Dr Alex FreemanTo mark International Clinical Trials Day this year we speak to Dr Alex Freeman, Consultant Histopathologist at University College London and lead of the Clinical Trials workstream for NCRI’s Cellular Molecular Pathology (CM-Path) initiative, to ask him about the importance of pathology in clinical trials.

As a pathologist, how did you become interested in being involved in clinical trials?

As a trainee I attended a pathology meeting at which one of the speakers talked about his involvement in an early clinical trial and how it had enabled him to work closely with his surgical and oncology colleagues and resulted in the identification of a novel biomarker that was going to undergo further testing in a national trial. This encouraged me to keep an eye out for potential research opportunities at my local hospital and shortly afterwards I heard about a research team that was looking for a pathologist to undertake a medical thesis in molecular pathology. After interviewing for the post, I decided to accept the offer and was able to register this with the Royal College of Pathologists as an ‘out of programme’ experience, enabling me to return to pathology afterwards to complete my training. Following my appointment as a Consultant Pathologist, I continued my involvement in clinical trials by joining the NCRI Prostate Clinical Studies Group (CSG) and interacting closely with surgical and oncology colleagues from across the country to discuss newly proposed as well as ongoing clinical trials.

What made you want to be a part of the NCRI CM-Path initiative?

I firmly believe that pathology has a lot to offer in the development and running of clinical trials. This starts from the inception of a trial with input in to the potential utility of collecting blood or tissue to help evaluate the pathophysiological effects of the study on the patient, with advice regarding optimisation of tissue fixation, processing and storage protocols to allow robust and reproducible future molecular analysis and with assisting in the selection of biomarkers that will explore the molecular changes that have taken place in the tissues of patients who have completed the trial. By working with the NCRI CSGs I have seen examples of how clinicians and pathologists have worked together closely to design clinical trials that can get the optimum information from the trial for the benefit of further studies and future patients. I believe the CM-Path Initiative is a very good way of encouraging pathologists from across the UK to become more actively involved in clinical trials and I am very glad to be able to participate in this exciting and innovative venture.

What are the aims of the clinical trials workstream of CM-Path and how will it enhance clinical cancer research?

The 3 main aims of the Clinical Trials workstream are to:

  • encourage trainee and consultant pathologists from across the UK to think about participating in clinical trials with colleagues in surgery, oncology or imaging and research scientists
  • promote the value of pathology input into the early stages of clinical trial development as well as throughout the running of the trial and the analysis of information obtained at the completion of the trial
  • assist funding bodies and charities to publicise the potential value of incorporating blood or tissue collection within clinical trials in their calls for research proposals.

What would success look like after five years of CM-Path activity in clinical trials?

It would be great if CM-Path was able to facilitate pathologist involvement in clinical trials across the UK in all aspects of translational and molecular research in a wide range of cancers and non-cancer-related chronic diseases.

» Find out more about the NCRI CM-Path initiative (NCRI webpage)