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Meet the researchers - Dr Fieke Froeling

Dr Fieke Froeling Imperial College London

Interview with Dr Fieke Froeling, Academic Clinical Lecturer,
Imperial College London

Fieke, 36, grew up in a small village in the south of Holland. She moved to Utrecht to study Medicine when she was 18, then moved to London in 2007 for her PhD research, the findings of which are now the subject of a clinical trial. Fieke was awarded a PCRF grant in 2015. Outside of work she loves cycling and running and also loves to travel the UK as she says the countryside here is so beautiful and dramatic in comparison to Holland’s very flat landscape!   

Your research career path has been somewhat unusual!
Yes, I qualified as a medical doctor in 2006 after which I started a PhD at Barts Cancer Institute with Professor Hemant Kocher as my supervisor. Following my PhD, I went back into medicine to start my training in medical oncology. Not many clinicians do a PhD so early in their medical career, but I’ve always had a certain curiosity about the “why and how” and was drawn to science during the final years of medical school. As I had a particular interest in cancer and gastrointestinal diseases, I was very excited to be given the opportunity to work in Hemant’s lab to study pancreatic cancer. During that time, I learned a lot more about pancreatic cancer, how difficult it is to treat and the need for better outcomes for pancreatic cancer patients – something that has motivated me ever since. I was Hemant’s first PhD student and he was and continues to be a wonderful mentor to me.

And now Hemant is leading a clinical trial that’s based on your PhD research?
Yes – it’s so cool! I was able to show that targeting the fibrous coating of pancreatic cancer 
tumours (the stroma) with a specific form of vitamin A resulted in tumour regression and we are currently studying the potential of this as new treatment strategy for pancreatic cancer in the STARPAC clinical trial. The ultimate aim of our research is to make a difference for pancreatic cancer patients, so to see my research going from the laboratory to the clinic is a dream start to my research career. However, we need make sure we continue to learn as much as possible from the patients treated within the STARPAC clinical trial by studying tissue samples in the laboratory, something for which the PCRF National Pancreas Tissue Bank is providing essential support.

So you’re now both a researcher and a clinician?
That’s right. I spend about 50% of my time in the clinic and 50% in the laboratory, so I get to do both things that I love. It’s such a privilege to work with cancer patients and their families: they are unbelievably brave and I’m taken aback by the strength they demonstrate in facing their illness. Our relationships with patients are in a professional capacity, but we’re human too and losing patients is very hard. This is what keeps me motivated in the research side of my work. I’m determined that we will find new treatments, or make improvements to treatments to give people a longer, better quality of life.

What do you hope to achieve with your PCRF-funded project?
My current research focus is on ‘epigenetic changes’ in pancreatic cancer. These are changes in the DNA that result in certain genes being switched on or off, but without changing the genetic code itself. There are a lot of epigenetic changes that occur in pancreatic cancer and we believe that if we can understand these better, we can potentially find new treatments. So by studying the epigenetic changes in pancreatic cancer and assessing the response to different drugs, we aim to identify which changes in the cancer cell can predict a response to a certain drug.

 How is the project going?
It’s going well, but it’s very ambitious in scope. We’ve tested over 100 drugs already using pancreatic cancer cells of which we have a very detailed knowledge about the changes in their DNA, including changes in the expression of a gene that occur due to epigenetic mechanisms (no change in code of the DNA). My ultimate aim is to be able to say “a patient with this specific epigenetic change in their tumour cells will respond best to this particular drug” and to see some of these drugs reach patients.

 What do you think is the most exciting or the most important research development or discovery for pancreatic cancer in the past few years?
The increased insights into the diversity of pancreatic cancer – finding different subgroups which behave differently and need a different treatment approach is of major importance. It finally dispels the traditional “one drug fits all” approach to treatment and forces the research landscape into a new focus on personalised medicine for pancreatic cancer. If we can find the right drug for the right patient then we might finally see some progress in the terrible survival statistics.