Brain Tumour Research Funding

Liz Kendall Excerpts

Thursday 9th March 2023 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

I thank the Backbench Business Committee for granting this debate, the hon. Member for St Ives (Derek Thomas) for securing it, and all those charities and organisations that work so hard to push this issue up the agenda, including Brain Tumour Research and the Tessa Jowell Foundation. I also thank all hon. Members who have spoken on behalf of their constituents so very passionately and powerfully, particularly my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), who I thought gave an incredibly brave speech, which moved us all to tears—she did not mean to move us to tears; she meant to move us to action, and that is what we must resolve to do as a result of today’s debate.

We have heard that 16,000 people a year are diagnosed with a brain tumour, 3,200 of whom are diagnosed with glioblastoma, the most common primary brain tumour in adults. Getting this diagnosis can be utterly devastating —life can change in the blink of an eye—because we know that more children and adults under the age of 40 lose their lives to brain tumours than to any other cancer. They take the lives of more women under 35 than breast cancer, and the lives of more men under 70 than prostate cancer. I think we owe it to all those who have been diagnosed with a brain tumour and their families to set out a proper plan to improve outcomes. In particular —and I think this is the most important point for all of us here today—what are we going to do differently in the next 10, 20 or 30 years, because nothing has changed in the past 30 years? If we keep repeating what we have done before, we will only get the same result.

But I do not believe that it has to be this way. We have seen huge improvements in survival rates for so many other cancers. We know that 54% of people diagnosed with leukaemia will now survive for more than five years, and 85% of those diagnosed with breast cancer will survive for five years or more. That is an incredible success story, and I think that we need to look long and hard at how that was achieved. What changes were made, yes, in research funding, but also in training, in clinical trials, and in other forms of treatment and support?

We know that when we put our minds to it—when we have leadership, focus and a plan for action—we can deliver results. We must do that here. Fewer than 12% of people diagnosed with a brain tumour will survive beyond five years and, as my hon. Friend the Member for Mitcham and Morden said, the average survival for patients with glioblastoma is only nine months. That has not changed for 30 years. We need a different approach.

Many hon. Members have rightly said that proper investment in research is vital. Since 2002, only 1% of the national spend on cancer research has been allocated to brain tumours. That is around £126 million. Over the same period, just over £550 million was spent on leukaemia research, and £775 million on breast cancer research.

I do not think that anyone doubts that has made a real difference to the outcomes we have seen, so I hope that, when the Minister stands up to reply, he will say how he will deal with this issue. We know how this works: more research goes into areas where more people are suffering from a condition, but that cannot be the answer. I hope that the Minister will say whether the Government intend to change those funding proportions, and if so, how.

However, alongside investment there must be reform, because the current system is not working. We have heard from many hon. Members that, in response to the campaigning of the late Dame Tessa Jowell, the Government committed £40 million in funding on brain tumours to be made available via the National Institute for Health and Care Research. However, as of January 2023, just £15 million of that had been awarded. I would like the Minister to spell out why that has happened and what he will do to change it.

We must be much less risk averse when allocating research funding, and we must ensure that the people who are making the decisions fully understand the issues around brain tumours and research. I think that the Minister needs to explain whether NIHR actually has that expertise on its board, and if not, what he will do to change it.

We also must look at the issue, which many hon. Members have spoken about, of research funding getting stuck in lots of different silos. The Department of Health and Social Care and the Department for Science, Innovation and Technology must work together much more closely to ensure that early-stage research quickly progresses to clinical trials, and then to the bedsides of patients via new treatments. Is there any sort of group or format to do that? If there is, it is obviously not working, so how does he intend to change that? That is one of the key asks of the APPG on brain tumours, so I think that we really need to get to the bottom of it.

I now want to focus on the issue of clinical trials—although, my hon. Friend the Member for Mitcham and Morden spoke so powerfully that I almost feel that I should just sit down and let that speak for itself. However, I spoke to Professor Paul Mulholland, who is a medical oncologist who exclusively treats brain cancer, at University College Hospital, the National Hospital for Neurology and Neurosurgery, and Mount Vernon Cancer Centre. He is, rightly, extremely concerned about how few, if any, patients with glioblastoma in this country are currently on clinical trials. Unless we significantly increase both the number and the size of those trials, we will never make progress and patients will be forced, if they have the means to do so, to go to other countries. That is not acceptable.

How are we going to do that? Professor Mulholland believes that the first change required is for all medical oncologists to receive mandatory training in primary brain cancer. We may be told that they receive training in brain cancer, but that usually relates to secondary brain cancer. He believes that there needs to be a minimum period of specific training, because it is not currently required. That will increase understanding of the issues and possibly the propensity to support and understand the risks and benefits of clinical trials.

The second change required is clear targets for increasing the number of brain tumour patients on drugs trials, starting with 200 a year and increasing to 1,000 a year in five years’ time. We must have a goal and must know how we are going to get there. The third change required is that the pharmaceutical sector must be involved— no ifs, no buts. Professor Mulholland believes that the Government need to have a very targeted working group, with Cancer Research UK, the pharma companies and Health Education England saying, “We’re going to make this happen,” and explaining how and when.

I know that the Minister has received many requests for meetings during this debate, but I urge him to meet Professor Mulholland to talk through those ideas. They are different and are not necessarily what others are calling for, but he has an idea about how things need to change. We need change, so I hope that that is what happens.

For all those who have died from brain tumours, for the families who have felt that devastating impact, for all those who are currently going through all the stress, strain and trauma of treatment, and for all the families who love them and want to make a difference, we need change and we need to get it right, and I really look forward to hearing the Minister’s response.

--- Later in debate ---

[Will Quince]

I thank the right hon. Gentleman for his question, and I shall try my best to answer it. It is a question that I listened to very carefully when he posed it in his contribution, and it is one that I have posed myself when looking at the NIHR and what it does. The committees for NIHR and the programmes that come forward receive a diverse range of applications, which is understandable. Their make-up, therefore, is that of a broad range of expertise. As I said a few moments ago, they may or may not contain experts in the field of brain tumour research. However, having said that, the NIHR committees then use peer review from appropriate experts, which would include brain tumour expertise as relevant to the brain tumour proposal that is under review in each individual case. That is there deliberately to inform their decision-making. They co-opt particular expertise on to the committee, which is an option always available to NIHR if the committee needs that particular input. If clinicians and scientists are telling the right hon. Gentleman that that is not happening, or is not happening to the degree that we would want and expect it to, I would want to take that away and look at that further.

I wish to come back to a comment that the right hon. Gentleman made about brain tumours and why they remain a challenging area for research. There is the complexity of the brain itself as an organ, and the way that perception, memory, and emotion— everything the brain does—can be affected differently by different types of tumour. Brain tumours are different diseases that can differ in terms of histology, molecular characteristics, and clinical behaviour, meaning that many different treatments must be developed. Brain tissue is precious and obtaining it for research purposes can be difficult. Obtaining biopsy samples is risky and invasive, and animal models are of limited applicability. Additionally, the community of active clinical researchers is relatively small—it is certainly small in relation to the scale of need. This all makes research on brain tumours challenging, as has been well articulated today, and progress, if we are to make it—and I am determined that we will—requires a collaborative effort between researchers, clinicians, and funding agencies.

How do we grow the field of brain tumour research? This was a challenge from the shadow Minister. We have been taking action to grow the field by supporting researchers to submit high-quality research bid proposals. That has been supported by working with the Tessa Jowell Brain Cancer Mission, which hosts workshops for researchers, and provides research training specifically for clinicians.

Since the initial Government announcement of £40 million over five years ago, we have spent £33.9 million on brain cancer research across Government. I am conscious that there is a difference in the two figures, but that is because we are combining spending from UK Research and Innovation with the spending of NIHR. However, as I have made clear already, we want to spend more and the NIHR welcomes funding applications for research into brain tumours, and the Department of Health and Social Care priority call on brain tumours remains open. Critically, all applications that have been assessed as “fundable” in open competition have been funded, and that will continue.

As I have said, brain tumour research is one of the most difficult scientific challenges of our age. We need to invest across the translational pipeline, from fundamental science through to effective treatments. These are long-term challenges and we are committed to them for the long term. To be clear, the £40 million announcement was a signal to the research community that we are serious about funding research in this space. It is not a ceiling. If we can spend more on the best quality science, let me assure the House that we will do so. I understand and share the frustrations that only a proportion of the £40 million on brain tumour research has been allocated so far, but this funding will remain available. I genuinely believe that the funding for brain tumour research is promising and we look forward to considering the all-party group recommendations with colleagues across Government. I am confident that the Government’s continued commitment to funding will help us make progress towards effective treatment.

[Liz Kendall]

As the Minister may be about to close, I would like to ask him whether he would respond to a request to meet Professor Mulholland about the other issues that he raised around training and clinical trials, because that would make a hugely useful contribution to the debate.

[Will Quince]

The hon. Lady pre-empts not only that I am coming to a close, but my final response. I have a little more time than I would ordinarily, but in closing such debates, one never quite gets the opportunity to answer every single question. I have never turned down a meeting with a colleague, and I do not intend to start doing so today—it is important that we consider some of the issues that have been raised this afternoon, including the report’s recommendations—and, of course, I would be very happy to meet senior clinicians and scientists in the field as well.

In closing, I want to say how much I appreciate the vital work of my hon. Friend the Member for St Ives as chair of the all-party parliamentary group on brain tumours, of all those who have spoken so powerfully today, and of the powerful advocacy for more research on brain tumours and better treatments and care for patients, not least in last week’s report and in this important debate. It has been my pleasure to respond to the powerful points that everyone has made.