Meet the team leading the charge against cervical cancer

Professor Maria Kyrgiou's Lab Group

Cervical Cancer Prevention Week serves as a poignant reminder of the impact this devastating disease can have on women's lives.

Every day in the UK, two women lose their lives to cervical cancer, and nine more receive a life-changing diagnosis. Although NHS England has pledged to eliminate cervical cancer by 2040, the urgency to achieve this goal sooner has never been more critical.

To raise awareness around Cervical Cancer Prevention Week, we are shining a light on the important work being done in Professor Maria Kyrgiou’s group, based in the Department of Metabolism, Digestion and Reproduction. These dedicated academics, who are at the forefront of the fight against cervical cancer, are carrying out ground-breaking research and studies with the goal of creating a world where cervical cancer is a thing of the past.  

Sophie Stephens: Investigating the microbiome

Meet Sophie Stephens, a first-year PhD student on a mission! Alongside other members of the Kyrgiou group, she is exploring how microbes in the cervix affects the development of cervical cancer. 

Sophie and her team are using a special mix called bacterial-conditioned media to mimic the vaginal microbiome. They apply this mix to a cell model that acts like cervix cells and has human papillomavirus (HPV) – a virus linked to cervical cancer.

Using this 2D cell model, they found that certain bacterium types (CST IV) impact the expression of HPV oncogenes. When these genes are active, cells multiply, producing more HPV particles and potentially causing cervical disease.

Sophie is also currently building a 3D model of the cervix that's infected with HPV. These models, called cervical organoids, will help her test a special kind of bacterial-conditioned liquid. By using these organoids, Sophie can get a more accurate picture of how HPV oncogenes (genes that can lead to cancer) drive the growth of cells. This is important because it can help us understand the biomarkers that signal the development of cervical disease and cancer

Dr Laura Burney Ellis: DNA Methylation as a diagnostic tool 

Dr. Laura Burney Ellis is a Clinical Research Fellow under the guidance of Professor Maria Kyrgiou, funded by Imperial Health Charity/NIHR Imperial BRC. Her research revolves around using DNA methylation as a biomarker for diagnosing cervical precancer and cancer. Currently, she is conducting a meta-analysis of all published literature to identify the most effective marker.

Additionally, Dr. Ellis has carried out an epigenome-wide association study in a group of women undergoing conservative management for cervical precancer. This study revealed a new site that shows promise in distinguishing between precancerous lesions that may progress to cancer and those that may regress to normal. 

The potential significance of this research lies in its ability to identify individuals at risk of developing cancer before it manifests, thereby preventing associated health issues and mortality. Moreover, it could aid in appropriately selecting patients for conservative management, potentially avoiding surgical interventions, and mitigating the associated risks on future pregnancies. 

Dr Apostolia Galani: Bridging lab findings to clinical applications 

Also at the forefront in the fight against cervical cancer is Dr. Apostolia Galani, a Clinical Research Fellow at Imperial. She specializes in innovative approaches to cervical health. Her research is dedicated to advancing the early diagnosis and treatment of cervical precancerous lesions through the development and application of metabolic technologies. In essence, she works on translating laboratory discoveries into practical applications in clinical settings for the improvement of early detection and treatment in cervical disease. 

Additionally, Dr. Galani is actively engaged in a systematic review and meta-analysis of adjunctive colposcopy technologies (using a specialised instrument known as a colposcope to examine the cervix, vagina, and vulva closely). This rigorous examination involves assessing the diagnostic performance of various technologies. By conducting this comprehensive analysis, she aims to provide valuable insights into the potential of these technologies to enhance the detection of cervical cancer. 

Dr Konstantinos Kechagias: HPV vaccination's impact on recurrence 

Meet Dr. Konstantinos Kechagias, a specialist trainee in Obstetrics & Gynaecology in the North West Thames deanery, concurrently serving as a Clinical Research Fellow at Imperial with funding from the NIHR Imperial Biomedical Research Centre and "The A.G. Leventis Foundation."  

His ongoing research is centred on investigating the impact of HPV vaccination on women undergoing surgical treatment for cervical precancer. In a recent study published in The BMJ, Dr. Kechagias, along with his research group under the guidance of Professor Kyrgiou, revealed that HPV vaccination could potentially lower the risk of recurrence of cervical precancer. This reduction is particularly notable in cases associated with HPV16 or HPV18 infections among women treated with local excision - a surgical procedure to remove a small area of diseased or problematic tissue with a margin of normal tissue. The findings may extend to women with multifocal disease, other conditions linked to HPV infection, and individuals diagnosed with malignancies related to HPV infection.  

Dr Antonios Athanasiou: Balancing reproductive morbidity and effectiveness 

Dr. Antonios Athanasiou and his research team have been investigating the effects of various treatments for cervical precancerous lesions and early-stage cervical cancer on subsequent pregnancies. Their findings indicate that the more aggressive the treatment, the higher the risk of preterm birth, but at the same time, there is a lower risk of recurrence of the condition. In simple terms, there is a trade-off between the impact on reproductive health and the effectiveness of the treatment. 

Among the treatments studied, loop excision, which is the most commonly used method in the UK and other developed countries, was identified as achieving the optimal balance between preserving reproductive health and ensuring favourable oncological outcomes. Despite this, the researchers emphasise that loop excision may not be the most suitable option for all women.  

They advocate for a personalised approach to treatment selection, highlighting that factors such as age and the severity of precancerous lesions should be considered. For instance, older women with severe precancerous lesions might be candidates for more radical treatments. The research outcomes were recently published in Lancet Oncology, providing valuable insights into the delicate balance between preserving reproductive health and effectively managing cervical precancerous conditions.

Dr Sarah Bowden: Unravelling the genetic component

Meet Dr. Sarah Bowden, an NIHR funded Academic Clinical Lecturer, who recently completed her Wellcome Trust/Imperial NIHR BRC funded PhD focused on cervical cancer. In her research endeavours, she conducted a genome-wide association study to enhance our comprehension of the genetic aspects of cervical cancer. Notably, she identified mutations in three genes—PAX8, CLPTM1L, and HLA—associated with cervical cancer development. These findings suggest a potential connection to immune function pathways and could have applications for future risk-based screening 

Furthermore, Dr. Bowden is investigating the significance of epigenetics in the risk and early detection of cervical cancer, including a meta-analysis focusing on the methylation of Human Papillomavirus as a diagnostic test and potential implications for use in cervical screening. The results of this analysis were published in eBioMedicine.

Additionally, Dr. Bowden conducted a comprehensive analysis, known as an umbrella and Mendelian randomisation study, to explore and establish the evidence related to environmental risk factors for cervical cancer. The findings from these studies were published in BMC Medicine.

Dr Anita Mitra: Pioneering Research in Gynaecological Oncology and Vaginal Microbiome

Dr Anita Mitra is currently undertaking her sub-specialty training in Gynaecological-oncology, where she sees and treats women with gynaecological cancers, including cervical cancer. In addition to this, she has an NIHR-funded academic clinical lectureship. She completed her PhD in the vaginal microbiome and cervical precancer with Prof Kyrgiou, publishing one of the first studies showing that the vaginal microbiome type is associated with progression or regression of cervical precancer.

Her research is focused on the vaginal microbiome, and evidence synthesis in cervical cancer and cervical precancer. She recently led the team in a collaboration with the European Society of Gynaecological Oncology Cervical Cancer Prevention Society on a statement summarising all the available evidence for probiotics and prebiotics in gynaecological malignancies.

Dr Mary Paraskevaidi: Innovations in cancer screening 

Dr. Maria Paraskevaidi works as a Research Fellow in the Faculty of Medicine, specifically in the Department of Metabolism, Digestion, and Reproduction at Imperial College London. Her primary focus revolves around using advanced analytical methods to screen and diagnose gynaecological cancers, including cervical, endometrial and ovarian malignancies.  Maria’s translational research is dedicated to enhancing early cancer detection programmes and developing innovative, cost-effective technologies that could improve patient outcomes and survival.   

Metabolomic changes (“deregulating cellular energetics”) of cancer cells were added to “the next generation” hallmarks of cancer in 2011. Metabolomics have since offered a powerful approach to study a set of small molecules (metabolites) in a multiple-marker manner and have been extensively employed in investigating cancer metabolism and identifying disease biomarkers.  

Ambient ionisation mass spectrometry techniques have revolutionised the way metabolomic studies are conducted as they allow real-time analysis, without the need for prior sample preparation. Dr Paraskevaidi is employing such techniques to enhance the early detection, diagnosis and treatment of gynaecological cancers and lead to improved prognosis for patients. 

Professor Maria Kyrgiou: Leading the research charge 

Last but not least meet Professor Maria Kyrgiou, a distinguished expert in gynaecology and gynaecological oncology. In her clinical practice, Professor Kyrgiou specialises in minimal access and complex surgery for gynaecological cancers. Her research is primarily focused on translational research in gynaecological diseases and cancers, specifically cervical, endometrial, and ovarian cancer. Her work places a strong emphasis on prevention, early detection, and personalised treatment. 

Professor Kyrgiou heads a research program exploring the genetic, epigenetic, microbiome, and host interactions involved in the development of gynaecological cancers. Notably, she is the Chief Investigator of the NOVEL trial, which investigates the impact of HPV vaccination in women with cervical disease. Her research group is dedicated to studying the influence of obesity and metabolic disorders on the development of gynaecological cancers. Moreover, her work delves into understanding the role of the genital tract and gut microbiome in the development and response to treatment of gynaecological cancers. 

Professor Kyrgiou, Dr Anita Mitra, Dr Sarah Bowden, and Dr Laura Burney Ellis, in collaboration with the European Society of Gynaecological Oncology, recently published a paper in the Lancet Microbe, summarising the evidence on the use of pre and probiotics in the prevention and treatment of gynaecological cancers, in particular, cervical cancer.

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