Obesity is associated with risk for several cancer types, including colorectal and breast cancers (1). Obesity also predicts for a poor outcome after cancer treatment. This might partly be explained by the clinical practice of ’dose-capping’ - in other words, patients might be sub-optimally treated because they are obese.
We already have a clinical PhD student (Corinna Slawinski) looking at this in colorectal cancer, and you will work with her to explore other cancer types as well - mainly through systematic review processes.
Primary outcome measure: first-dose chemotherapy capping
Secondary outcome measures: subsequent-dose chemotherapy capping, adherence
1. Is the clinical practice of dose-capping attributed to obesity prevalent across several cancer types (for example, colorectal, breast, ovarian cancers)
2. What is the impact of dose-capping on survival endpoints in different cancer types? The survival endpoints will include overall survival, cancer-specific survival and either disease-free or progression-free survival.
1. This literature review will build upon previous reviews from the Renehan team (2, 3)
2. Based on the literature review, the research team will re-group and determine whether a formal meta-analysis of these data is feasible and appropriate
3. Individual-level data will be sought through Project Data Sphere (https://www.projectdatasphere.org/projectdatasphere/html/home), a free-available repository of > 150 trials in oncology. This database is free to academics and has been used the Renehan team before. With these data, the student will target a selection of cancer types (colorectal, breast, ovarian) and their trials to (i) address Q1 above; and (ii) undertake time-to-event analyses to evaluate the effect of dose-capping on survival endpoints.
4. For a student that makes rapid progress, there will be opportunities to use mediation (statistical) analyses to effect understand the impact of dose-capping on survival.
Training/techniques to be provided:
Lead supervisor meetings are weekly in the first 6 months; fortnightly thereafter.
There are monthly lab meetings and monthly virtual journal clubs. Students will present their work and bring new ideas to lab meetings.
All PhD studentships include multi-disciplinary inputs with quarterly face-to-face supervisor meetings.
As the student matures, they are encouraged to develop autonomy and independence.
The ‘lab’ culture is one of integration, continuity, synergism, cross-covering, and collaboration.
(i) Integration: sharing of ICD codes for obesity-related cancers;
(ii) Continuity: a year 3 student directing a year 1 student to optimal resources;
(iii) Synergism: running models of similar hypothesis testing for different cancer types;
(iv) Cross-covering: named individuals deputising to recruit patients into studies measuring liver fat using advanced MR imaging;
(v) Collaboration: includes several collaborations within the Manchester NIHR Biomedical Research Centre Cancer Prevention and Early Detection (PED) theme (lead: Renehan) https://www.manchesterbrc.nihr.ac.uk/our-research/cancer-ped/obesity-related-cancers-opportunity-prevention-early-detection/
Candidates are expected to hold (or be about to obtain) a minimum upper second class honours degree (or equivalent) in a related area / subject.
1For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor. On the online application form select PhD Health Informatics
For international students we also offer a unique 4 year PhD programme that gives you the opportunity to undertake an accredited Teaching Certificate whilst carrying out an independent research project across a range of biological, medical and health sciences. For more information please visit www.internationalphd.manchester.ac.uk