I joined the DDU as a final year medical oncology trainee after completing two years of medical oncology advanced training in Australia. The DDU is the largest early phase clinical trials centre outside of the United States, and as such, I had the privilege of working on a range of cutting edge trials using novel technologies such as radioimmunoconjugates, personalised cancer vaccines and bispecific antibodies – I have no doubt that some of these exciting research agents will become standard of care in the years to come.
In addition to the clinical work on trials, the DDU is an extremely supportive teaching and research environment for fellows who wish to explore their ideas with very supportive consultant mentors and excellent research support. I had elected to commence a PhD examining informed consent for early phase clinical trials that I started concurrently with my fellowship at the DDU and I received significant support from the unit for my project – I was able to present my findings at ESMO in poster form for two successive years (Pal, Stapleton, and Lopez 2019; Pal et al. 2020), and I have a number of manuscripts in preparation. The highlight was being able to set up a randomised clinical trial (CONSENT) of informed consent aids (a 2 page study aid and a set of videos), opening at the DDU and recruiting the first patients before leaving the unit. This achievement was only possible with the close mentorship of one of the DDU consultants and the support of the wider team to navigate the multiple complex hurdles involved in opening a clinical trial.
In addition to my PhD projects, I was able to take part in several other research projects in conjunction with the staff from the Institute of Cancer Research, London, which gave me the opportunity to develop and deepen my knowledge of multiple other key aspects of drug design and development. Being able to work closely on academic projects with some of the world leaders in cancer drug development was again an invaluable experience (Papadatos-Pastos et al. 2020; Bono et al. 2019, 2020; Scaranti et al. 2019).
Following my fellowship at the DDU, I have been appointed as an Early Phase Clinical Trials Staff Specialist at Liverpool Hospital, New South Wales, Australia and I have also been awarded an NHMRC Postgraduate Scholarship to complete my PhD, continuing to work on CONSENT with the DDU and looking at informed consent and clinical trials in Australia. I have no doubt in my mind that joining the DDU was an excellent personal and professional choice and I would highly recommend it to any medical oncologist (or final year trainee) who would like to build their experience as clinician researchers in the fast paced and exciting world of early phase clinical trials under the supervision of a set of consultant mentors who are very interested in the professional growth of the fellows.
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As a freshly minted medical oncologist with a year of laboratory benchwork under my belt, looking to advance my career as a clinician scientist, the DDU was a perfect fit – a nexus of benchwork and patient impact, research and clinical practice.
From the time I decided to spend a year doing my fellowship at the DDU, Professor Stan Kaye, Professor Johann de Bono, and the team at DDU were extremely helpful in assuaging my anxieties of the move and helping with the necessary applications. I was particularly touched that they were also concerned about my family and how we would settle in to London, giving useful advice about lodging, transport and schooling issues.
Over the year, I had the opportunity to be the lead fellow on a variety of trials spanning from targeted agents, immunotherapy, and new novel combination treatments. The first-hand experience in managing patients, participating in robust discussions on trial progress and interim reviews, and opportunity to work with trial sponsors and monitors in evaluation of trial design and data was invaluable in allowing me to get a more complete picture of the behind the scenes work required for successful trial execution.
The department has a strong focus on teaching, with regular journal clubs and teaching sessions that span a multitude of subjects, including protocol writing, trial conception, and statistic and data analyses. The participation of The Institute of Cancer Research (ICR) scientists in these sessions allows us a first-hand view of the cutting edge of medical science. We’re encouraged to ask questions, to develop our own ideas, and to pitch them at a monthly meeting to consultants who will give feedback on how to improve our proposals. Besides teaching, there are also ample opportunities to help prepare manuscripts for completed trials and meeting abstracts, giving the chance to improve writing skills and also pick up how to analyse data that has been collected from patients.
What struck me most was the open-door policy in the department – I never felt that there was any question that was too silly to be asked, any idea too farfetched to propose. The consultants were always ready to help, and the level of mentorship that I have received in this department has been immense, and has helped grow my confidence and independence as an author and a peer-reviewer.
I feel privileged to have had the opportunity to work amongst the excellent team at the DDU, and hope to be able to pay it forward by taking the lessons learnt at the DDU to the growing phase one unit at my home institute, The National Cancer Institute of Singapore, and mentor younger clinicians looking at branching into research. As I embark on the next phase of my journey to be a clinician scientist, I look back with fondness of the lifelong ties built here, and look forward to continued collaborations with my colleagues from the DDU.
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I had the honour of working at the DDU from 2015 until 2017. I came following my specialist oncology training in Ireland to gain further expertise in clinical trials and translational research. I also came to have the privilege of working with Professor Johann de Bono and Professor Udai Banerji and the more recently joined consultants to the DDU, the accomplished and talented, Dr Juanita Lopez and Dr Anna Minchom.
From the very start, I realised what an incredibly special unit this is - a close knit department of consultants, fellows, nurses and trials team. The comradery and collegiality was so deep-seated that the DDU was such an easy and enjoyable place to work. The ten fellows I had the pleasure of working with were from all over the world: Singapore, Australia, Italy, Spain, Greece, Canada, US and Brazil. In this international group of talented and dedicated clinicians, I have made friends for life. The exceptional DDU alumni continue to work together professionally and stay in contact personally after leaving the unit, building global oncology networks and relationships.
I am currently a Consultant in Medical Oncology in Cork University Hospital, Ireland, with a special interest in thoracic and gynaecology malignancies. I am a Senior Clinical Lecturer with University College Cork (UCC) and the Medical Oncology Lead of our clinical trials unit; one of the leading trials units in the country. I am Principal Investigator on a number of translational studies aided by my experience gained in the DDU and continue my relationship with Dr Anna Minchom of the DDU by collaborating in small cell lung cancer research.
Furthermore, the expertise and opportunities from the DDU have allowed me to successfully apply for numerous research grants here in Ireland, most noteably the Irish Cancer Society Clinician Research Leadership Award 2020. This Award will protect more time for my investigator-initiated, early phase clinical trial endeavours and allow me to progress into a clinician scientist role. This Award also incorporates the ongoing mentorship of Professor Johann de Bono and Dr Anna Minchom of the DDU. Furthermore, my experience from the molecular tumour boards and patient allocation meetings of the Royal Marsden NHS Foundation Trust and DDU has allowed me to be among the first group of Irish Oncologists to pioneer a National Molecular Tumour Board here.
I could not recommend the DDU fellowship highly enough - it has brought me so many opportunities and experiences in my career as well as fellow colleagues that will be in my personal and professional life forever. The unit gave me a thorough education in early phase trial design, development and delivery, as well as protocol writing, publication writing, trial monitoring and regulatory processes. I also gained experience in clinical interpretations of somatic sequencing results and identification of novel and experimental treatments that may benefit.
As regards the patients that I met during this time, many have left the deepest mark upon me professionally. The frequent schedules of these studies have allowed me to develop profound relationships with many trial participants. It is thanks to them, and their precious time they have given, that we can advance oncology research and clinical trials. This is truly humbling to be a part of.
The DDU is a truly special place to work and I recommend it to all doctors seeking experience in translational and early phase clinical trials.
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I pursued a fellowship at the DDU following numerous colleagues highly recommending the unit to me. After meeting the team at ASCO, I took the plunge and embarked upon a two-year fellowship. Over this time, I have had an immensely enjoyable time in the DDU. There were a plethora of learning opportunities which came with managing clinical trial patients, being involved in trial set-up for first in human studies, operational aspects of clinical trials, initiating new trials and writing study protocols.
In such a rich academic environment, there were ample opportunities to craft, revise, execute, analyse and publish scientific research and the unit was extremely supportive of learning development opportunities, including my application for the Methods in Clinical Cancer Research Workshop in Zeist. This was also accompanied by a structured teaching program which included journal clubs, weekly small group discussions with internationally renowned scientific leaders at the ICR and The Royal Marsden, and the opportunity to pitch original research ideas in the Dragons’ Den forum. A new initiative which I particularly enjoyed was a DDU away day, where the team worked together on investigator-initiated trial concepts, which eventually made it to fruition!
There were two aspects that were particularly striking during this experience. Firstly, the amazing opportunities for mentorship under Professor Johann de Bono, Professor Udai Banerji, Dr Juanita Lopez and Dr Anna Minchom, who shared their unique insights on the challenges and opportunities present in running early phase trials. Secondly, the unique setting of the DDU, which brought together doctors and scientists from the UK and around the world, allowed for the opportunity to work and form collaborations in a truly international environment, and to engage and debate the merits of different aspects of oncology with bright and inquisitive minds on a shared mission from far-reaching places, such as Singapore, Ireland, Canada and Europe.
I am confident that my experience at the DDU will be invaluable as I return to Australia to pursue a career as a clinician scientist, as it has allowed me to not only develop a strong understanding of the foundational aspects of early phase and translational studies, but also to form numerous lifelong friendships with colleagues from around the world.
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I joined the DDU as a clinical fellow shortly after completing my training in Medical Oncology in Singapore. The DDU has given me a unique experience, unlike any other. The diaspora of fellows who travel from far and wide to learn from the best of the best in clinical trial design and management enrich the unit with their own experiences. At any given point in time, there are fellows from at least 5 or 6 different countries, all of whom are carefully chosen to ensure the best minds work together towards a singular goal – serving patients the best we can.
The consultants have an unparalleled depth of knowledge in phase I clinical trials, and with varying tumor group sub-specialties, also have the breadth to cover the spectrum of cancer – an aspect of the DDU which cannot be found as easily in other units. The team is very encouraging and supportive, individualizing the progress of each fellow to suit their needs and goals as well as capabilities. Any oncologist who wishes to specialize in clinical trials must consider the DDU as one of their top choices for their fellowship.
I am currently an Associate Consultant at the National University Cancer Institute, Singapore specializing in gastrointestinal cancers and early phase clinical trials. The DDU has helped transform me from a freshly-minted clinician to an aspiring translational clinician scientist, and given me a significant boost into this arena, equipping with the knowledge, as well as the skills to navigate this highly competitive field.
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