All-Ireland Cancer Liquid Biopsies Consortium (CLuB) advancing Ovarian Cancer Research

The All-Ireland Liquid Biopsy Consortium (CLuB; www.clubcancer.ie) is a collaborative program focused on advancing liquid biopsy technologies for cancer diagnosis and treatment. It unites researchers, clinicians, patients and institutions across both Northern Ireland and the Republic of Ireland. The consortium aims to develop minimally invasive, cost-effective, and reliable liquid biopsy methods that could complement or, in some cases, replace traditional tissue biopsies. These blood tests seek to enable earlier and more precise diagnoses, support personalised treatment strategies, and enhance patient outcomes. By combining expertise across the island, the consortium accelerates innovation in the field of liquid biopsy.

CLuB is led by Prof Lorraine O’Driscoll in Trinity College Dublin and the Northern Ireland lead is Prof Paul Mullan in Queens University Belfast (QUB). It is funded by the Higher Education Authority under the North South Research Programme, emerging hub of excellence. The premise of CLuB was to amalgamate the fragmented research that was happening across the country so that the information is maximised for liquid biopsies from patients. This information would then be processed by data scientists in the University of Galway under the direction of Dr Pilib Ó Broin to develop better algorithms for diagnosis and treatment.

CLuB focuses on a number of components of the liquid biopsy, namely;

• Circulating tumours cells (CTCs) – cancer cells that have detached from a primary tumor and are circulating in the blood. (Dr Sharon O’Toole, Prof John O’Leary and Dr James Beirne lead the ovarian strand and Dr Kathy Gately leads the lung strand)
• Circulating tumour DNA (ctDNA) – fragments of DNA shed from tumors into the bloodstream. (Prof Paul Mullan)
• Extracellular vesicles – small vesicles released from cells, including tumour cells, that carry various molecular signals. (Prof Lorraine O’Driscoll)
• Other biomarkers – such as proteins that may indicate the presence of cancer or provide an insight into the tumour behaviour.

In addition to blood samples, CLuB under the direction of Dr Niamh Buckley in QUB, also works with excised tumor tissue/organoids as “avatars” to better understand the origin of components present in liquid biopsies and test the effectiveness of potential treatments.

Ovarian cancer is one of a number of cancers being investigated within the CLuB consortium which also includes lung, breast, pancreatic and gastric and has the ambition to expand to other cancer types in the interest of all patients with cancer.

Ovarian cancer is one of five gynaecological cancers (vulva, vaginal, cervix, uterine and ovarian) but it has the highest mortality of the gynaecological cancers due to late presentation of disease and the development of chemoresistance. Annually, approximately 400 women are diagnosed with ovarian cancer, and almost 300 women die from this disease in the Republic of Ireland (National Cancer Registry Ireland). In Northern Ireland, almost 300 are diagnosed and 128 women die (Northern Ireland Cancer Registry). Ovarian cancer is the fourth leading cause of cancer death in women in Ireland, after lung, breast, and colorectal cancer. Currently there is no screening for ovarian cancer and current diagnostics lack sensitivity and specificity. Symptoms of ovarian cancer can be vague and CLuB realises the importance of awareness initiatives and supports the work of the Irish Network for Gynaecological Oncology (https://isgo.ie/irish-network-for-gynaecological-oncology/) in their award winning BEAT awareness campaign.

• Bloating that is persistent and doesn’t come and go
• Eating less and feeling full more quickly
• Abdominal and pelvic pain you feel most days
• Toilet changes in urination or bowel habits

CLuB researchers Dr Brian Henderson and Ms Faye Lewis working alongside Dr Mark Ward are focused on novel diagnostics for ovarian cancer but also looking at the role of the liquid biopsy for helping guide the treatment for ovarian cancer patients to enable a more precision medicine-based approach. CLuB is following patients longitudinally throughout their treatment, with the help of our research nurse Sinead Hurley and researcher Marika Kanjuga, to determine the role of the biomarkers in predicting response to treatment.

Embedded in CLuB is the patient voice and CLuB are fortunate to have the input of a passionate and dynamic patient advocacy panel who are excited at the prospect of developing novel liquid biopsy tests to improve patient outcomes (Jacqueline Daly, Krista Costello, Roberta Horgan and Gemma Ward, coordinated by CLuB project manager Dominique Plant).

CLuB is grateful to our funders (Higher Education Authority North South Research Programme), the clinicians who consent and to all the patients who donate their samples for research.

Written by Sharon O’Toole, Senior Research Fellow, Departments of Obstetrics and Gynaecology/Histopathology, Trinity Centre,
St. James’s Hospital

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