The following projects are still on-going:
MERCURY 3
Some patients, particularly patients with cancer of the lower part of the bowel, may benefit from radiotherapy or chemotherapy before surgery, but there are serious side-effects, such as poor long-term bowel function and increased need for a permanent stoma bag. In this context, selection of the right treatments for each individual patient is crucial and Pelican is a leader in surgical treatment and educational initiatives to improve individualized patient care.
Pelican has helped develop, fund and deliver two world class studies entitled MERCURY 1 and MERCURY 2. The pre-operative scans can predict not only what would be found under the microscope after surgery but also risks of a patient developing a recurrence of their cancer after surgery.
The original MERCURY studies went on to change the way pre-operative imaging for rectal cancer staging was carried out worldwide. This meant that with accurate MRI scans, many patients could be spared additional treatments before surgery by identifying those who could be cured with surgery alone.
Pelican is currently working with Prof Gina Brown, Prof Brendan Moran and Miss Amy Lord to develop and deliver MERCURY 3, which is a futuristic study, further refining the use of MRI to stage cancers in patients with rectal cancer. This study will involve national and international collaborators, multicentre patient research and educational initiatives for radiologists, surgeons and other professionals. MERCURY 3 will be initially in the UK and Ireland, prior to global extension, to improve staging, surgical precision and maximise outcomes for patients with rectal cancer.
The team has already shown that MRI-TDV staging was able to predict prognosis better than MRI-TNM (Lord et al, Lancet Oncology 2021). The results suggested that there may be a tendency to overtreat around one third of patients with radiotherapy when using MRI-TNM staging, meaning they would have all of the side effects of treatment (such as poor bowel function) but no benefit in terms of cancer cure and survival.
This has major implications for both patients’ quality of life and the use of NHS resources when giving unnecessary, potentially harmful, treatment.
Building on experience from the previous MERCURY studies, the key aim of MERCURY 3 will be to train radiologists and multidisciplinary teams (MDTs) at multiple sites, to use MRI-TDV. The aim is to prove that MRI-TDV can be reliably reported by all radiologists and confirm that it predicts prognosis better than MRI-TNM in a larger scale study involving multiple hospitals.
Pelican is providing funding to directly involve patients in this process from the beginning and ensure their voices are heard and plans to play a key role in future training of radiologists and other MDT members through a national training programme aiming to improve rectal cancer staging and decision-making based on the results of MERCURY 3.
CALI Study - Histological Evidence of Reversibility of Chemotherapy Associated Liver Injury.
In 2020, in collaboration with Hampshire Hospitals Foundation Trust (HHFT), with funding from The Liver Fund, Pelican agreed to support this study, led by Merv Rees. Pelican donated £4K for seed funding. In January 2025 the study was given approval to go ahead, and the study is now adopted by NIHR.
This study aims to document how liver wellbeing is affected in patients who were given neoadjuvant chemotherapy prior to an operation to remove colorectal secondaries in the liver. The study group will comprise patients who subsequently underwent a second liver resection, after liver hypertrophy, and enable focus on any differences in histological liver injury scores of the resected specimens between the first and second operation. This analysis will clarify the quality of liver tissue that has regrown and what factors influence this. Such knowledge will be vital in informing decisions on how to manage patients who require repeated liver surgery.
LRRC – QoL (Locally Recurrent Rectal Cancer – Quality of Life Study)
The LRRC-QoL study was originally funded by the Pelican in 2019 (£20K)
Locally recurrent rectal cancer (when rectal cancer comes back in the same area after initial surgery) is relatively rare and therefore our understanding about the unique challenges faced by patients with this condition is limited. This is a large international project exploring patients’ quality of life and the issues encountered by long term survivors who have had surgery for recurrent rectal cancer.
These results will allow better counselling of patients with recurrent rectal cancer about what to expect after surgery and could lead to further research about how to mitigate and deal with the challenges they face.
The lead Deena Harji from the University of Leeds, Institute of Clinical Trials Research has advised that they are currently in the analysis phase and completion is anticipated for 30th June 2025.