageal cancer to 50% in selected patients. Similarly, it will identify those patients who are unlikely to survive despite being identified as potentially curable under present staging. In his words “we will operate more on fewer patients, with greater success”. In order to achieve this, cancer management will become more collective and less the responsibility of individual institutions.

The successful award is based on eight years of research. Much of this has been achieved using a collaborative approach. For example, work with the Oesophageal Cancer Clinical and Molecular Stratification (OCCAMS) consortium identified new mutational profiles of oesophageal cancerwhich will form the basis of the Southampton group’s work for the next five years.

 

Tim hopes that other AUGIS members will be encouraged by his award which demonstrates that there can be high-level support for surgeons who have an interest in basic and translational science.


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