News
Trust awarded £250,000 government funding to launch pioneering endometriosis trial
University Hospitals of North Midlands (UHNM) has secured £250k to trial a dye-based technique in endometriosis surgery aimed at reducing pain and surgical complications.
The two-year ICE trial will compare the use of indocyanine green (ICG) dye with standard ureter stenting, aiming to better protect urinary structures during deep endometriosis procedures.
Funded by the NIHR Research for Patient Benefit Programme, the feasibility study will explore whether this method can improve outcomes, reduce complications, and support recovery.
Mr Gourab Misra, consultant gynaecologist at UHNM and chief investigator, said: “Surgery for deep endometriosis is complex and carries a risk of damaging the ureters, the delicate tubes connecting the kidneys to the bladder.
“Traditionally, surgeons use stents to identify and protect these structures, but these can cause significant pain, bleeding, and require a second procedure to remove.
“As a group of surgeons, we saw the challenges our patients faced and worked hard to design this proposal.
“Our aim is to minimise complications and improve the patient journey, reducing pain and morbidity associated with these complex procedures.”
Endometriosis is a condition where tissue similar to the womb lining grows outside the uterus, often causing chronic pelvic pain and infertility.
In severe cases, surgery may be required, which carries a risk of injuring the ureters—tubes that transport urine from the kidneys to the bladder.
Currently, surgeons often use plastic tubes called stents to protect the ureters during surgery.
These are typically left in for two to four weeks but can cause pain, blood in the urine and require removal through an additional procedure.
The new approach uses a small catheter to deliver ICG dye into the ureters, making them visible under a special light during surgery—potentially avoiding the need for stents.
The trial will recruit 70 patients across UHNM and Birmingham Women’s and Children’s NHS Foundation Trust, with participants randomly assigned to receive either the conventional stent method or the dye-based technique.
It will assess feasibility, including whether patients and surgeons are willing to participate, with the goal of informing a future full-scale trial that could lead to wider adoption across the NHS and internationally.
Professor Justin Clark, consultant gynaecologist leading the study at Birmingham Women’s and Children’s NHS Foundation Trust, said: “Deep endometriosis affects and causes significant pain adversely affecting quality of life.
“Whilst surgery is effective, it is highly complex.
“This trial uses a novel dye called ICG that identifies the ureters, which are pipes that transport urine from the kidney to the bladder.
“We hope that this study will show that using ICG can reduce complications, speed up surgery, and reduce pain following the operation, as well as enhance recovery.”
Cancer
Lung cancer drug shows breast cancer potential
Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.
PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.
Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.
The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.
In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.
Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.
Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.
Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”
John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”
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