Interview, Fireside Chat
Dr. Naureen Starling, Consultant Medical Oncologist at The Royal Marsden
- Dr. Noreen Starling's transition to oncology was driven by a combination of her gastroenterology background during general training at Northwick Park Hospital, a chance encounter with an inspirational oncologist, and strong mentorship at the Royal Marsden Hospital.
- Her clinical focus remains exclusively on bowel, pancreatic, esophageal, and gastric cancers, selected for their high clinical challenges and the specific unmet need for improved treatment outcomes.
- During the initial phase of the pandemic, the Royal Marsden and partner London hospitals (UCLH, Guy's, and Thomas's) established "COVID-free cancer hubs" to safely resume major curative surgeries and protect vulnerable patients.
- The UK government allocated a £160 million fund to accelerate patient access to innovative cancer treatments that minimize hospital visits and infection risks.
- The Royal Marsden charity, supported by a donation from Goldman Sachs, launched a research collaboration with the Crick Institute to study immune responses in over 1,000 cancer patients undergoing chemotherapy.
- A pilot liquid biopsy diagnostic protocol was initiated to overcome diagnostic delays and enable patients to access treatment more rapidly during the pandemic.
- The cost of sequencing a patient's cancer genome has dropped to under £1,000 in a few days, accelerating the global adoption of precision medicine compared to the multi-billion dollar costs of the first human genome.
- Regulators recently approved a novel targeted combination therapy for the 10% of bowel cancer patients with the BRAF V600E mutation following a successful campaign to overturn an initial NHS rejection.
- Clinical trials suggest immunotherapy could replace chemotherapy as the first-line treatment for the 4% of advanced bowel cancer patients exhibiting mismatch repair deficiency; NICE is expected to review this data early next year.
- The UK government has partnered with Grail to pilot a liquid biopsy test capable of identifying up to 50 different cancer types via a methylation component in the blood.
- The Grail pilot program is currently involving 165,000 NHS patients, with a potential rollout to one million patients dependent on successful data validation.
- The Royal Marsden has designated a full floor for early detection that integrates clinical care with research to develop new testing protocols and understand patient symptoms.
- Persistent barriers to early diagnosis include healthcare system organization, patient health behaviors regarding symptom reporting, and the inherent difficulty of detecting cancers like pancreatic and gastric malignancies before they progress.