ESCALON – To Understand, Predict and Diagnose Hepatobiliary Tumours

Earlier this year, it was announced that researchers from Manchester were part of ESCALON – a collaborative network between Europe and Latin America which aims to improve both the detection and treatment of hepatobiliary cancers. We interviewed Dr Angela Lamarca, a consultant in Medical Oncology at The Christie NHS Foundation Trust, to find out more about the network and her important role.

What is ESCALON?

ESCALON is a global network between Europe and Latin America aiming to learn more about biliary tract tumours in order to improve patient outcomes. The network arranges for hospitals around the world to contribute biomarkers from patients with hepatobiliary cancers to Latin America, with the hope that new biological discoveries can be made. The project involves multiple research centres from across the world, including centres in Spain, the Netherlands, Chile, Argentina, Ecuador, Canada, Germany, and of course, Manchester.

Why does ESCALON focus on hepatobiliary cancers in Latin America?

Hepatobiliary cancers are extremely difficult to detect and treat. This difficulty constitutes a major problem for many countries across the world, especially in Latin America, where the incidence is high. ESCALON is aiming to alleviate this through the identification of new blood markers that could be used for early detection of liver and biliary tract cancers. At the moment, screening strategies are only in place for a specific subtype of liver cancer (hepatocellular carcinoma), mainly because the population at risk of developing this cancer is easier to define. Screening consists of abdominal ultrasonography every six months to detect the cancer at an early stage. Many places across the world simply do not have the resources to do such screening, or if resources are in place, the distances may be too long for the patient to travel for these investigations. Unfortunately, no screening has shown benefit for biliary tract cancer, since patients at risk are difficult to define. As a result, hepatobiliary cancers are leading killers globally, including in the UK.

This problem is highly visible in Latin America because many people, particularly those in rural areas, do not have easy access to healthcare. By uniting leading cancer centres across the world, ESCALON is aiming to identify blood markers thereby creating a cheaper and more accessible way of detecting hepatobiliary cancers, accessible to all countries across the world and all patients, regardless of where they live.

How is Manchester contributing?

The University of Manchester is one of 9 institutions contributing to ESCALON. The University of Manchester and The Christie have been world-leading in the clinical management and clinical trials for patients diagnosed with cholangiocarcinoma and gallbladder cancer and our main aim is to provide clinical expertise to make sure that the data generated is also of use for our future patients. In addition, we are also contributing by providing access to some of the samples stored at the MCRC Biobank. Work on Manchester’s involvement in the project is led by Professor Juan Valle and I am the local sub-investigator.

However, Manchester’s involvement in ESCALON is multi-faceted and is not limited only to professional input. There is a wealth of ‘indirect’ involvement taking place every day at The Christie, from its patients giving medical samples to the clinicians taking them. Patients from The Christie can be proud in saying that they are part of a global network rallying to improve medical outcomes in countries with fewer resources. With Manchester being the only UK city involved in ESCALON, we can be proud of our part in such a worthwhile and ambitious project.

What progress has ESCALON made so far?

Our team and clinicians around the world have started gathering samples ready for identification in what is called the sample collection phase. This identification is taking place in Manchester, and also in Spain, Latin America and the Netherlands, where links between particular indicators and types of cancers are established. Once this identification process has taken place, its findings can be implemented into creating more efficient ways of detecting hepatobiliary cancers in Latin America and beyond.

How is ESCALON funded and what is the future for the project?

The consortium is funded by a Horizon 2020 Grant which is due to last 4 years, however we expect our collaborations and networks to continue into the future. Also involved is ENS-CCA, the European Network for the Study of Cholangiocarcinoma, the ‘umbrella’ which oversees ESCALON, ensuring that the project has suitable and resourceful supporters. ENS-CCA is supported by AMMF, the only UK-based cholangiocarcinoma charity, and CCF, the US-based Cholangiocarcinoma Foundation, whose support is then channelled to relevant projects by ENS-CCA. By mapping the consortium’s sponsors, we can distinguish the international nature of ESCALON and be proud that Manchester is involved in two continents coming together under one mutual aim; to improve hepatobiliary cancer survival rates.

You can learn more about ESCALON on its website here.

This study was supported by the European-Latin Amedican ESCALON consortium, funded by the EU Horizon2020 program, project number 825510