Cancer care depends on drug clinical trials, but also on surgery, radiotherapy and survivorship trials. These studies are crucial but face unique challenges in Ireland.

While people often associate clinical trials with new medicines, research in Ireland also focuses on surgery, radiotherapy, nursing and lifestyle interventions. These studies are equally important in shaping cancer care and improving patients’ quality of life.

Why non-drug trials matter

As surgical co-chair of the Gastrointestinal Disease-Specific Subgroup of Cancer Trials Ireland, I see the critical role of investigator-led studies in addressing questions that drug trials cannot. We’re developing a Phase III multicentre randomised controlled trial for resectable T3 rectal cancer, comparing two approaches: standard long-course chemoradiotherapy and total neoadjuvant therapy pre-surgery. Key outcomes include complete response, organ preservation (avoiding pelvic surgery and possible stoma formation), disease-free survival and overall survival. It’ll also use serial measurements of circulating tumour DNA to assess minimal residual disease. Although proposed, it’s not yet open due to funding and start-up challenges.

Ireland is also involved in international surgical research that can advance cancer care. The MelMarT study examines whether narrower versus wider excision margins in melanoma surgery can safely remove cancer while reducing wound complications. The TAXIS study evaluates de-escalating axillary surgery in node-positive breast cancer by combining targeted lymph node removal with radiotherapy to lower risks of lymph node dissection while maintaining regional control.

sustainable capacity for non-drug research demands targeted investment, protected clinician time and cross-disciplinary collaboration.

Our challenges

Non-drug trials are often harder to establish. They require institutional backing because surgical and lifestyle interventions are complex to standardise and measure, and often depend on limited public or charitable funding. Staffing shortages, especially in research nursing and radiotherapy, also restrict capacity, with radiotherapy facing a major workforce gap. This year’s Cancer Trials Ireland Cancer Retreat highlighted that sustainable capacity for non-drug research demands targeted investment, protected clinician time and cross-disciplinary collaboration. Figures from the Retreat showed that Denmark, a similar-sized country, has about 75 registered nurse-led cancer trials, while Ireland has around seven.

Non-drug trials create opportunities to evaluate safer surgical options, enhanced recovery and better long-term outcomes, including survivorship. With adequate support, Ireland can build on its collaborative tradition and ensure that research in surgery, radiotherapy and survivorship flourishes alongside drug development.

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Mohsen Javadpour

Consultant Neurosurgeon at Beaumont Hospital

Professor Mohsen Javadpour and Dr Lisa Costelloe discuss how breakthrough studies in brain aneurysms and Multiple Sclerosis (MS) monitoring are helping clinicians deliver safer, smarter and more effective neurosurgical and neurological care.

Consultant neurosurgeon Professor Mohsen Javadpour speaks of his special interest in brain aneurysm research, highlighting its tangible impact on risk factor consultation and interventional treatment pathways.

Brain aneurysm research

“About 3% of the population harbour an aneurysm, most of which never rupture. So, what makes an aneurysm rupture?” he asks.

To answer this, Javadpour and his team built a prospective risk model database at Beaumont Hospital, alongside local audit nurses and nurse specialists who’ve helped to collect data on over 1,000 cases of subarachnoid haemorrhage (SAH).

“Analysing cases of ruptured aneurysm helped us to clearly identify major risk factors: hypertension increases risk 2.5-fold, smoking eightfold, but combined, the risk rises thirtyfold. This changes the way we speak to our patients about prevention.”

Further research includes leading an international multicentre study examining risk factors for aneurysm recurrence following treatment and the prospective use of aggressive, early intervention for poor-grade SAH. “Poor grade SAH has traditionally been managed in a delayed fashion, but our study of 250 patients showed that early treatment allowed over half of patients to survive and remain independent, particularly younger patients.”

“Neurosurgical research involves assessing high-risk procedures, making trial design and patient recruitment challenging,” continues Javadpour. “Despite this, neurosurgery has been at the forefront of randomised controlled trials, with our clinical research centre running and participating in multiple international studies.”

This is an extremely exciting and fruitful area of research at the moment, with a real potential to drive meaningful change for MS management

Novel outcome measure for multiple sclerosis

The last decade has transformed multiple sclerosis (MS) care, with an expansion of disease-modifying therapies providing hope to the 2.9 million people affected globally. To measure the effectiveness of potential drug candidates, novel outcome measures are urgently needed to capture subtle changes in disease activity and progression. Dr Lisa Costelloe, consultant neurologist, explains.

“Outcome measures for MS need to reflect the full diversity of the symptoms experienced,” she explains. “We often see patients with MS who feel their condition has worsened, but their MRI hasn’t changed. In addition, cognitive difficulties, fatigue, visual changes and subtle disease progression cannot always be captured with standard MRI monitoring.”

Driving effective patient management, Dr Costelloe’s team is investigating a novel potential biomarker, ocular microtremor (OMT), alongside measures of gait and cognition, as well as standard clinical monitoring. With funding from Enterprise Ireland and collaboration with local medtech company, Head Diagnostics, the research hopes to provide more comprehensive, accurate and real-time data on MS disease activity.

“We’re lucky to receive funding for this project, without which, it wouldn’t be possible,” continues Costelloe. “This is an extremely exciting and fruitful area of research at the moment, with a real potential to drive meaningful change for MS management.”

The RCSI CRC supports research within Beaumont Hospital, providing the infrastructure, support and high-level quality management needed to run complex clinical trials in-house, allowing principal investigators at Beaumont Hospital to “engage ethically and effectively in research,” explains Javadpour. “We have a strong track record of research at Beaumont, and we’re well equipped for clinical trials.”

“The clinical research centre provides the perfect infrastructure to conduct high-quality clinical research,” explains Dr Costelloe. “We have the expertise, allied services on site and a large population of neurological patients, making it an excellent platform for securing research funding.”

The expertise and infrastructure of both Beaumont Hospital and the RCSI CRC combined make it the perfect partner for international clinical research. This is evidenced by involvement in the recent neurosurgical study — the BONANZA trial — within which Beaumont Hospital is the highest recruitment site in Europe.

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Biobanks are the backbone of cancer research and a vital tool in understanding many illnesses, including rare diseases and cancers that need large numbers of samples to gain crucial insights.

Biobanks play one of the most important roles in medicine. By providing researchers with carefully curated samples and linking them with anonymised clinical data, biobanks help speed up the development of new tests, new treatments, and more personalised care for today’s and tomorrow’s cancer patients.

Patient-centred biobanks

For this to be meaningful, it must be done responsibly. Every sample collected in a biobank is stored and handled with strict quality and ethical standards, including consent.

In Ireland, however, biobanks are spread out across the country, which can make it harder for researchers to access the materials they need. The Biobank Ireland Trust, a charity founded in 2004, aims to change that by connecting these collections into a single, coordinated national network whilst always keeping patient voices at the centre of its work.

These samples are precious, and discoveries that lead to tomorrow’s cures will come from the biobank collections we build today.

Collaborative effort in building tomorrow’s cures

A biobank is more than a room of freezers. It takes a team of professionals to gather, label, store and look after each sample, whether it’s a small piece of tumour tissue, a blood sample, or medical images. These samples are precious, and discoveries that lead to tomorrow’s cures will come from the biobank collections we build today.

The Trust is already making real progress. It helps link biobanks across the Island from Biobanc na Gaillimhe and Trinity St James’s Biobank to Cork University Hospital, St Vincent’s University Hospital and the Northern Ireland Biobank. In October, the Trust and Biobanc na Gaillimhe held the first-ever All-Island Biobanking Symposium in Dublin, bringing experts together to focus on technical advances and the patient experience. The Trust is also working with Health Research Charities Ireland and the University of Galway to publish the first national ‘Biobanking in Ireland’ directory.

Our work is supported by our Biobank Warriors, volunteers who run marathons, compete in triathlons, organise golf events and more to raise vital funds.

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Nikki Kane

COO, Mater Private Network

Ireland’s push toward digitisation is accelerating, with electronic health records (EHRs) forming the backbone of community-focused care.

While technology adoption might feel like a step away from human-led care, Ireland’s Digital Health Strategy places people firmly at the heart of its transformation.

Digitisation is expected to eliminate the delays and duplication caused by patient records being held across multiple locations. In the longer term, sharing data seamlessly between acute hospitals, primary care and community services can be essential to the Health Service Executive’s (HSE) shift toward more community-based care.

The Strategy is guided by a roadmap running from 2024 to 2030, with much of its success dependent on EHRs, a secure digital version of a patient’s health record.

Decades of groundwork toward digitisation shift

The shift towards digitisation may feel like a leap, but organisations like MEDITECH have been laying the groundwork for decades.

MEDITECH Executive Director, International, Gina Kerley explains, “We began work in Ireland back in 2002 when patient records were stored in filing cabinets and departments had little to do with each other. Over time, the sector has moved towards end-to-end EHRs that span the entire continuum of care.”

MEDITECH has developed tools such as its Expanse platform — a web-based EHR that brings patient information into a single longitudinal record. Today, it’s the EHR supplier to more than 80% of the private healthcare market in Ireland.

Unified records shape patient care

Among the first to adopt EHRs is Mater Private Network, which provides care in 12 locations in Ireland. They took an all-or-nothing approach, implementing MEDITECH’s Expanse platform in 2024 in two phases, with less than three months between phases     .

The move from manual documentation to a single unified patient record started years earlier and involved training around 2,500 staff, from finance and administration to nurses and independent consultants.

But, as Nikki Kane, Chief Operating Officer of Mater Private Network, explains, the benefits are already evident. “From a patient point of view, it has definitely improved safety, because you have all the information there when it’s needed.”

sharing data seamlessly between acute hospitals, primary care and community services can be essential to the Health Service Executive’s (HSE) shift toward more community-based care.

EHRs’ real-time data and ability to access information instantaneously can enable teams to respond in emergencies, track referrals and monitor clinical outcomes.

“In terms of what we can do with that data from a patient-experience perspective, that can ultimately transform healthcare,” concludes Kane, who views this as just the start of a digital journey. With the EHR in place, the scope for future integrations such as AI-driven tools is huge.

Kerley continues, “We have a genomics solution that continues to evolve. For example, if a patient has a genetic factor, there may be specific medications that work more effectively for them, or others that should be avoided and that will be flagged. This enables physicians to identify the best medication and dosage based on a patient’s genetic information, which ultimately leads to better outcomes and fewer side effects.”

Integrated AI-enabled analytics can help predict patient no-shows and streamline appointment scheduling. AI technologies are also improving the clinician experience, reducing administrative burden and giving time back to patient care.

As the HSE aims to shift care from hospital settings to community-based support, joined-up services and interoperability become more critical. Adopting standardisation among EHRs will be key to ensuring a connected healthcare system with patient needs at the heart. It will also open opportunities for greater transparency and autonomy via the HSE Health App — dubbed the ‘Digital Front Door.’ Having worked on implementing EHRs in healthcare settings worldwide, Kerley believes Ireland is poised to reap the benefits. “The foundation is just getting the right EHR in. The journey really begins once the platform is in place and its tools, data and interoperability come together to support better decisions and improve care.”

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David Mccarthy

Patient in Metabolic Trial

Kate Coyle

Parent of Patient in a Duchenne Muscular Dystrophy Phase 1 clinical trial

Martina Nolan

Patient in Phase 3 Clinical Trial relating to Polymyalgia Rheumatica

Clinical Research Facility showcases the real-world impact of clinical trial involvement, with patient case studies spanning neurology, cardiology and metabolic disorders.

For many, clinical trials are something you hear about from a distance, but for some, it’s an everyday reality. The Wellcome HRB Clinical Research Facility at St James’s Hospital, a state-of-the-art research facility in Ireland, hopes to highlight the real-world impact of clinical trials on everyday people.

“There’s something really comforting about the consistency you get when you participate in a clinical trial,” explains Harry Freed, currently involved in a trial targeting cardiac amyloidosis, a hereditary condition that also affected his brother. “My brother also participated in clinical trials and believed deeply in contributing to new knowledge — that perspective stayed with me.”

My brother also participated in clinical trials and believed deeply in contributing to new knowledge — that perspective stayed with me.

Real-world outcomes

Clinical trials represent the difference between the standard of care and therapeutic innovation, often looking at the current therapeutic landscape through a new lens to discover new treatments. While not knowing whether you’re on a placebo or an active drug can be unsettling, tangible clinical outcomes and drug approvals can help address these concerns.

“Because my condition is so common, I expected treatments to be available,” explains Martina Norman, who has been involved in a Polymyalgia Rheumatica (PMR) clinical trial for the last 18 months. “I recently saw a new drug announced for my condition, and it made me feel proud. Being part of research that helps get these drugs approved is incredibly rewarding.”

Dave McCarthy, who has worked in St James Hospital for many years, has seen a range of life-changing and measurable clinical outcomes from his involvement in an obesity drug treatment trial. Losing four stone through the trial has significantly improved his BMI, cholesterol and blood pressure. “This trial has genuinely given me my life back; I am healthier and more energised than I’ve ever been.” 

For some, clinical trials mean the difference between life and death. With no curative treatments currently available for Muscular Dystrophy, Catherine, mother of 13-year-old patient Ingus, views clinical trial involvement as an act of remarkable courage, paving the way for the discovery of new treatments. “The level of care is definitely higher within a research facility, likely because clinical trials are run to specific standards and procedures,” she explains. “There are so many people working hard behind the scenes to make these trials possible, and everyone who participates in a clinical trial is very courageous, giving up their time and data for the benefit of others facing the same illness.”

“Our family owes a huge debt of gratitude to St James’s for having the vision and courage to repeatedly seek the funding needed to bring its facilities to the highest standard. Their commitment has helped make it possible for organisations and pharmaceutical partners to invest in Ireland, and, most importantly, to invest in the people of Ireland.”

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Dr Araz Raoof

University College Dublin, ARC Hub for Therapeutics Executive Director

National research hub bridges Ireland’s biopharmaceutical sector with the academic ecosystem, accelerating research towards commercial success and cultivating the next generation of research entrepreneurs.

Ireland has the highest number of third-level graduates in Europe per population among people aged 25–34, with 25% of PhD graduates pursuing employment in the biopharmaceutical sector. “Ireland may seem small, but it’s the 3rd largest exporter of pharmaceuticals worldwide, with a strong foundation of technology, making it well placed to innovate within the therapeutic space,” explains Professor Vincent Kelly, Academic Director.

The ARC Hub for Therapeutics is leveraging Ireland’s biomedical infrastructure to support early-career researchers. “The sheer depth of knowledge required to develop a therapeutic is enormous,” explains Kelly. “We’re supporting early-career researchers to realise their commercial ideas, connecting them to an ecosystem of support far wider than their academic institutions.”

Multi-institution partnership and mentorship

Hosted at Trinity College Dublin, alongside University College Dublin and the Royal College of Surgeons, the ARC Hub will strengthen collaboration and knowledge transfer between universities, investors, industry and clinicians to create new therapeutic products, industry licenses and high-quality spin-outs indigenous to Ireland.

“The risk is high in therapeutics, and community is important,” explains Dr Araz Raoof, Executive Director. “The Hub brings together a diverse skillset of expertise and comprehensive operational models to help researchers with concept validation, clinical development and competitive analysis, helping to shape and mature ideas.”

The Hub connects key stakeholders in therapeutic development, combining experts in project management, discovery research and business development with leading academic institutions, which Kelly refers to as Ireland’s “powerhouses of research.”

The sheer depth of knowledge required to develop a therapeutic is enormous,

Strategic investment in therapeutic innovation

The ARC Hub for Therapeutics is co-funded by the Government of Ireland and the European Union through the ERDF Southern, Eastern and Midland Regional Programme 2021-2027, and aligned with national priorities to affirm Ireland as a hub for therapeutic discovery. “We’re catalysts and connectors, a key player in driving therapeutic innovation at both a national and European level,” explains Raoof, “We hope to have a voice in driving the national life science strategy.”

The ARC Hub is helping Ireland realise its promise as a leading biomedical ecosystem, creating a pool of researchers with therapeutic discovery mindsets, and promoting discovery in high-priority areas such as small-molecule programmes, gene therapy, biomaterials and therapeutic biomarkers.

To mark the progress made since inception, The ARC Hub for Therapeutics held a ‘launch event’ bringing together academics, investors, business leaders, researchers and international accelerator programmes to showcase the projects underway and the possibilities for future innovation.

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With advances in screening, earlier diagnosis and improved treatments for breast cancer, the five-year survival rates have improved to up to 87%. BreastCheck plays a vital role in cancer care in Ireland.

Around one-third of all breast cancer cases diagnosed each year are identified through BreastCheck. This invaluable national screening service is provided free to women aged 50–69 years. To avail of this screening service, women should check that they are registered on Registration – Breastcheck. If you are not registered, you will not receive an invitation to the screening service.

Examine your breasts and get checked

The risk of developing breast cancer increases with age and is more common in women aged 50 or older who have been through the menopause. However, cancer can occur at any age. Therefore, it is important that women and girls are aware of the signs and symptoms.

We encourage girls from the age of 18 years to carry out a monthly self-breast examination. Women should know what looks and feels normal for them and when changes occur. If changes occur between screening appointments, it is important to get checked. Find more information on how to check your breasts on cancer.ie/breast-cancer.

We encourage girls from the age of 18 years to carry out a monthly self-breast examination.

Signs and symptoms of breast cancer

The following are the signs and symptoms of breast cancer, and you should always consult your doctor to discuss these symptoms.

• A lump or thickening in your breast or armpit.
• A change in the size or shape of one breast.
• A change in the skin of your breast, like puckering or dimpling (the skin may look like orange peel).
• A breast abscess (infected boil); this may appear as a red, tender area on your breast.
• A change in your nipple, like a pulled-in (inverted), sunken or flattened nipple.
• An unusual discharge (liquid) from one or both of your nipples; the discharge may be blood-stained or watery.
• A change on or around the nipple, like a rash or flaky or crusted skin.
• Swelling in your armpit or around your collarbone.

If you are worried or have concerns about breast cancer or any cancer, call the Irish Cancer Society Support Line on Freephone 1800 200 700 or email supportline@irishcancer.ie

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Generative artificial intelligence (AI) and large language models are transforming every facet of society — cancer research is no exception.

At the recent Irish Association for Cancer Research (IACR) 2025 meeting in Belfast, the session ‘AI in Cancer Research’ showcased how cutting-edge AI technologies are reshaping approaches across cancer biology.

Discussions ranged from mapping genetic vulnerabilities in cancer cells to understanding interactions between cancer drivers and the tumour immune microenvironment. In a standout moment, Dr Fredrik Strand, Consultant Radiologist at the Breast Imaging Unit at Karolinska University Hospital, presented about a clinical study leveraging machine learning to improve breast cancer outcomes.

ScreenTrustMRI trial

The study¹ (ClinicalTrials.gov registration: NCT04832594) addressed a critical challenge: breast cancers are often missed by routine mammography, particularly in women with dense breast tissue. Breast density is the proportion of fibroglandular tissue compared to fatty tissue within the breast. High breast density poses a challenge for standard mammogram interpretation because dense tissue appears white on the image, similar to many tumours, making it difficult to visually detect small or suspicious lesions.  While MRI offers superior accuracy for early cancer detection, its high cost limits its use in standard screening programs. To bridge this gap, the team developed AISmartDensity, an AI tool that reviews mammograms to identify women at high risk of undetected cancer, recommending supplemental MRI for these cases.

The results were striking. The detection rate — 64.4 breast cancers per 1,000 MRI exams — is almost four times higher than the DENSE² trial, which relied on traditional breast density measures.

Although widespread MRI referral may not be feasible in all healthcare systems, AISmartDensity offers additional value by flagging suspicious mammograms for radiologist re-review, enabling earlier intervention for high-risk patients.

The detection rate — 64.4 breast cancers per 1,000 MRI exams —
is almost four times higher than the DENSE² trial, which relied on traditional breast density measures.

AI’s promise for precision oncology

This study underscores the transformative potential of AI in cancer detection, offering just a glimpse of what machine learning can achieve in advancing precision oncology. A recent review in Nature Cancer³ highlights three areas where AI is poised to deliver the greatest impact: cancer prevention and diagnosis, optimisation of existing treatments and acceleration of new therapy development. Collectively, these innovations demonstrate how AI isn’t only enhancing current clinical practice but also redefining the future of cancer research and treatment.

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Ireland took a leading role at the world’s largest lung cancer conference this year, with insights that will shape both global and Irish oncology research.

This September, I had the honour of serving as one of the Chairs of the IASLC World Conference on Lung Cancer (WCLC 2025) in Barcelona, the world’s largest meeting dedicated to lung cancer.

Sharing this role with Dr Noemí Reguart, Prof Umberto Malapelle and Prof Isabelle Opitz was a privilege and milestone for Ireland. It highlights the standing of Irish oncology in the international community and our growing contribution through clinical trials and collaborative research.

Key highlights from Barcelona

Several breakthroughs unveiled at WCLC 2025 could change lung cancer standards of care.

Combination therapy in EGFR-mutant lung cancer: The phase III FLAURA2 trial showed improved overall survival with combination therapy. Results suggest combined approaches may offer deeper, longer-lasting benefits for selected patients.

Long-term survival with immunotherapy: Five-year results from the Phase II NADIM study showed exceptional outcomes, with survival rates near 70%. These data confirm that early-stage lung cancer can be curable for some patients.

Lung cancer screening: A major analysis of high-risk individuals (with smoking history, lung conditions or advanced age) in Manchester suggested extending screening eligibility. With Ireland’s first lung cancer screening pilot now underway in North Dublin and the Northeast (Lung Health Check), sponsored by the Irish Cancer Society, Beaumont Hospital, RCSI and the EU4Health SOLACE consortium, these findings are timely as Ireland evaluates national screening strategies.

the Phase II NADIM study showed exceptional outcomes, with survival rates near 70%.

Over 35 Irish delegates attended WCLC, including presenters from clinical, research and advocacy backgrounds. Their work showcased Ireland’s growing multidisciplinary strength in lung cancer care and its role in shaping future clinical trials.

Bringing global insights home

As Chair of the Lung Disease-Specific Subgroup of Cancer Trials Ireland, I lead national collaboration to develop and deliver new lung cancer trials. Lessons from Barcelona will directly inform our portfolio, refining trial design, broadening eligibility and aligning with cutting-edge science.

Our challenge now is to turn momentum into real progress so that international breakthroughs translate into longer lives and better outcomes for people with lung cancer in Ireland.

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Healthcare accounts for approximately 4-5% of global CO₂ emissions, and Ireland is no exception. Like health systems worldwide, Ireland needs to balance delivering high-quality care while reducing its environmental footprint.

The HSE Climate Action Strategy 2023-2050 stresses that meaningful progress requires collective action, meaning hospitals, suppliers, clinicians and communities must work together.

The urgency of sustainable healthcare

Reducing emissions is inseparable from improving population health, as climate-driven factors such as heat, air pollution and shifting disease patterns are already influencing clinical demand.

Innovation and transformation

Within Ireland, the most carbon-intensive aspects of healthcare are hospital buildings, energy consumption and the broader supply chain. Imaging particularly contributes significantly due to its high-power requirements and complex materials. However, technological innovation is reshaping sustainability in this area.

Modern MRI platforms now incorporate helium-efficient systems, represented by sealed-magnet designs like Philips BlueSeal, which use less than 0.5% of the helium previously required. This breakthrough not only reduces dependence on scarce resources but also strengthens the resilience and sustainability of healthcare services.

Similarly, next-generation CT systems offer workflow efficiencies that can reduce scan setup times by over 50%, lowering energy use per patient and streamlining care pathways.

Digital transformation is accelerating these changes. Remote clinical support, virtual training and connected-care pathways are reducing travel for both patients and clinicians, a key contributor to healthcare emissions. This shift aligns with the HSE’s growing emphasis on digital innovation, service redesign and community-centred models of care.

Ireland’s opportunity

Sustainability is now central to healthcare planning in Ireland. The country has a unique opportunity to lead by adopting circular-economy principles, investing in longer-life equipment, ensuring transparent reporting and developing low-carbon digital pathways. Through collaboration across the Irish health ecosystem, Ireland can build a cleaner, more resilient system that’s better prepared for climate risks and supports healthier people and a healthier planet.

Partnering for a sustainable future

Philips is proud to support Ireland’s healthcare system in its journey toward a low-carbon future. From helium-free MRI technology like BlueSeal to energy-efficient CT platforms and digital solutions that reduce travel emissions, Philips delivers innovations that make healthcare greener, smarter and more resilient.

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