Cancer Research pulls funding for Scots clinical trials unit

A shortfall in fundraising during the pandemic has been blamed.

It is also pulling core funding from its CTU in Cardiff, meaning that only seven sites - all in England - will remain fully operational. This includes a new base in Oxford.

The charity insists that cancer patients in Scotland will continue to have the same access to clinical trials and experimental therapies as they do now, but the decision has been described as a "kick in the teeth" which has left cancer researchers in Scotland "outraged" and in "absolute shock".

One clinician, speaking to the Herald on condition of anonymity, said: "This is a severe blow to Scottish academic-led patient research community and will only have a negative impact upon cancer patients throughout Scotland, and also Wales.

"It marks a fatalistic step backwards in cancer research progress in Scotland, and is detrimental for committed oncology research doctors who wish to run valuable national academic trials, led from Scotland."

Another source close to the Beatson-based unit said it was "difficult to see how no patients would be disadvantaged".

It comes as a recent report by the charity warned that the number of people diagnosed with cancer in Scotland is set to increase by a quarter by 2040, mainly due to ageing, obesity, alcohol, and smoking.

READ MORE: The blood tests that could revolutionise early cancer detection

The new five-year funding term for the CTU network takes effect from October this year, but CRUK has pledged to wind down core funding to the Glasgow CTU over two years to enable a "managed transition" and provide time for the team to seek alternative financial support.

Existing clinical trials will continue in the meantime, but the decision has left a question mark over the unit's capacity to carry out research longer term.

The pot of money affected, known as "core funding", is provided by CRUK to the Glasgow CTU to cover the cost of salaries for the specialists - including scientists, statisticians, and project managers - required to run clinical trials.

This is distinct from the funding which pays for research, which scientists apply for separately.

Around half the clinical trials delivered at the Beatson West of Scotland Cancer Centre are sponsored by drug companies, but the remainder are the academic (non-commercial) trials which are co-ordinated by the CTU and mostly paid for by charities.

One clinician, who did not want to be identified, said: "It is important to recognise that the CTU is a non-profit academic research unit, where the focus is on delivering high quality research to improve patient outcomes.

"When the CRUK funding stream is withdrawn the impact will potentially be on all trials run by them, existing and new.

"Without the CRUK funding the CTU is based upon, there will be insufficient income to permit research to continue in its current manner.

"The only resolution for the CTU seems to be for an alternative funding body to be identified - not an easy task by any means."

Both the Scottish Government and CRUK stress that they are increasing investment in clinical research for cancer, but those close to the Beatson site fear that unless extra funding can be found to secure the jobs and expertise currently in place at the CTU its research portfolio will be forced to shrink.

The CTU is also the only unit in Scotland which can run cancer clinical trials from start to finish - taking a study from the inception of an idea for research through to final publication of the results, a process which takes years.

Researchers fear that the loss of a CTU in Scotland able to develop and lead its own studies from scratch means that research into certain cancers - such as mesothelioma or head and neck cancer, which is unusually prevalent in the west of Scotland - may decline.

One source said: "How would patients feel about this knowledge that there is nothing in Scotland, nothing in Wales? Northern Ireland didn't put in an application.

"But to have all the sites centred in England - three of them in London - that seems very uneven."

READ MORE: Why are cancer deaths in Scotland lower in 2022 than before the pandemic - and will it last? 

It is unclear exactly why the decision was reached to withdraw core funding from the Glasgow CTU, and there is no opportunity to appeal.

Sources close to the Beatson-based site believe they submitted a "superb" application, and were stunned by the outcome.

The Herald understands that CRUK prioritised sites considered most effective.

The charity has pushed back against "scaremongering" suggestions that patients from Scotland will be required to travel to England to take part in clinical trials, stressing that this is "absolutely not true".

While CTUs coordinate clinical trials, the recruitment of patients onto trials takes place via hospitals throughout the UK in order to accumulate the hundreds or thousands of eligible participants required.

As a result, patients with a specific form of cancer in Aberdeen or Leeds may join in a clinical trial currently led by the Glasgow CTU without ever attending the Beatson.

CRUK said it "will be making clear" to all future CTUs that they are obliged to open trials "where appropriate and feasible, across all regions of the UK, including devolved nations, to facilitate equity of access to trials across the UK".

Elspeth Banks, a former cancer clinical trial participant who chairs the PPI (Patient-Public Involvement) Oversight Group for the portfolio of clinical trials co-ordinated by the Glasgow CTU, said she has "never ceased to be hugely impressed by the dedication and commitment of everyone in the team".

"It is vital they are able to continue, unhampered by financial uncertainties," said Banks, a retired headteacher.

She added that the "geographical spread" of Scotland - including cancer patients living in rural and island communities - "adds weight to the need for all cancer patients to be offered the opportunity to be recruited to all appropriate trials in Scottish cancer centres".

Health Secretary Humza Yousaf on a visit to the Beatson West of Scotland Cancer Centre in Glasgow in 2022 (Image: PA)

Breast cancer survivor and campaigner, Lesley Stephen, had been given months to live when she joined a clinical trial led by the Beatson-based CTU in 2016.

She urged CRUK to reverse its decision.

She said: "The pandemic was awful for those of us living with cancer. Fundraising by cancer charities went down; research, new trials and cancer screening stopped with the predictable outcome that we are now seeing many more patients than usual presenting with cancer.

"This decision by CRUK not to provide the core funding that pays for the oncologists, clinical trials co-ordinators, radiographers and many others who are key to treating the disease, will be devastating for many cancer patients.

"It may result in us seeing cancer outcomes for Scotland worsen, and we already lag behind most European countries in terms of patient survival."

READ MORE: Glasgow Beatson 'at crisis point', leaked emails reveal 

Dan Burkwood, director of research operations at CRUK said: “Cancer Research UK has a duty to ensure that funding kindly donated by our dedicated supporters is targeted to where it can make the greatest impact towards our ultimate goal of beating cancer.

“CTUs specialise in designing, conducting, analysing and publishing clinical trials.

"Although we have had to make the difficult decision to reduce funding to the Glasgow CTU, we are continuing to fund seven CTUs elsewhere in the UK which oversee trials that serve patients at NHS facilities across the UK, including in the devolved nations.

“It is important to stress that patient access to clinical trials in Scotland will continue and we have recently increased funding to the Experimental Cancer Medicines Centres (ECMCs) in Glasgow and Edinburgh which deliver early phase clinical trials directly to patients.

"Glasgow’s ECMC and paediatric ECMC was recently awarded up to £2.3 million over the next five years, while the Edinburgh ECMCs was awarded up to £1.8m over the same period."

A spokesman for NHS Greater Glasgow and Clyde said the "vast majority" of cancer trials run at the Beatson will be "completely unaffected" by CRUK's decision.

He added: “While it is disappointing this funding will soon come to an end, we are working to make alternative arrangements so that this activity can continue.

"Our first priority will be to ensure all patients already involved in trials run by the clinical trials unit can continue their treatment unaffected.”