The Primrose Oncology  Research Unit  

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A core clinical research team has been created, led by Professor Thomas entirely self funded entirely from commercial, lottery and charitable sources. A full report of our research can be found in the Primose Research update.

Translational research projects have been established via the appointment of Dr Naderi, a Medical Oncologist who also runs a Lab in Cambridge University. Four health economics studies run jointly with economics department at Cranfield University. Two Qol, breast cancer studies have linked with Hull University . A further double blind randomised study (NCRN adopted) also teams up with the Cranfield, statistics unit. A PhD student (Nichola Davies) is joint supervised and funded by Dr Thomas and Sarah Morgan at Cranfield University.  Madeleine Williams is the research manager and Anne Willis is the NCRN funded trials nurses.

We now recruit 38% of patients into home grown, NCRN or commercial trials annually. A source of funding in addition to the 100k raised form Dr Thomas leading a team in the London Marathon each year. All team members, including our receptionist, participate in clinical research and have presented work in international meetings each year.

Summary of completed projects :


Publication: Journal & date

Key improvements

Patient’s preferences for video recorded information.  Effect of age, sex & ethnic group.

Thomas R, Deary A, D. Stockton, N DeZeeuw . The Euro J Cancer Care. 1999; 8 83-86

We learnt from patients how they want information and discovered deficits in our service.

Patient information satisfaction following a diagnosis of cancer.

Deary A, Thomas R. Annuls of Oncology. 1999, 9, S4, p143.

This is initial survey showed that patient were dissatisfied

Anxiety & Depression - Effect on patient’s preferences for info.

Thomas R, Brown C, Stockton D. Anns of Onc 9, S4, pp 141.

Poor information is associated with Anxiety and depression

Epo for anaemia & qol in patients undergoing chemotherapy

H Thomas, R Thomas, K McAdam, S ESMO , Nice 2002.

Epo improved anaemia and qol

Epoeitin: Attitudes of community and hospital nursing staff.

A Deary & R Thomas. EJC. Vol.35. Suppl.4. p.30  (ab. 92).

Epo use is well accepted by nursing staff

Do patient's want the same information as the GP?

Kaminski E, Deary A, Thomas R. EJC. 1997. 33, S8, 1391.

Most but not all and may frighten some.

Patient preferences for a breast care nurse specialist.

Shingler G, Smith S, Thomas R. EJC. 1997. Vol. 33, S8, 1397.

Accepted greater responsibilities of  breast care nurses

Patients attitudes to a bespoke filofax information system.

Kaminski E, Balusu R, Thomas R.  EJC. 1997,. 33, S8, 1401.

Highly acceptable

Patient information: A new structured information package.

DeZeeuz N, Bulusu R, Thomas R.  EJC. 1997. 33, S8, 1400

Feed back from patients helped us design this file

Where do patients seek additional information after a diagnosis?

Shingler G, Bulusu R, Thomas R. EJC. 1997. Vol. 33, Sup8, 1426.

Interesting insight into patient behaviour – word of mouth

Why Oncologist should provide a web site for their patients.

L Dalton and R Thomas. The EJC. 1999 35. S4. p.46  (ab. 164).

Uncontrolled internet sites. We developed

Forewarned is forearmed – preparatory information on video cassette for chemotherapy & radiotherapy - a randomised trial.

Thomas R, Daly M, Perryman B, Stockton D. EJC 36 (2000) 1536-43. JCO 1999 ASCO): 1570 and  EJC.;35. S4. 275

We developed, then evaluated an information film, free at Bedford distributed nationally by Cancer Bacup.

Developing and evaluating a regional information strategy.

R Thomas, C.Lockery. EJC 2001 vol 37, supp.2 pp 62

This review summarised our information strategies

Lyphpoma Chemotherapy – an audit of neutrpenia, dose intensity, and gcsf use in the UK

R Thomas, J.Sweetman, P Hoskins. EJC 2001 vol 37, supp.2 pp119

Showed the lack of maintaining dose intensity in the UK with gcsf

Adjuvant UK breast cancer Chemotherapy – audit of neutrpenia, dose intensity & gcsf.

R Thomas and R Leonard. EJC 2001 vol 37, supp.2 pp61

Showed the diverse choice of regimens and lack of maintenance of dose intensity

Lessons Learnt from Raltitrexed – QA, Patient Education and Intensive Supportive Drugs

R.J. Thomas, M. Williams, J. Garcia-Vargas Clinical Oncology (2003) 00:1-6

For colorectal cancer - Showed how to optimize tolerability, now  AstraZeneca guidelines

Examining quality of life issues in relation to endocrine therapy for breast cancer.

Robert Thomas. American Journal of Clinical Oncology 2003. Vol. 26, No. 4, p S40-44

Showed the importance of letting patients have greater input into their management.


National publication

Conformal Rxt better

Viktor study (MRC)

National Publication

Trial stopped - cardiac morbidity

Measuring information strategies – developing an information satisfaction questionnaire

Thomas R, Kaminski E, Stanton E and Williams M. EJCC, 2004, 13, 65-70.

This questionnaire is now used internationally to measure patient satisfaction to information

Giving patients a choice improves qol: A multi-centre, investigator-blind, RCT of letrozole v  anastrozole

R. Thomas, S. Godward, A. Makris, D. Bloomfield, A.M. Moody, M. Williams. Clinical Oncology (2004) 16: 485-491.

Qol and tolerability can be improved by giving patients a choice.

Patient Information materials in Oncology: Are they needed and do they work?

Thomas R, and H Thorton. Clinical Oncology 1999;11: 225-231.

This review helped us understand the available literature and improve our service

How to deal with the complexities of patient consent?

Robert Thomas.  Pulse Clinical pp42-43 Dec2003.

This review helped us re-write our consent sheet.

The changing face of informed consent

R Thomas. B Journal of Can Man. Summer 2004 Vol. 1 No. 1.

This review also helped us re-write our consent sheet.

What are the costs of not using rhEPO to treat anaemia in cancer.

R Thomas. Focus on anaemia in cancer. 2002, 3, 2, pp52-53.

This review identified the most cost effective patients for epo

NICE guidance on supportive and palliative care – Implications for Oncology Teams.

Dr R Thomas and Professor Alison Richardson. Clinical Oncology (2004) 16: 420-424.

Summarised the NICE guidelines for oncologist

The NICE guidance on supportive and palliative care.

R Thomas and Prof A Richardson. B J CM2004. 1. 3

Summarised the NICE guidelines for managers

Anaemia fatigue and Epoeitin in Oncology

R Thomas. British Journal of Cancer Management. April 2005.

A summary of the evidence helped us write the epo guidance

PET saves man

R Thomas, M Williams & S Old. BJCM 2004 Vol. 1 No. 1

Highlighted the advantages of PET in colorectal oncology

Information – Local policies or a national strategy?

Thomas R, British Medical Journal, 1999, vol 318. page 462

Comment on the importance of give local info for local patients

The Role of an Italian Volunteer Organisation.

F. De lorenzo, R. Thomas,. L. 1998. Health communications.

Evaluated the Italian translation of our patient information film.

An open randomised trial of second-line endocrine therapy in breast cancer: comparison of the letrozole and anastrozole.

C. Rose, O. Vtoraya, A. Pluzanska, N. Davidson, M. R. Thomas, S. Johnson, et al. EJC 39 (2003) 2318-2327

This head to head comparison suggested letrozole has some advantages in terms of response.

Dietary advice combined with a salicylate mineral and vitamin supplement  (CV247)- a phase II study

R Thomas, M Blades, M Williams Nutrition & Food Science. 2005 35 ,6, 436-451.

One of the first studies to suggest dietary intervetion after cancer may affect progression

Avastin saves the day

 R Thomas, A Eldin, BJCC, 2006,  vol.2,no.2, 20-21

Interesting case report on the use of Avastin

Erbitux the new team player

Y Habba, R Thomas, D Skipper, M Rees, BJCM Jan 2006

Highlights a potential new role for erbitux

Complementary & alternative medicine- evidence online

J Richardson, K Pilkington R Thomas, BJCM 2005, 2;2,10-14

Reviewed the evidence for CAM therapies often taken by patients

Can we move to a paperless information system?

A Deary, R Thomas, M Williams ESMO 2005

Evaluated the attitudes & costs of an online only system

Patients in trials are more satisfied with their received info

R Thomas, M Williams ESMO 2005

Reassures patients they are well informed in clinical trials

Phase 111 study of gemcitabine and capecitabine for pancreas

National publication

Help understand the chemo responsiveness of pancreatic ca.

Can switching to letrozole improve hot flushes, qol and patient preference

R Thomas, L Walker, C Marshall, San Antonio breast cancer conference 2005 & ESMO Istanbul 2006

This study, with Hull & Cranfield Universities highlights the qol benefits of changing to letrozole

Adjuvant breast cancer drugs – blockbusters or bankrupters

R Thomas, J Green, M Callam. BJCM Jan 2006

Reviewed evidence & cost of  Rx for our health economics study with Cranfield University

Cost effectiveness of adjuvant exemestane R Thomas, M Williams, J Glen ECCO 2007 and Nottingham Breast conference 2007  
Cost effectiveness of adjuvant arimidex R Thomas, M Williams, J Glen  - ongoing  
Cost effectiveness of adjuvant taxotere R Thomas, M Williams, J Glen - ongoing  

Can switching to exemestane improve hot flushes, qol and patient preference

R Thomas, L Walker, C Marshall, ECCO 2007 - ongoing

This study, with Hull & Cranfield Universities highlights the qol benefits of changing to exemestane

Double blind randomised trial of CV247 v sodium salicylate in men with indolent prostate cancer

R Thomas, M Williams etc - ongoing

NCRN trial designed at Bedford. completed and being analysed.


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