Download THE INSTITUTE OF CANCER RESEARCH/THE ROYAL MARSDEN

THE ROYAL MARSDEN NHS FOUNDATION TRUST
IN ASSOCIATION WITH
THE INSTITUTE OF CANCER RESEARCH
JOB DESCRIPTION
CLINICAL FELLOW IN PAEDIATRIC ONCOLOGY DRUG DEVELOPMENT
Full Time Post
One year fixed-term contract
THE ROYAL MARSDEN NHS FOUNDATION TRUST
The Royal Marsden is recognised worldwide for the quality of its cancer services. The Royal
Marsden NHS Foundation Trust’s strategic aim is to achieve excellence in cancer treatment
and diagnosis, through partnership and collaboration. In association with The Institute of
Cancer Research it constitutes a centre of excellence for research and development,
education, treatment and care in cancer, and the combined institutions form one of the
largest comprehensive Cancer Centres in the world.
The prime purpose of the Trust is the provision of state of the art cancer services as well as
enabling research into the development of improved methods of prevention, diagnosis and
treatment of cancer. Its other main purpose is teaching and the dissemination of knowledge
both nationally and internationally. In 1991 it became the first NHS hospital to be awarded
the Queen’s Award for Technology for its work on drug development. The hospital achieved
the international quality standard ISO 9001 for radiotherapy in 1996 and for chemotherapy in
2003. It was recognised as one of six centres of excellence in the Government’s NHS Plan
and has achieved four national Charter Marks for all its services. The Royal Marsden has
consistently been awarded three stars in the NHS performance indicators, rating it among
the nation’s best in terms of clinical quality and patient care.
As a leading Cancer Centre the Trust has close working relationships with many Cancer
Units and other Cancer Centres. Predominantly the Trust’s workload is from within the South
West and West London Cancer Networks but the Trust is unique in having a high out-of-area
referral rate for rare cancers, recurrent disease and treatment-related problems. The Trust
forms a joint cancer centre with St. George’s Healthcare NHS Trust.
The Royal Marsden’s new 31-bed Oak Centre for Children and Young People is one of the
largest comprehensive cancer centres in Europe for children and teenagers. The Centre
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sees almost 600 inpatients and more than 5,000 day patients every year. It is based in the
heart of the hospital which means our young patients benefit from a wealth of expertise,
which ensures that the care provided is both comprehensive and tailored to their specific
needs.
The Royal Marsden NHS Foundation Trust comprises two units (169 beds at Chelsea, and
184 beds at Sutton). Over 40,000 patients attend the Royal Marsden each year. The Trust
employs 2300 staff, including 300 medical staff. As a specialist cancer centre, the Trust
serves local populations within the London Boroughs of Merton, Sutton, Wandsworth,
Kensington & Chelsea and Westminster, as well as receiving referrals both nationally and
internationally.
The Royal Marsden supports a number of junior doctor training programmes, and provides
core training across a wide range of tumours in Clinical and Medical Oncology and Surgical
Oncology (including gynaecological cancer, gastro-intestinal, breast cancer and sarcoma and
melanoma). The Trust also participates in rotations for the training of junior doctors in a
number of other specialties.
Organisation
The Trust Board comprises an independent chair, Mr Ian Molson, executive directors, and
five non-executive directors from outside the NHS.
At The Royal Marsden NHS Foundation Trust the hospital management structure is
organised into three Divisions; Cancer Services, Clinical Services and Community Services.
Each Division is led by a Divisional Director, reporting to the Chief Operating Officer, and
supported by a Divisional Medical Director. The lead consultant for each Clinical Unit or
specialty is a member of the Medical Advisory Committee. This is chaired by the Medical
Director, Dr Nick van As, who together with the other directors (i.e. Chief Nurse, Finance, IT,
Strategy & Service Development, HR, Private Practice and Estates) and the Divisional
Directors form the Clinical Executive Board. The Management Executive is chaired by the
Chief Executive, Miss Cally Palmer.
The Consultant leads of each clinical unit or specialty formally meet as the Divisional
Management Team on a bi-monthly basis.
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Clinical Services Division:
Radiology, Pathology, Pharmacy, Theatres, Day Surgery, Palliative Care, Physics,
Radiotherapy, Critical Care, Cancer Genetics, Medical Records & Patient Transport,
Outpatients, Anaesthetics, Rehabilitation, Transitional Care Unit, Academic Biochemistry,
SSD, Pain Services, Nuclear Medicine, Minor Procedure Suite, Endoscopy, Minor
Procedures Suite, Central Referrals, Equipment Library.
Cancer Services Division:
Breast, Lung, GI, Neurology, Gynaecology, Urology, Day Care including IV team and Medical
Day Unit, Breast Diagnostic Unit including Rapid Diagnostic & Treatment Centre (RDAC),
Sarcoma, Head & Neck, Thyroid, Neuro-oncology, Leukaemia & Myeloma, Clinical
Pharmacology, Lymphoma, Paediatrics, Drug Development Unit, Cell Bank, Academic
Haematology.
Community Services Division:
The Royal Marsden is the provider of Sutton and Merton Community Services. These include
health visitors, specialist community nurses, outpatient physiotherapy, podiatry, falls service
and children’s physiotherapy in the Sutton and Merton area.
The Divisions are supported by the following corporate directorates:
Nursing, Rehabilitation and Quality Assurance Directorate:
Rehabilitation, Pastoral Care, Lymphoedema, Volunteer Services, Community Liaison, Social
Services, Quality Assurance, Research, Practice and Professional Development.
Finance, Human Resources, Computing and Information, Estates and Private Practice
THE INSTITUTE OF CANCER RESEARCH
The Institute of Cancer Research is a College of the University of London. It was established
in 1909 to investigate the causes of cancer and develop new strategies for its prevention,
diagnosis, treatment and cure and is now a centre of excellence employing some of the
world’s leading scientists working on cutting edge research.
The Institute is located adjacent to both the Chelsea and Sutton sites of the Royal Marsden
and is closely integrated with the clinical NHS provision.
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Research
The joint research interests of The Institute and the Trust are extensive and complementary,
with an increasing emphasis on translational research. Research is carried out in a number
of Divisions (Breast Cancer Research, Cancer Biology, Cancer Therapeutics, Clinical
Studies, Genetics and Epidemiology, Molecular Pathology, Radiotherapy and Imaging,
Structural Biology), Academic Departments, and Clinical Units, and the research in the joint
institution can be grouped into 9 distinct themes: paediatric oncology, breast cancer, cancer
diagnosis and imaging research, cancer genetics, cancer therapeutics, haematological
cancers, healthcare research and screening, molecular pathology, radiotherapy and
oncology. The majority of research funding comes from external sources and the grant
success rate for The Institute is outstanding, at average 81% (by value) 2003-2007 of all
applications from peer-reviewed grants to medical charities and government funding
agencies.
The Institute is particularly indebted to its major sponsoring partners – Cancer Research UK,
Breakthrough Breast Cancer, Leukaemia Research, the Kay Kendall Leukaemia Fund,
Prostate Cancer Charitable Trust, Association of International Cancer Research, Breast
Cancer Campaign, and to many other medical research charities. In addition, commercial
partners collaborating in drug development at The Institute and supporting clinical trials at
The Royal Marsden include Vernalis, Astex, Novartis, Astra Zeneca, Roche-Genentech,
Glaxo-Smith-Kline, amongst others.
As a UK higher education institution, The Institute receives substantial public funding directly
from the Higher Education Funding Council for England (HEFCE) each year. This money is
awarded in direct recognition of The Institute’s scientific excellence, which is measured by
the quinquennial Research Assessment Exercise (RAE). The Institute once again produced
outstanding research ratings in the most recent RAE, with The Institute receiving the highest
percentage of research assessed as four stars, world leading, in the areas of biological
sciences and cancer studies.
Training
There are currently well over 100 MPhil/PhD Students (including clinical fellows and part-time
students) as well as MD (Res) students. In addition there is a locally funded Clinical
Research Fellowship Programme and over 100 MSc students registered on The Institute's
MSc in Oncology.
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CHILDREN’S AND YOUNG PEOPLE’S UNIT
Consultant Paediatric Oncologists/ HaematologistsDr J Chisholm
Consultant Paediatric Oncologist with an interest in
Sarcoma and Young People, Clinical Head of Unit.
Honorary Faculty ICR, Divisions of Clinical Studies
and Molecular Pathology
Dr D Lancaster
Consultant Paediatric Oncologist with an interest in
leukaemia / lymphoma and early phase trials for
haematological malignancies and Deputy Research
Lead (Phase III studies) and current Interim
Research Lead
Dr M Taj
Consultant Paediatric Oncologist with an interest in
leukaemia / lymphoma / late effects
Dr S Vaidya
Consultant Paediatric Oncologist with an interest in
neuro-oncology and solid tumours based 50% at St
George’s Hospital.
Dr S Zacharoulis
Consultant Paediatric Oncologist with an interest in
neuro-oncology and solid tumours based 50% at St
George’s Hospital.
Dr L Marshall
Oak Foundation Consultant Oncologist in Paediatric
and Adolescent Drug Development with an interest
in Neuro-oncology and Neuroblastoma; Deputy
Research Lead (Phase I/II Studies)
Dr L Moreno
Honorary Consultant Paediatric Oncologist in Drug
Development with an interest in Neuroblastoma
Professor L Chesler
Honorary Consultant, Team Leader in Paediatric
Oncology – Neuroblastoma and Medulloblastoma
Drug Development, Institute of Cancer Research
Divisions of Clinical Studies, Cancer Therapeutics
and Cancer Biology
Dr A Atra
Consultant Paediatric Haematologist with an interest
in malignant, benign haematology and Langerhans
Cell Histiocytosis. Based 50% at St George’s
Hospital
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DrElsje Van Rijswijk
Locum Consultant Paediatric Oncologist with an
interest in malignant haematology. Based 70% at St
George’s Hospital
In addition, the appointment of a new Paediatric Research Lead and Honorary
Consultant in Paediatric Drug Development is pending mid-2016, following the
retirement of the previous post-holder and a recent international recruitment process.
Consultant Paediatric Palliative Care
Dr AK Anderson
Consultant Clinical Oncologists
Dr F Saran
Dr H Mandeville
Consultant Haematologists with responsibility for Adult and Paediatric Bone Marrow
Transplantation
Dr M Potter
Dr M Ethell
Consultant Paediatric Endocrinologist
Dr A Albanese
Consultant Anaesthetist
Dr R Self - Lead Consultant Anaesthetist
Dr D Chisholm, Dr O Lacey, Dr A McLeod, Dr A Oliver, Dr R Juneja
Consultant Radiologists
Dr D MacVicar - Lead Paediatric Radiologist
Dr OM Koh – Consultant in Functional Imaging with an interest in Paediatric
oncological imaging
Dr D Levine – Consultant in Functional Imaging with an interest in Paediatric
oncology imaging
Consultant Paediatric Surgeons
Mr B Okoyo (Honorary Consultant) St George’s Hospital)
Mr S Guiliani (Honorary Consultant) St George’s Hospital)
Mr Z Mehta (Honorary Consultant) St George’s Hospital)
Mr E Nicholls (Honorary Consultant) St George’s Hospital)
Mr CK Sinha (Honorary Consultant) St George’s Hospital
Consultant Paediatric Neurosurgeons
Mr S Stapleton (Honorary Consultant, St George’s Hospital)
Mr A Martin (Honorary Consultant, St George’s Hospital)
Mr C Chandler (Consultant, Kings College Hospital)
Consultant Histopathologists
Professor C Fisher
Dr A Wotherspoon
Dr K. Thway
Dr S O’Connor
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Consultant Paediatric Histopathologists
Dr I Jeffrey (Honorary Consultant) St George’s Hospital
Dr R Nash (Honorary Consultant) St George’s Hospital
Consultant Paediatric and adolescent Psychiatrist
Dr J Khor
Consultant Clinical Psychologists
Dr L Edwards
Consultants Paediatric Infectious Disease
Prof M Sharland (Honorary Consultant) St George’s Hospital
Dr P Heath (Honorary Consultant) St George’s Hospital
Consultant Paediatric Neurologists
Dr A Clarke ((Honorary Consultant) St George’s Hospital
Dr P Fallon (Honorary Consultant) St George’s Hospital
Nurse Consultant in for Adolescents and Young Adults
Louise Soanes
Matron for Children’s and Young People’s Services
Carly Snowball
Speciality Doctors
Dr Jane Passmore
Dr Martha Perisoglou
Dr Rubina Malik (SGH)
1 additional post pending appointment
Junior Medical Staff
Specialist Training paediatric registrar Year 6-8
Specialist Training paediatric registrar Year 3
Clinical Service Fellow
Bone marrow Transplant Fellow
Paediatric Drug Development Fellow
3 FTE
2 FTE
3 FTE
1 FTE
3 FTE
Children and Young People Outreach and Symptom Care Nurse Specialists (POONS) Team
3 x Clinical Nurse Specialists (leukaemia, solid tumours, neurooncology)
2 Specialist Sisters
The Children’s and Young People’s Unit of the Royal Marsden NHS Foundation Trust, Sutton
is based in an internationally renowned cancer centre; has excellent integration with all adult
oncology specialities and enjoys the significant benefits of co-location with The Institute of
Cancer Research. The on-site radiotherapy facilities have undergone extensive expansion.
The clinical oncology service for children and young people with malignancy has a very high
international reputation and has an established record in innovative radiotherapy techniques.
It is one of the larger Children’s Cancer and Leukaemia Group (CCLG) centres. The
Children’s and Young People’s Unit has an excellent, well established paediatric oncology
nursing service and has a robust and well developed mechanism for shared-care. Patients
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have rapid access to high quality diagnostic techniques. There is excellent multidisciplinary
care with well developed, integrated psycho-social, educational and family support. The
Royal Marsden Hospital NHS Foundation Trust opened a new Teenage Cancer Unit at the
Sutton site, in January 2012.
The Royal Marsden NHS Foundation Trust and St Georges Hospital form a unified,
integrated paediatric oncology centre for children with malignancy south of the Thames. The
Royal Marsden Hospital provides cancer diagnosis, cancer treatment expertise, psychosocial support and non-surgical cancer therapy and St George’s Hospital provides paediatric
specialist services, including paediatric intensive care, paediatric surgery, neuro-surgery and
paediatric infectious disease specialist care.
Local, comprehensive, integrated, high quality care for children and young people with
malignancy is delivered by robust clinically governed programmes and patient pathways.
Treatment is according to current international therapeutic protocols and trials.
The Unit’s philosophy of family-centred care has been developed by involving parents and
carers with the treatment plan, both in the hospital and at home. Families have open access
to the unit and a community liaison team facilitates home treatment and shared care with
local hospitals. Early return to school is encouraged and the teachers and social workers
based on the unit work closely with schools and other community based services.
The Royal Marsden, in collaboration with the two regional paediatric neuro-surgical centres
(St Georges & Kings College Hospital), has been developing a comprehensive South
Thames Paediatric Neuro-oncology Service and is one of the largest paediatric neurooncology units in the UK. There is close joint working between the paediatric and adult
neuro-oncology teams in the form of weekly joint multi-disciplinary team (MDT) meetings and
joint clinics.
There is a well-established allogeneic Haematopoetic Stem transplant programme with two
joint Adult and Paediatric Stem Cell Transplant consultants. This is complemented by an
active programme for myeloablative procedures requiring autologous haemopoeitic stem cell
rescue. There is on-site provision of total body irradiation.
There is a very active, innovative, Palliative Care and Symptom Control Service led by a
dedicated Consultant in Paediatric Palliative Care, providing twenty four hours out of hours
care and linking with a local Hospice.
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The Children’s and Young People’s Unit clinical facilities at the Royal Marsden Hospital
Sutton are in a purpose built substantial new £20 million build
which was opened in
September 2011. It comprises 18 children inpatient beds, outpatient and day care facilities, a
dedicated 13 bed Teenage and Young Adult Cancer Unit, including beds for children’s and
young people’s drug development.
The Unit has approximately 220 new malignant registrations per year, including children with
leukaemia, central nervous system and extra cranial tumours. Children are referred from
south of the Thames, Kent and the south coast, although for early phase studies patients are
referred from all around the UK via defined referral networks, with a third of patients recruited
to paediatric early phase studies coming from out of region.
The Unit is currently involved in multi-centre national and international trials evaluating new
therapeutic strategies.
The research activities of the clinical Unit are closely integrated with the Division of Cancer
Therapeutics, The Institute of Cancer Research. The overall goal of the research strategy is
to improve the five year survival of childhood and adolescent cancer via the Paediatric and
Adolescent Oncology Targeted Drug Development Programme at The Institute of Cancer
Research / Royal Marsden NHS Foundation Trust. This comprehensive programme
comprises drug discovery, pre-clinical evaluation, early clinical trials and a clinical facility (the
Oak Foundation Unit). The clinical facility includes four Phase I inpatient beds (with potential
to increase this number further on the Teenage and Young Adult Unit), outpatient chairs and
daycare beds together with an adjacent laboratory on site for pharmacokinetic and
pharmacodynamic sample processing, and two new suites for radioisotope therapy which will
help facilitate novel studies involving radioisotope components.
Over the past seven years, funding from the Oak Foundation has facilitated the development
of a strong Paediatric and Adolescent Drug Development Team of twenty three dedicated
individuals with expertise and knowledge in the field of drug development. Oak Foundation
funding has provided pivotal staff (including the Oak Foundation Consultant in Paediatric and
Adolescent Oncology Drug Development post, part funding for a Honorary Consultant, two
part-time research nurses, one part time clinical trial co-ordinator, an academic personal
assistant to the Drug Development Team and a clinical fellow in radiology to work specifically
in the area of paediatric early phase trials and functional imaging). Additional staff are funded
via other sources (two dedicated senior Drug Development Fellows with a third due to be
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appointed shortly, additional research nurses, trial co-ordinators, data managers, and a
tissue collector). Several of the existing NHS consultants work closely with the team taking
responsibility for organisation and recruitment for some of the tumour-specific early phase
trials, including phase I & II trials.
This clinical Paediatric and Adolescent Drug Development Team has developed a broad and
increasing portfolio of molecularly targeted agents and plays a key role within European
Paediatric Drug Development networks as well as being increasingly involved in the design
and conduct of transatlantic paediatric cancer early phase studies. The team integrates
closely with translational scientists and clinicians with extensive research and trial
experience. The Unit has already been able to capitalise on these developments and is now
poised to do so even further. This supporting infrastructure has allowed the paediatric early
phase clinical trials portfolio to increase from just 2 open studies in 2006 to 26 open studies
in 2015 (18 of these molecularly targeted agents; 15 first in child studies), with further new
studies opened/opening in 2016. This is the largest portfolio of paediatric early phase trials in
the UK and one of the largest in Europe. A third of children treated in phase I/II clinical trials
were referrals from outside our catchment area.
We are increasingly able to:

Select novel agents based on:
New pre-clinical models, which we believe will be more predictive of clinical
activity;


Tumour molecular biology;
Base clinical trials on strong biological hypotheses, including pharmacodynamic
biomarkers to show proof-of-target inhibition and downstream effects;

Develop clinical trial designs that do not require large numbers of patients;

Increase the availability of new agents for paediatric investigation by strong links with
pharma

Play a leading role in recruiting into international collaborative early clinical studies.
THE POST
The position will be a key post in the Paediatric and Adolescent Oncology Targeted Drug
Development Programme.
The Paediatric and Young People's Targeted Drug Development Programme at the Royal
Marsden Hospital / The Institute of Cancer Research encompasses molecular pathology,
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drug discovery, preclinical investigation (in a comprehensive range of model systems),
preclinical imaging and early clinical studies with functional imaging and pharmacodynamic
biomarker analysis.
The Fellow will work very closely with other members of the multidisciplinary team carrying
out early clinical studies of novel agents in children and young people at the Royal Marsden
Hospital.
The established team comprises Paediatric Drug Development Consultants
Research Nurses, Clinical Fellows, Clinical Trial Co-ordinators, Data Managers and Tissue
Collectors. The Fellow will be involved in the care of children and young people enrolled on
early clinical studies of new agents. The team has strengthened the high quality standards of
Good Clinical Practice (GCP) and developed excellent links with academic and industrial
sponsors.
Patients are referred from other centres and there has been very positive
feedback from referring clinicians, their shared care colleagues and the families themselves
about the service for these patients. The team works to an excellent patient care level with
strong pharmacovigilance. There have been three external audits in the past four years and
no critical or major findings were found. The Team were praised on their dedication to meet
GCP standards.
In addition there will be opportunities to be involved in devising and writing early clinical
studies, develop paediatric biomarker platforms and input into pilot imaging studies. The
Fellow will also have an opportunity to develop an interest in neuroblastoma, neurooncology, sarcoma or leukaemia.
The post holder would be responsible for reviewing patients on Phase I/II clinical trials, both
on the ward and in the Paediatric Drug Development clinics. The post holder will receive
training in and be actively involved in liaising with academic and commercial clinical trial
sponsors about patients recruited onto trials, new trials and new drugs, collection of clinical
trial data to GCP standards and the regulatory aspects of paediatric early phase trials to
enable them to work effectively in the set-up of new early phase trials, under consultant
supervision.
There are particularly strong links with the Cancer Research UK Cancer Therapeutics Unit,
the Adult Drug Development Unit – Oak Ward and the Department of Nuclear Medicine
(RMH) and the Cancer Research UK and EPSRC Cancer Imaging Centre. The post holder
will link closely with radiology colleagues for the imaging assessments of patients on clinical
trials.
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A central theme of the programme will be the translation of laboratory research to clinical
trials, which will ultimately alter international practice in paediatric oncology.
This post in paediatric oncology is suitable for trainees wishing to gain experience in
paediatric oncology drug development. The post holder will have the opportunity to develop
their own projects in the area of drug development.
Ideally the post holder will have already obtained a higher degree, be in the process of doing
so or have a strong interest in pursuing such an opportunity in the near future.
The post holder will take part in the paediatric oncology on call rota at SpR level.
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PERSON SPECIFICATION
CLINICAL FELLOW IN PAEDIATRIC ONCOLOGY DRUG DEVELOPMENT
Person
Qualities and Attributes
Essential
Desirable
Specification
Status
Membership of the Royal 
College of
and
Paediatricians
Child
Health
or
equivalent qualifications.
Eligible
for
full
GMC

Registration.
Advanced Paediatric Life 
Support
or
equivalent
certificate.
A Higher Degree or desire
to pursue one at a later
stage.

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Experience
Broad-based experience in 
Paediatrics and Paediatric
Oncology

Organisation of education
and
training
of
junior
doctors.
Experience in medical audit

IT skills


Training and/or Experience
in
regulatory
relevant
to
matters
paediatric
clinical research
Personal
Approachability

Team Player

Enthusiasm

Effective communication

Qualities
Committed to personal and 
professional development
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