A key objective for OCF is to support, influence and inform the development of impactful research that addresses the important clinical challenges that Oesophageal Cancer patients, their families and carers face on an ongoing basis. We do this through a collaborative model that is always patient centred, with the aim of finding new methods and treatments from prevention to early diagnosis, treatment and through survivorship. Therefore, we are already committed to a significant investment of money and resources into research of 30% of our operational budget while at the same time playing our part in the cancer care community in Ireland.
In 2023 OCF continued our investment in the Barrett’s Oesophagus Registry and Biobank which now totals over €2.3 million since 2009. This unique national resource over the years has now developed into a rich resource of information on over 9,000 Barrett’s Patients on the registry and the biobank of consented tissues and bloods for research. These are now playing a central role in different international collaborative studies by linking with the Northern Ireland Registry through the All-Ireland Cancer Network (AllCaN) which was launched in 2023. The biobank is also now linked to an important Pan European study ‘ENDEAVOR’ looking at better methods of detecting which Barrett’s patients are at greatest risk of disease progression. This was also the year when the Neo-Aegis Clinical Trial concluded, and we are very proud to share the results through this Annual Report and through our Patient Support Programme. We must also thank and remind
our families, our donors, our medical and research partners, our volunteers and the overall OCF community that none of this research would be possible without their ongoing support.
Our funding of the Neo-Aegis Clinical Trial concluded in 2022/3. This was a major, international randomised controlled trial developed by Irish Clinicians, and sponsored by Cancer Trials Ireland. The trial recruited 377 people with
Oesophageal Cancer, 34% of whom are based in Ireland with the remainder in France, Denmark and the UK. 362 patients were evaluable. The trial set out to establish the best available treatment for patients presenting with advanced but potentially curable Oesophageal Cancer, and compared chemotherapy alone combined with surgery, against a combination of chemotherapy and radiation therapy prior to surgery.
The trial showed no evidence that peri-operative chemotherapy is unacceptably inferior to multimodal therapy in the primary outcome of overall survival, and therefore strongly suggests non-inferiority which supports equipoise in clinical decision making in modern practice. Neo- AEGIS provides the largest comprehensive randomised dataset for patients with adenocarcinoma of the oesophagus and oesophagogastric junction treated with perioperative chemotherapy (predominantly the modified MAGIC regimen), and CROSS trimodality therapy.
The impact of the Neo-Aegis trial is that it has cemented two ‘standard of care’ treatment options for Oesophageal Cancer as ‘equivalent’, thereby keeping treatment options open and viable for patients with Oesophageal Cancer depending on regional and national networks. Importantly the outcomes have been excellent in both treatment arms, with a 3-year estimated survival probability of 57% and 55% respectively, and no major differences in operative and health-related quality of life outcomes. This result is particularly important bearing in mind the differing availability of treatment options in different regions nationally and internationally.
Professor John Reynolds and the team published the results of the Neo-Aegis/CTRIAL-IE 10-14 trial, with OCF listed as a funder in the manuscript. We were delighted to see that this study got the recognition it deserved by getting accepted to the Lancet Gastroenterology & Hepatology, one of the world’s highest-impact academic journal https://www.thelancet.com/journals/langas/article/ PIIS2468-1253(23)00243-1/fulltext
Neo-Aegis was presented by Prof. Maeve Lowery (St. James’s Hospital) at the 2023 ASCO GI Cancers Symposium, with OCF listed as a funder in both the abstract and on the presentation.
In the Q&A session that followed, Dr. David H. Ilson (Gastrointestinal Oncologist – Memorial Sloan Kettering Cancer Center) highlighted that what is striking about the results is that just five doses of carboplatin and paclitaxel as chemotherapy [radiotherapy was also given] achieved the same survival as around 4 months of chemotherapy. This, he said, could lead to new directions of research, looking at systemic therapies and whether more chemotherapy is really any better.
A key objective for OCF is to support, influence and inform the development of impactful research that addresses the important clinical challenges that Oesophageal Cancer patients, their families and carers face on an ongoing basis. We do this through a collaborative model that is always patient centred, with the aim of finding new methods and treatments from prevention to early diagnosis, treatment and through survivorship. Therefore, we are already committed to a significant investment of money and resources into research of 30% of our operational budget while at the same time playing our part in the cancer care community in Ireland.
In 2023 OCF continued our investment in the Barrett’s Oesophagus Registry and Biobank which now totals over €2.3 million since 2009. This unique national resource over the years has now developed into a rich resource of information on over 9,000 Barrett’s Patients on the registry and the biobank of consented tissues and bloods for research. These are now playing a central role in different international collaborative studies by linking with the Northern Ireland Registry through the All-Ireland Cancer Network (AllCaN) which was launched in 2023. The biobank is also now linked to an important Pan European study ‘ENDEAVOR’ looking at better methods of detecting which Barrett’s patients are at greatest risk of disease progression. This was also the year when the Neo-Aegis Clinical Trial concluded, and we are very proud to share the results through this Annual Report and through our Patient Support Programme. We must also thank and remind
our families, our donors, our medical and research partners, our volunteers and the overall OCF community that none of this research would be possible without their ongoing support.
Our funding of the Neo-Aegis Clinical Trial concluded in 2022/3. This was a major, international randomised controlled trial developed by Irish Clinicians, and sponsored by Cancer Trials Ireland. The trial recruited 377 people with
Oesophageal Cancer, 34% of whom are based in Ireland with the remainder in France, Denmark and the UK. 362 patients were evaluable. The trial set out to establish the best available treatment for patients presenting with advanced but potentially curable Oesophageal Cancer, and compared chemotherapy alone combined with surgery, against a combination of chemotherapy and radiation therapy prior to surgery.
The trial showed no evidence that peri-operative chemotherapy is unacceptably inferior to multimodal therapy in the primary outcome of overall survival, and therefore strongly suggests non-inferiority which supports equipoise in clinical decision making in modern practice.
Neo AEGIS provides the largest comprehensive randomised dataset for patients with adenocarcinoma of the oesophagus and oesophagogastric junction treated with perioperative chemotherapy (predominantly the modified MAGIC regimen), and CROSS trimodality therapy.
The impact of the Neo-Aegis trial is that it has cemented two ‘standard of care’ treatment options for Oesophageal Cancer as ‘equivalent’, thereby keeping treatment options open and viable for patients with Oesophageal Cancer depending on regional and national networks.
Importantly the outcomes have been excellent in both treatment arms, with a 3-year estimated survival probability of 57% and 55% respectively, and no major differences in operative and health-related quality of life outcomes. This result is particularly important bearing in mind the differing availability of treatment options in different regions nationally and internationally
At the Oesophageal Cancer Fund (OCF), we fill the gap in support, awareness, and research for Oesophageal Cancer a disease that impacts 500 families in Ireland each year. In fact, Ireland faces one of the highest rates of this cancer globally which is the sixth leading cause of cancer- related deaths. Therefore, the fight against Oesophageal Cancer is urgent and real. Early detection is our best weapon in increasing the 5-year survival rates of just 24% in the Republic of Ireland and 19% in Northern Ireland. Treatment typically involves radiation, chemotherapy and/or surgery to remove the oesophagus with implications for diet, sleep and exercise that last a lifetime.
At OCF, we are unwavering in our commitment to achieving our Vision and Mission to improve these survival odds through heightened awareness and early detection. However, it takes significant time and money and we operate in a tough fundraising climate, with no State funding (so far). It takes up to €500,000 annually to fuel our mission at OCF and we did it in 2023 thanks to the loyal support of our donors and supporters.
By Q4 2024, we will have secured 70% of what we need, leaving €150,000
to raise by Christmas. Our fundraising drive is non-stop, as we depend 100% on donations from the public. We are very proud to be Triple Locked by the Charities Institute of Ireland, demonstrating our commitment to good governance and financial transparency in all we do.
Patient Support (40%) – We are expanding our nationwide support to five regional meetings in 2024, up from two in 2023, with ten planned for 2025. Throughout 2023 and 2024, we provided a support line, peer-to-peer programme, online resources, podcasts, videos, all rooted in personal stories. In 2024/5 we aim to employ a part-time specialist nurse or dietitian to further enhance patient support.
Driving Awareness (30%) – Awareness is key to early detection. Our national campaigns, like Lollipop Day, were big drivers in 2023. And with Golf Legend Padraig Harrington as our Patron, we are reaching more people than ever, demonstrating that a Little Lolly goes a long way. We have big plans for Lollipop Day on February 28 and March 1, 2025
Funding Research (30%) – like the National Barrett’s Registry and Biobank, a crucial tool for early detection and monitoring of Barrett’s Oesophagus, a precursor to Oesophageal Cancer. In use by researchers on an All-Ireland basis.