The Royal Marsden has opened a new Centre for Cancer Genomics to help develop better ways of diagnosing cancer, tailoring treatments to individual patients and improving access to clinical trials across the UK.
Made possible by funding from The Royal Marsden Cancer Charity, alongside a grant from the National Institute for Health and Care Research (NIHR), the Centre brings together scientific research, advanced cancer testing and clinical expertise.
It is the first NHS facility specifically designed to develop and deliver a new generation of cancer tests known as composite biomarker testing. By combining different types of information about a patient and their cancer using machine learning, these tests aim to give doctors a more complete understanding of the disease and help them identify which treatments are most likely to work.
The Centre will also will expand circulating tumour DNA (ctDNA) testing, which uses a blood sample to look for tiny fragments of DNA released by cancer cells. Alongside this, the Centre will carry out translational research, which will help bring promising discoveries in the laboratory closer to benefitting patients.
Composite biomarker testing: building a fuller picture
Traditionally, genetic testing has often focused on finding a single biomarker – a biological indicator such as a genetic mutation – and matching it to a treatment. But cancer is complex. A single biomarker cannot always explain why one patient responds well to a treatment while another does not.
Composite biomarker testing, on the other hand, brings together multiple types of information to build a fuller picture about a patient's cancer. These could include genetic mutations, characteristics of the immune system, and information from scans and imaging.
Researchers can then use machine learning to analyse this information and identify patterns that might be missed by the human eye. By looking at these different signals together, they hope to better understand which patients are most likely to respond to certain treatments or combinations of drugs.
Bringing advanced cancer testing to more patients
The Royal Marsden Centre for Cancer Genomics will act as a national facility for biomarker testing in clinical trials, enabling researchers to analyse samples from hospitals across the UK.
This could help more patients access clinical trials of highly personalised treatments, without necessarily needing to travel to a major cancer centre.
The Centre will also support translational research. This means taking promising discoveries made in the laboratory and working to turn them into tests, treatments or approaches that can be evaluated in clinical practice.
A simple blood test could improve cancer care
One of the key areas of work being expanded at the Centre is circulating tumour DNA (ctDNA) testing.
Sometimes called a ‘liquid biopsy’, ctDNA testing looks for tiny fragments of DNA released by cancer cells into the bloodstream. Because it requires only a blood sample, it offers a less invasive way to gather information about a tumour than a traditional tissue biopsy.
The Royal Marsden has been at the forefront of developing and delivering this technology. In 2023, the hospital became the first in the NHS to deliver large-scale ctDNA testing and co-led a national pilot that received samples from hospitals across the country.
The Centre will support the wider use of ctDNA testing in patient care, while also allowing researchers to explore new ways of using the technology. This includes looking at how ctDNA could be combined with other types of diagnostic information to build a fuller picture of a patient’s cancer.
Professor Michael Hubank, Scientific Director of Clinical Genomics at The Royal Marsden, says:
“The Royal Marsden Centre for Cancer Genomics will create the capacity for us to develop and deliver these new, highly sophisticated tests. By helping to establish and support new diagnostic approaches across the country, we can ensure that more patients benefit from the most advanced cancer testing and the personalised treatments it enables.”
“So reassuring”: Elaine’s story
For Elaine, 45, from Reading, personalised ctDNA testing is already part of her cancer care.
Elaine was diagnosed with stage 3 lobular breast cancer in March 2020. Following chemotherapy, radiotherapy and a mastectomy, she was given the news that she was cancer free.
She was then offered the opportunity to take part in the TRAK-ER trial at The Royal Marsden, which is supported by funding from The Royal Marsden Cancer Charity. The trial uses a personalised ctDNA test every three months, for up to three years, to monitor Elaine's risk of her cancer returning.
If the test indicates an increased risk of relapse, her treatment can be changed with the aim of preventing the cancer from returning.
“To have such a simple blood test detect something like this, it’s incredible,” says Elaine. “It was just so reassuring to be part of something that may be able to give me forewarning of relapse, especially because the test is tailored to my specific tumour.”
Regular monitoring provides Elaine with a sense of security as she moves forward with her life.
“Even just knowing that I’ve been monitored so frequently gives me a huge safety net. Anything that gives me a greater chance of being here for longer, and being well for longer, is amazing.”
How your support is helping
The new Centre for Cancer Genomics, which is enabling the expansion of ctDNA testing at the Marsden, has been made possible through funding from The Royal Marsden Cancer Charity and an infrastructure grant from NIHR.
Thanks to supporters like you, The Royal Marsden can continue exploring new ways to understand and treat cancer – bringing hope and the possibility of more personalised care to patients like Elaine.