Upper Gastro-Intestinal Cancer

Haematoxylin and eosin stained gastric cancer under the microcope

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What is Upper GI cancer?

Upper gastro-intestinal (Upper GI) cancers affect the oesophagus and stomach. These cancers are becoming more common in many Western countries, including the UK, due to our lifestyles and other factors.

Doctors often find these cancers at a later stage, which can make them harder to treat. Researchers need better ways to detect Upper GI cancers earlier and develop more targeted treatments.

At the Manchester Cancer Research Centre, our multidisciplinary Upper GI research team brings together clinicians, scientists and patients. Together, they develop patient-centred research to improve care and treatment for people affected by Upper GI cancers.

Upper GI Research in Manchester

Clinicians at The Christie NHS Foundation Trust care for one of Europe’s largest single-site populations of people with Upper GI tumours. This gives Manchester researchers access to deep clinical expertise and a strong platform for research that can improve patient care.

The Upper GI team works across Greater Manchester’s clinical and academic network. Patients remain at the centre of every project. The team also trains the next generation of clinicians and scientists.

Our approach starts with urgent questions from patients and clinical teams. We take these questions into the lab, develop new ideas, and bring promising solutions back into patient care. This model connects medical oncology and surgical consultants from The Christie NHS Foundation Trust and Northern Care Alliance NHS Foundation Trust with researchers from The University of Manchester and the CRUK National Biomarker Centre. It also draws on patient samples from the MCRC Biobank.

Our research strategy

Our research strategy addresses the unmet needs of people with Upper GI cancers. It includes laboratory research at the CRUK National Biomarker Centre, clinical trials that test new medicines, and studies that explore how to improve quality of life during and after treatment.

In our lab at the Paterson Building, researchers study tumour and blood samples from patients in detail. They use this work to understand how cancer cells survive, how treatments can work better, and how doctors could offer more precise and less invasive care. When the team identifies a promising advance, our clinicians can test it through clinical trials.

Clinical projects led by Professor Was Mansoor focus on improving quality of life for patients. This includes work to better understand and improve patients’ appetite during treatment.

By working across disciplines, the team can move new diagnostic and treatment ideas from the lab into hospital-based clinical trials. These include trials of new medicines and liquid biopsies, which use blood samples to help guide cancer care.

Developing the next generation of immunotherapy

In our lab at the Paterson Building in Manchester, researchers are developing a new way to help immune cells attack Upper GI cancer cells. These immune cells, called T lymphocytes or T cells, play a key role in the body’s response to cancer. Our team wants to make them work harder and last longer against cancer cells. With funding from the Medical Research Council, the lab has developed a promising prototype medicine. Early results show that it works well in ‘tumours on a dish’ and in fragments of patients’ cancers. The next step is to develop it into a medicine that could move towards clinical testing.

Using liquid biopsies to develop more precise, less invasive tests

Researchers can study fragments of dead cancer cells found in a patient’s blood. The fragments can reveal what the cancer was doing before the cells died. This helps the team understand why some cancers respond to treatment while others do not. In future, this work could support a simple blood test that helps doctors choose the best treatment for each patient.

Key questions for future research

Our researchers tackle key challenges for people with Upper GI cancers. Key questions for our future research include:

What would help immune cells attack Upper GI cancers more effectively?
What steps are needed to move new immunotherapies safely from the lab into clinical trials
Could liquid biopsies help doctors choose treatment and track how well it works?
Why do some cancers respond to treatment while others become resistant?
Can patient-derived models help researchers develop new medicines faster?
Which approaches could improve quality of life during treatment, including nutrition, appetite and symptoms?
What closer links between the lab and the clinic could bring benefits to patients sooner?