2024-25 Project (Staines & Groppelli)

Development and evaluation of novel point-of-need cervical cancer screening devices to improve women’s health in low resource settings

SUPERVISORY TEAM

Supervisor

Dr Henry Staines at SGUL
Email: hstaines@sgul.ac.uk

Co-Supervisor

Dr Elisabetta Groppelli at SGUL
Email: e.groppelli@sgul.ac.uk

PROJECT SUMMARY

Project Summary

The next generation of point-of-need diagnostic technologies aims to provide accurate disease information in a clinically relevant timeframe at the patient’s side, allowing appropriate treatment there and then. Here, we’ll develop and evaluate molecular diagnostics platforms adapted to screen for high-risk human papillomavirus (hrHPV) in resource poor settings, such as those found in low-and-middle-income-countries, LMICs. Persistence of hrHPV infection leads to cervical cancer, which is a major cause of death in women in LMICs. The project will focus on the accelerated development and evaluation of novel hrHPV screening devices and other diagnostic tests that may provide added benefit. Furthermore, understanding the attitudes towards and requirements for “screen and treat” cervical screening will be studied. It is envisaged that the student will spend some time undertaking field studies in Senegal and will have the opportunity to convert to an iCASE studentship.

Project Key Words

Molecular biology, PCR, Diagnostics, Infectious diseases, Human papillomavirus, Cervical cancer

MRC LID Themes

  • Global Health = Yes
  • Health Data Science = No
  • Infectious Disease = Yes
  • Translational and Implementation Research = No

Skills

MRC Core Skills

  • Quantitative skills = Yes
  • Interdisciplinary skills = Yes
  • Whole organism physiology = No

Skills we expect a student to develop/acquire whilst pursuing this project

Bioinformatics; development of novel diagnostic assays; processing and analysis of clinical samples, using molecular assays (e.g. qPCR), and sequencing; using lateral flow diagnostic devices; phylogenetics; training in good clinical and laboratory practice; field methods in epidemiology.

Routes

Which route/s is this project available for?

  • 1+4 = Yes
  • +4 = Yes

Possible Master’s programme options identified by supervisory team for 1+4 applicants:

  • SGUL – MRes Biomedical Science – Infection and Immunity
  • SGUL – MSc Global Health, Infection and Immunity

Full-time/Part-time Study

Is this project available for full-time study? Yes
Is this project available for part-time study? Yes

Eligibility/Requirements

Particular prior educational requirements for a student undertaking this project

  • SGUL’s standard institutional eligibility criteria for doctoral study.
  • Laboratory experience of molecular biological techniques including PCR would be useful but not essential.

Other useful information

  • Potential CASE conversion? = Yes

PROJECT IN MORE DETAIL

Scientific description of this research project

Cervical cancer is a leading cause of death among women of reproductive age in most low resource countries. It is caused by chronic and persistent infection with one or more high risk oncogenic types of human papillomavirus, HPV. The majority, if not all, sexually active women are infected with HPV during their lifetime, but most infections resolve without intervention. However, in the absence of vaccination programmes ~10% of women, for some unknown reason, are unable to clear the infection, which can then progress to pre-cancer and cancer.  Recently, several international organisations have released new guidelines and recommendations favouring the use of HPV DNA testing for primary screening for cervical cancer (rather than use of cytology, via the “Pap” smear). We are working with several companies to develop point-of-need screening devices that can rapidly provide the HPV status of women, enabling test and treatment strategies to be used.   

Project objectives: 
1. To accelerate development and evaluation of novel high risk (hr)HPV point-of-need screening devices, including a cassette-based molecular assay that uses a portable molecular platform for detecting 14 hrHPV oncotypes and a low-cost, point-of-need triage assay that detects HPV oncotypes 16 and 18 (responsible for over 50% of cervical cancers) 
2. To investigate attitudes towards cervical screening in Senegal and in doing so determine the potential of point-of-need hrHPV screening devices to enable and impact cervical screening pathways in LMICs  
3. To provide pilot data for larger point-of-need screening device evaluation studies, working with clinical virologists in Senegal and conventional screening assays to estimate community prevalences of hrHPV 
4.  Identify/develop/evaluate other rapid point-of-care tests that might provide additional benefit for women’s health (e.g. tests for other sexually transmitted diseases)   

Techniques to be used: 
A range to techniques will the used to develop and evaluate novel HPV screening devices in comparison with “gold standard” laboratory-based assays, including bioinformatics and molecular techniques (e.g. nucleic acid amplification methodologies -PCR, qPCR, LAMP – and DNA extraction and sequencing). These will be coupled with the development of questionnaires and field epidemiology to establish an understanding of HPV and cervical cancer in target communities in Senegal.   

Confirmed availability of any required databases or specialist materials: 
Our industrial collaborators have already confirmed availability of their screening devices. In particular, we are already undertaking a pilot study for one device developed by QuantuMDx in conjunction with the colposcopy unit at St George’s Hospital. A second device will make use of a low-cost platform developed for testing for SARS-CoV-2 by another industrial collaborator, Global Access Diagnostics, GADx (formerly Mologic). GADx have close links with the Institut Pasteur de Dakar in Senegal, who we’ll work closely with on this project. GADx have also agreed in principle to converting the studentship into an iCASE award, demonstrating their commitment to the project (with a current MRC LID student, Nick Eckersley, having just spent a highly productive 4-month iCASE placement at their premises in Bedford).   

Potential risks to the project and plans for their mitigation: 
The main risk to the project is that our industrial partners change their scientific direction due to commercial reasons. By working with more than one industrial partner, we aim to mitigate this risk. We are also flexible with regards to assays/devices that we can help develop and evaluate and our industrial collaborators are all embedded in developing diagnostics for low resource settings.   

We also have a number of sites internationally at which field evaluations could be undertaken if for any reason one site cannot be used (our main field site is in Dakar, Senegal).

Further reading

(Relevant preprints and/or open access articles)

Additional information from the supervisory team

  • The supervisory team has provided a recording for prospective applicants who are interested in their project. This recording should be watched before any discussions begin with the supervisory team.
    Staines-Groppelli Recording

MRC LID LINKS