Dr Ranjit Manchanda

Dr Ranjit Manchanda

MD, MRCOG, PhD
Centre: Centre for Experimental Cancer Medicine
Clinical Senior Lecturer, Consultant Gynaecological Oncologist
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QMUL Directory

My main research areas are:

  • Risk prediction, screening and prevention of ovarian and endometrial cancer
  • Population based approach(es) to genetic testing for risk stratification and cancer prevention
  • Targeted surgical approaches for prevention of gynaecological cancer
  • Familial gynaecological cancer

Research Details

Research interests

Population based genetic testing for cancer prevention

Development and implementation of a population based risk stratification approach for prediction and prevention of gynaecological cancers

Targeted surgical strategies for prevention of tubal/ovarian cancer: risk reducing salpingo-oophorectomy, opportunistic salpingectomy, early salpingectomy and delayed oophorectomy

Cancer MDT coordinated Precision medicine (CMP) approach for genetic testing of population based ovarian and endometrial cancer case series for guiding ascertainment of high risk genes, precision medicine and cancer prevention.

Familial ovarian and endometrial cancer screening

Management of familial gynaecological cancer such as: breast and/or ovarian cancer families, Lynch Syndrome; Cowden’s Syndrome

Gynaecological Oncology Training; Role and importance of accredited training

POPULATION-BASED GENETIC TESTING

PROMISE Feasibility Study

Pilot study led and coordinated from BCI, QMUL which aims to evaluate the feasibility and acceptability of undertaking a study to predict and stratify a population on the basis of ovarian cancer risk as well as offer risk management options of screening and prevention based on their predicted risk.

Cost-effectiveness of population based genetic testing strategies for cancer prevention

We are developing a number of models to explore and evaluate cost-effectiveness of different population based genetic testing driven cancer prevention strategies: BRCA testing in the Ashkenazi Jewish population (stratified by levels of ancestry), BRCA testing in the Sephardi Jewish Population; and multigene panel testing in the general non- Jewish population. Our collaborators include teams at LSHTM, UCL, UNSW Sydney Australia, Melbourne University Australia, Cedars Sinai USA, University of Manchester, Shaare Zedek Jerusalem, & University of Cambridge.

PROMISE (Predicting Risk of Ovarian Malignancy Improved Screening and Early Detection) research Programme

PROMISE is a multicentre, international programme bringing together 36 researchers from a number of leading centres (Manchester, UCL, Barts Cancer Institute QMUL, Cambridge University, Harvard University, UNSW Australia and Cedars Sinai USA) to address the challenge of effectively translating advances in risk stratification, screening and early detection for ovarian cancer into population-based interventions by developing and validating models for risk stratification, early detection and diagnosis of ovarian cancer which incorporate clinical, epidemiological, genetic, proteomic and imaging data and evaluating health behavioural aspects of their application to large populations.

GCaPPS (Genetic Cancer Prediction through Population Screening) Study

We use the Ashkenazi Jewish population as a population model and BRCA1/2 gene mutations as a disease model for research into a population based approach to testing for high penetrance cancer genes. GCaPPS is a randomised trial (ISRCTN73338115) comparing the family history and population based approaches to genetic testing for BRCA mutations in the North London Jewish population. In a non-inferiority cluster randomised trial we compare DVD-based and standard genetic counselling approaches to BRCA testing in an unselected Jewish population.

We are interested in evaluating the BRCA detection rates across the greater London population within the NHS and predicting time to detection of the estimated pool of carriers.

FORECEE (Female Cancer Prediction Using Cervical Omics to Individualise Screening and Prevention)

We collaborate on a UCL led multicentre H2020 programme which uses omics-based methods to develop a test for the stratification and risk prediction of breast, ovarian, endometrial and cervical cancers.

SIGNPOsT study: SystematIc GeNetic testing for Personalised Ovarian cancer Therapy

We are evaluating a Cancer MDT coordinated Precision medicine Pathway for panel based germline and BRCA somatic tissue testing in high grade epithelial ovarian cancer patients. Outcomes include: mutation rate, acceptability, uptake, psychological well-being, quality of life and cost-effectiveness.

We are developing projects for evaluating a CMP approach for unselected testing in endometrial cancers.

TARGETED SURGICAL APPROACHES FOR OVARIAN CANCER PREVENTION

We are interested in undertaking studies in the area of targeted surgical prevention strategies for prevention of ovarian cancer.

PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal): National study on Early Salpingectomy and delayed oophorectomy for ovarian cancer prevention in high risk women. (expected to commence in early 2018)

Defining the ovarian cancer ‘risk thresholds’ for risk reducing salpingo-oophorectomy (RRSO) for ovarian cancer prevention.

We have developed models to define the risk thresholds for undertaking surgical prevention for ovarian cancer. This provides utility for implementing model based risk and testing for intermediate risk genes. Guidelines for surgical prevention of ovarian cancer need changing.

Exploring attitudes, acceptability, barriers and behaviour towards salpingectomy and salpingo-oophorectomy based surgical prevention strategies in high, intermediate and low risk women.

Developing studies around opportunistic salpingectomy in low risk women.

OVARIAN & ENDOMETRIAL CANCER SCREENING

We collaborate with the team at Dept of Women’s Cancers, University College London on ovarian and endometrial cancer screening research projects.

UKFOCSS (United Kingdom Familial Ovarian Cancer Screening Study): UK National trial for screening for ovarian cancer in high risk women.

ALDO (Avoiding Late Diagnosis of Ovarian Cancer): Ovarian cancer screening in high risk women using 4 monthly Ca125 based ROCA (Risk of Ovarian Cancer Algorithm) and annual ultrasound scan. This is a project undertaken through the Vanguard initiative and is expected to commence in spring 2018. Centres include: University College London, Barts Health, Hammersmith/Imperial and Manchester.

OTHER

Developing core outcome sets (COS) for gynaecological cancers

We are developing patient reported core outcomes sets for endometrial cancer, atypical endometrial hyperplasia and fertility sparing treatment in cervical cancer in collaboration with Prof Khalid Khan’s group at Blizzard Institute, QMUL. This work is supported by a CRUK grant.

Collaboration with Tata Medical Cancer Centre Kolkata

We are partners on their UKIERI - UK India Education Research Initiative, Dept Science & Technology Grant. Investigating BRCAness in epithelial ovarian cancer in India to develop stratified surgical & chemotherapy options. We are helping TMC Kolkata to help establish an organized familial gynaecological cancer and genetic testing clinical service.

We collaborate on Quality of life and cost-effectiveness studies in endometrial cancer with teams at UCL and London School of Hygiene and Tropical Medicine.

Collaboration - CanRisK Programme: Developing models for predicting ovarian, breast and prostate cancer risk: We collaborate on a CRUK programme grant led by Prof Antonis Antoniou, Cambridge.

CLINICAL TRIALS IN GYNAECOLOGICAL ONCOLOGY

Collaborator and Barts Health PI on number of gynae-oncology trials:

SHAPE: Simple Hysterectomy and Pelvic Node Dissection in early stage low-risk cervical cancer study. Phase III RCT comparing radical hysterectomy and pelvic node dissection vs simple hysterectomy and pelvic node dissection in patients with low-risk early-stage cervical cancer.

STATEC: Selective Targeting of Adjuvant Therapy for Endometrial Cancer trial. International RCT of non-selective versus selective adjuvant therapy in high risk apparent stage 1 endometrial cancer (EC).

ROCkeTS: Refining Ovarian Cancer Test Accuracy Scores. A test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer.

SOCQER-2: Surgery in Ovarian Cancer – Quality of Life Evaluation Research study. Multicentre international Quality of life study following ultra-radical surgery for ovarian cancer.

GROINSS-V-II: GROningen INternational Study on Sentinel nodes in Vulvar cancer. International observational study on sentinel node in early stage vulvar cancers.

CLINICAL INTERESTS

• Advanced complex laparoscopic surgery in gynaecological oncology

• Ultraradical debulking surgery for ovarian cancer

• Sentinel Node technique in gynaecological cancers

• Familial gynaecological cancer

My clinical practice is at the Royal London Hospital, Barts Health NHS Trust.

TRAINING IN GYNAECOLOGICAL ONCOLOGY

• Mentor- IGCS Gynecologic Oncology Global Curriculum & Mentorship Program: Involved in the IGCS (International Gynecological Cancer Society) Sister Society Initiative supporting training in Low/Middle Income Countries

• We are a RCOG and ESGO recognised training centre and have an active Gynaecological oncology sub-speciality training programme supporting training of UK and European trainees

• Deputy Director Gynaecological oncology RCOG training programme Barts Health

• London Deanery Lead for RCOG Advanced Profession Module (APM) in Clinical Research, North & North-East London

• Member OOP (Out of Programme) London Deanery Academic committee for appointment and monitoring of Academic Trainees

• Development of an online member network tool for IGCS (for trainees and general members)

• We support training in gynaecological oncology and management of familial gynaecological cancer at TMC Kolkata, India

• Running workshops for trainees in gynaecological oncology

• We are interested in evaluating outcomes and factors affecting gynaecological oncology training

Profile

I joined Barts Cancer Institute as a Clinical Senior Lecturer and Consultant Gynaecological Oncologist in June 2015. I previously worked from 2014 as a Consultant Gynaecological Oncologist at St Bartholomew’s Hospital & was an Honorary Senior Lecturer at University College London, UK.

I completed a PhD in gynaecological oncology at UCL, along with subspecialty training in gynaecological oncology from UCLH and Bart's Hospital. I have served as the president of the European Network of young Gynaecological Oncologists (ENYGO) and a member of the European Society of Gynaecological Oncology (ESGO) council (2011-2013).

I chair the Gynecological Oncology clinical trials group at Barts & QMUL. I am a member of the NCRI Ovarian Cancer Surgical Sub group. I am Acting-PI, research lead and co-ordinator of the GCaPPS (Genetic Cancer Prediction through Population Screening) trial; CI on PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal) trial, the PROMISE Feasibility Study and the SIGNPOST (SystematIc GeNetic testing for Personalised Ovarian cancer Therapy) study. I am a co-investigator of the ‘Predicting Risk of Ovarian Malignancy, Improving Screening and Early detection’ (PROMISE) 2016 programme, member of the UKFOCSS (UK Familial Ovarian Cancer Screening Study) team. I lead the Bart's Hospital familial gynaecological cancer clinical service and co-chair the London Cancer high-risk gynaecological cancer MDT.

I am also actively involved in gynaecological oncology training issues, have helped develop and establish ENYGO (European Network of Young Gynaecological Oncologists) from its inception and both led and undertaken a number of initiatives for European and International trainees in gynaecological oncology. I am the deputy director of the Barts Health RCOG gynaecological oncology training programme and Mentor for the IGCS Gynecologic Oncology Global Curriculum & Mentorship Program. I am lead for the RCOG Advanced Professional Module (APM- Research) for trainees in North/North-East London.

Previous posts

March 2014 – May 2015 - Consultant Gynaecological Oncologist at Barts Hospital & Honorary Senior Lecturer at University College London.

Feb 2010 – Feb 2014 - NIHR Walport Clinical Lecturer & Sub-Specialty trainee Gynaecological Oncology (University College London Hospital, Bart’s Hospital, University College London)

Feb 2007 – Jan 2010 - Clinical Research Fellow, Gynaecological Oncology (University College London)

Sep 2001 – Jan 2007 - Specialist Registrar Obstetrics & Gynaecology East of England Training Programme (Cambridge rotation)

July 2000 – July 2001 - Indian Council Medical Research Fellowship, Obstetrics & Gynaecology, All India Institute of Medical Sciences, India

July 1993 – Oct 1999 - Junior and Senior Resident Obstetrics & Gynaecology (6 year training programme), All India Institute of Medical Sciences (AIIMS), India

Education & Qualifications

2014 CCT in Gynaecological Oncology and CCT in Obstetrics & Gynaecology

2014 BSCCP accreditation in Colposcopy: BSCCP

2013 PhD (Gynaecological Oncology): University College London, UK

2011 NIHR Leadership Programme for Trainees: Ashridge Business School, UK

2005 MRCOG : Royal College of Obstetricians & Gynaecologists (RCOG), UK

1996 MD (Obstetrics & Gynaecology): All India Institute of medical Sciences (AIIMS), Delhi, India

1993 M.B.B.S : All India Institute of medical Sciences (AIIMS), Delhi, India

Funding

2017-2020 PROTECTOR (Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal) study. Role – CI; £368,142, Barts & the London Charity

2017-2020 Investigating BRCAness in epithelial ovarian cancer in India to develop stratified surgical & chemotherapy options. Role- Co-investigator, Partner. £194,405 UKIERI - UK India Education Research Initiative, Dept Science & Technology (India)

2016-2018 Systematic genetic testing for gynaecological cancers. Role- CI; £81,000 Barts Charity

2016-2019 Developing Core Outcomes Sets to standardise reporting in endometrial cancer & atypical endometrial hyperplasia. Role- Co-investigator; £163,790, Cancer Research UK

2016-2018 Evaluating cost-effectiveness of population testing for ovarian & breast cancer gene mutations. Role – CI; £77,340/- The Eve appeal

2016-2019 Systematic genetic testing for ovarian cancer. Role- CI; £178,000 Barts Charity

2017-2018 PROMISE Feasibility Study. Role- CI; £130,000 CRUK & The Eve appeal

2011-2018 PROMISE 2016 Programme. Role - Co-investigator; £3.26M CRUK & The Eve appeal

2015-2018 Use of Plasmajet in ultraradical ovarian cancer surgery. Role- Co-investigator; £77,000 Bart’s Charity

2008-2018 Genetic Cancer Prediction through population Screening (GCaPPS). Acting CI; £561,523 The Eve Appeal.

2010-2014 NIHR Walport Academic Clinical Lecturer Award. £261,800, NIHR

Key Publications

Manchanda R, Patel S, Gordeev V, Antoniou AC, Smith S, Lee A, Hopper JL, MacInnis RJ, Turnbull C, Ramus SJ, Gayther SA, Pharoah PDP, Menon U, Jacobs I, Legood R. Cost-effectiveness of population-based BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 mutation-testing in unselected general-population women. J Natl Cancer Inst (2018); PMID: 29361001

Patel S, Legood R, Evans DG, Turnbull C, Antoniou AC, Menon U, Jacobs I, Manchanda R. Cost effectiveness of population based BRCA1 founder mutation testing in Sephardi Jewish women. Am J Obstet Gynecol (2018); PMID: 29288066

Manchanda R, Patel S, Antoniou AC, Levy-Lahad E, Turnbull C, Evans G, Hopper J, MacInnis RJ, Menon U, Jacobs I, Legood R. Cost-effectiveness of population based BRCA testing with varying Ashkenazi Jewish ancestry. Am J Obstet Gynecol (2017); PMID: 28690137

Manchanda R, Legood R, Antoniou AC, Gordeev SV, Menon U. Specifying the risk threshold of premenopausal risk reducing salpingo-oophorectomy for ovarian cancer prevention: a cost-effectiveness analysis. J Med Genet. (2016); 53:591–9 PMID: 27354448

Manchanda R, Burnell M, Loggenberg K, Desai R, Wardle J, Sanderson S, Gessler S, Side L, Balogun N, Kumar A, Dorkins H, Wallis Y, Chapman C, Tomlinson I, Taylor R, Jacobs C, Legood R, Raikou M, McGuire A, Beller U, Menon U, and Jacobs I. Cluster randomised non-inferiority trial comparing DVD-based and traditional genetic counselling in systematic population testing for BRCA1/2 mutations. J Med Genet. (2016); 53(7):472-80 PMID: 26993268

Manchanda R, Legood R, Burnell M, McGuire A, Raikou M, Loggenberg K, Wardle J, Sanderson S, Gessler S, Side L, Balogun N, Desai R, Kumar A, Dorkins H, Wallis Y, Chapman C, Taylor R, Jacobs C, Tomlinson I, Beller U, Menon U, and Jacobs I. Cost effectiveness of population screening for BRCA mutations in Ashkenazi-Jewish women compared to family-history based testing. J Natl Cancer Inst. (2015); 107(1) PMID: 25435542

Manchanda R, Loggenberg K, Sanderson S, Burnell M, Wardle J, Gessler S, Side L, Balogun N, Desai R, Kumar A, Dorkins H, Wallis Y, Chapman C, R, Jacobs C, Tomlinson I, McGuire A, Beller U, Menon U, and Jacobs I. Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomised controlled trial. J Natl Cancer Inst. (2015); 107(1) PMCID: PMC4301703

Jervis S, Song H, Lee A, Dicks E, Harrington P, Baynes C, Manchanda R, Easton D, Jacobs I, Pharoah P, Antoniou A. A Risk Prediction Algorithm for Ovarian Cancer Incorporating BRCA1, BRCA2, Common Alleles and Other Familial Effects. J Med Genet. (2015); 0:1–11. PMID: 26025000

Manchanda R, Godfrey M, Wong-Taylor LA, Halaska MJ, Burnell M, Grabowski JP, Gultekin M, Haidopoulos D, Zapardiel I, Vranes B, Kesic V, Zola P, Colombo N, Verheijen R, Bossart M, Piek. The need for accredited training in gynaecological oncology: a report from the European Network of Young Gynaecological Oncologists (ENYGO). J. Ann Oncol. (2013); 24(4), 944-52 PMID: 23172637

Rosenthal AN, Fraser L, Philpott S, Manchanda R, Burnell M, Badman P, Hadwin R, Rizzuto I, Benjamin E, Singh N, Evans DRG, Eccles DM, Ryan A, Liston R, Dawnay A, Ford J, Gunu RG, Mackay J, Skates SJ, Menon U, and Jacobs IJ. Evidence of stage-shift in women diagnosed with ovarian cancer during Phase 2 of the UK Familial Ovarian Cancer Screening Study (UKFOCSS). J Clin Oncol (2017); PMID: 28240969


Further Publications

For additional publications, please click here

My main research areas are:

  • Risk prediction, screening and prevention of ovarian and endometrial cancer
  • Population based approach(es) to genetic testing for risk stratification and cancer prevention
  • Targeted surgical approaches for prevention of gynaecological cancer
  • Familial gynaecological cancer

External Activities

• Member Editorial Board International Journal of Gynecological Cancer 2018-

• Deputy Director Gynaecological oncology RCOG training programme Barts Health, 2017-

• Mentor on the IGCS Gynecologic Oncology Global Curriculum & Mentorship Program, 2018-

• London Deanery lead for RCOG Advanced Profession Module (APM) in Clinical Research, North & North-East London, Dec 2017-

• IGCS Gynaecological oncology Online Global network Moderator, 2018-

• Lead Familial Gynaecological Cancer Service, Barts Health NHS Trust, 2014-

• Member UKCTOCS Trial Outcomes Committee, 2016-

• Member Surgical Working Group, NCRI Ovarian Cancer Subgroup, 2016-

• Co-Chair London Cancer High risk Gynaecological Oncology MDT, 2016-

• Chair Gynaecological Oncology Trials Group, Barts Health, Bart’s Cancer Institute, 2015-

• Member OOP (Out of Programme) London Deanery Academic committee for appointment and monitoring of Academic Trainees

• Scientific advisor BRCA Umbrella, 2014-

• Member ESGO Task Force: Prevention, Early diagnosis of Women Cancers (ENPIGO): 2014-

• President ENYGO (European Network of Young Gynaecological Oncologists): 2011 – 2013

• ESGO (European Society Gynaecological Oncology) Council member Sep 2011 - Oct 2013

• Organised/directed Cadaveric workshops on advanced laparoscopic surgery in gynaecological oncology: AIIMS Delhi, India 2018, 2017, 2015 and 2012; Bangalore, India 2015 (AGOI); London, UCLH (ESGO) 2012

• Organisation of a number of national and international workshops and meetings

News

Feb 2018: William Blair Bell Memorial Lecture Award- RCOG

Jan 2018: Invited speaker- P4 and Precision medicine in ovarian cancer. Tata Memorial Centre, Kolkata.

Jan 2018: Invited speaker- An overview of ovarian cancer prevention and clinical trials. Keynote lecture, KolGOTRG (Kolkata Gynaecological Oncology Translational Research Group) inaugural meeting, Kolkata.

Dec 2017: Invited Speaker, Role of laparoscopic surgery in ovarian cancer. ‘Frontiers of Oncology – Women’s Health’ Meeting, Royal College of Obstetricians and Gynaecologists, London

Nov 2017: Invited Speaker, Chemoprevention & prophylactic surgery for ovarian cancer. 25th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI), Vienna, Austria

Nov 2017: Invited Speaker, Hereditary Gynaecological Cancers: Prevention and Role of Prophylactic Surgeries. Prevention of Gynaecological Cancers- State of the Art. 20th International Meeting of the European Society of Gynaecological Oncology (ESGO 2017), Vienna, Austria

Oct 2017: Invited Speaker, Prevention of Ovarian Cancer: Options and Adverse effects. 26th Annual ESGE Congress, Antalya, Turkey

Advances and Controversies around Ovarian screening and Prevention. Welsh Obs and Gynae Society (WOGS) Meeting: 13 Oct 2017, Swansea, Wales.

May 2017: Chair Gynaecology working group session, NCRI workshop: The role of Germline Genetic Profiling for risk-based prevention and cancer screening, London.

April 2017: Invited Speaker, Gynae Oncology Trials. University College London Partners (UCLP) Research Day.

Mar 2017: Key Note Speaker, Population testing for risk stratification and ovarian cancer prevention. Annual Research Summit, Clinical Support Services CAG, Bartshealth NHS Trust.

Mar 2017: Invited Speaker, Population based testing for targeted ovarian cancer prevention. Annual Academic Meeting Joint RCOG/ Blair Bell Research Society, RCOG, London.

Feb 2017: Invited speaker, Para aortic node dissection. 3rd Cadaveric Workshop Gynae Onco Skills, FOGSI oncology committee and AGOI, AIIMS, Delhi, India

In the media

BBC News 'Angelina Jolie gene testing for all?

The Times 'Health chiefs urged to offer all women £175 genetic test for cancer'

Sky News 'All women over 30 should be tested for faulty cancer gene, researchers say'

Channel 4 News '80,000 cases of cancer in women 'preventable' if gene mutation screenings were offered'

 

See other researchers working on:

Clinical Trials Genetics Ovarian Cancer
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