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David Walker

Professor of Paediatric Oncology, Faculty of Medicine & Health Sciences

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Biography

David was born in Scotland but was mainly educated in London. He qualified in Medicine from University of Nottingham in 1977 and went on to train in adult and paediatric medicine in UK (Cambridge, St Mary's Paddington, Leicester, Sheffield, Great Ormond Street Hospital and Royal Children's Hospital, Melbourne Australia), being appointed as a Senior Lecturer in Paediatric Haematology and Oncology in Nottingham in 1990, being appointed as Professor in 2005.

He led the children's brain tumour trials' committees in UK (CCLG 92-97) and Europe (SIOPe 97-2001) and co-chaired the International Consortium of Childhood Low Grade Glioma 1997 - 2014. He helped to develop the Children's Brain Tumour Research Centre at the University of Nottingham http://www.cbtrc.org/. It is celebrating its 20thanniversary in 2017. He helped initiate the Teeenage Cancer Trust (TCT) adolescent units in East Midlands Children and Young People's Cancer Service (EMCYPICS) and was a TCT Visiting Professor to Royal Children's Hospital in Melbourne, Australia in 2007.

  1. led the team to launch, in 2009, the Royal College of Paediatrics and Child Health brain tumour diagnostic referral guideline and the HeadSmart public and professional awareness campaign (2011), which was associated with a halving total diagnostic interval across the UK (2007-2017)1. In 2017 this has been recently re-launched, targeting the teenage age group and primary care physicians (www.headsmart.org) .

He helped initiate through lobbying the UK All Party Parliamentary Group concerned with brain tumours in 2000. This group supported the Petition's Committee report and the subsequent Parliamentary Debate in April 2016 to highlight the need for enhanced research funding, resulting in the establishment of a UK Government commissioned Task and Finish Group advising on how to accelerate research in the field, which will report in October 20172

As a member of theSociétéInternationale d'Oncologie PédiatriqueEurope (SIOPE) Board (2010-2014) he worked to engage his local MEP, Glenys Willmott, Co-Chair of the Health Committee in the European Parliament to become Rapporteur for the Revision of EU Clinical Trials Legislation in 2014, successfully addressing the needs of children and young people with cancer involved in trials within the new legislation3. He has been involved in national campaigns to support the Access to Medical Treatments (Innovation) Act 2016 to provide legislative support for recording results of new drugs tested in individual cases4,5. He has been involved in highlighting issues surrounding funding of new drugs for childhood cancer6.

His current research programme seeks to develop methods for minimizing risk of cerebellar mutism syndrome, saving sight due to visual pathway glioma and chairing the recently launched Drug Delivery Research Consortium to enhance awareness of CNS directed drug delivery as a priority for drug development (www.cbtddc.org)7.

  1. has published over 100 papers and is one of 4 international editors for "Brain and Spinal. Tumours of Childhood" published Edward Arnold, Londonin 2004 and currently under revision for its second edition.

In his spare time, other than being with his family and his dog, he has played many sports, likes to climb Scottish mountains, having climbed 201 of 282 Munros (mountains over 3000 feet high in Scotland), he enjoys long cycle rides, having ridden the length of the UK twice, by different routes and partakes in a good whisky after a long day out.

Citations

1. http://www.headsmart.org

2. https://www.parliament.uk/business/committees/committees -a-z/commons- select/petitions-committee/inquiries/parliament-2015/funding-for-research-into-brain- tumours/

3. https://www.youtube.com/watch?v=NgH6bs2nH9s.

4. http://www.telegraph.co.uk/news/health/saatchi- bill/10763909/Saatchi-Bill-This-isnt-quackery-its-good-practice.html.

5. http://services.parliament.uk/bills/2015-16/accesstomedicaltreatmentsinnovation.html.

6. http://www.telegraph.co.uk/news/health/children/12140533/We-need-to-think-about-how-we-fund-childrens-cancer.html

7. http://ecancer.org/conference/831-drug-delivery-in-paediatric-brain-tumours.php

Expertise Summary

I have expertise in 4 main areas relating to my work as a specialist paediatrician and academic

  1. Clinical practice in paediatrics and haemato-oncology
  2. Education of undergraduates and post graduates
  3. Translational research
  4. Medical and professional management

1. Clinical practice in paediatrics focuses upon managing clinical problems in individuals who are in the process of growing and developing within a family, whilst pursuing education and training for adult life. During my career, health services have extended the scope of practice in this area to include teenagers and young adult (TYA) up to 24 years of age. This has come about because the processes of growth and development have a profound effect upon the style of communication, clinical practice and facilities that young people need, to be appropriately managed, when they are ill. The diseases that young people get differ in the character, frequently as a result of the interaction between normal tissue growth and development and the disease process eg infection or cancer. I have particular interest and training in the management of the TYA patient. I apply this skill set in clicnial care of patients in clincial trial of modern therapies and also in providing expert assessments of medicolegal cases involving the spectrum of clinical practice.

2. I have explored a wide range of educational techniques and strategies during my time as leader of the under graduate programme in child health. I continue to contribute to undergraduate training as a project supervisors for honouors year projects involving gaining early research and innovation experineces as part of the undergraduate training.

3. Translational research is about delivering innovation to clinical pracitce. I specialise in influencing clinical practice using quality improvement methods, raising awareness for research priorities, clinical trials of novel therapies and health services evaluation, audit andresearch. This has focused upon accelerating Diagnosis of Brain Tumour through the HeadSmart Campaign, a wide variety of clinical trials of new treatment in brain tumours, risk prediction of brina damage associated with tumour treatments. Close clinical observation is the bedrock of translational research. Testing hypotheses based upon clinical observation provides a strong impetus to apply the results of research back in practice. This creates the need to collaborate with a wide variety of research disciplines which in my case has included, nursing, psychology, psychiatry, rehabilitation therapists, social work, epidemiology, health economics, molecular biology, statistics, physiology, engineering, neuroscience, pharmacy, pharmacology, radiology, ophthalmology, pathology, surgery, radiation therapy, medical oncology, endocrinology and neurology.

4. Medical and professional management is an integral part of working in large institutions. Organisation of clinical or academic activities requires participants to contribute to strategy and implementation of institutional priorities, which in Government supported institutions, such as the NHS and Universities, needs close integration with national strategy development and implementation. I have contributed extensively in these processes both implementing and influencing national and regional strategies in NHS and University initiatives in clinical practice, education and research.

Teaching Summary

Undergraduate teaching activities:

· Pre-University: I organise ('91-'13) final year students' clinical experience (2-5 students per year). I have recently joined a national widening access network.

· Undergraduate: I deliver student teaching at 3rd, 4th and 5th year supervising projects (yr 3), contributing to Developmental Neuroscience module (yr 3), paediatric module and firm supervision (yr 4), SSM coordination (yr 5). Student project work has been widely presented, some winning awards or published. Median student feedback scores are > 4/5.

· I contribute to course development and management as 4th yr Paediatric Module Coordinator ('90-'97), 3rd year coordinator ('11-'13); internal examiner 4th yr Child Health '90-'13; external examiner at Imperial College ('08-'11).

Post-graduate teaching activities:

· I teach, supervise and examine students on MSc Oncology Module, and MSc, DM and PhD projects. Look at Appraisal documents for detail

· Post graduate clinical training and translational research keynote talks

Invited lectures (since 2008)

1. Invited speaker Teenage Cancer Trust 'Towards Best Practice' Conference, London, February 2008

2. Invited speaker 5th SIOP Asia Conference, Sultanate of Oman, February 2008

3. Invited speaker Perspectives in Central Nervous System malignancies IV, Berlin, Germany, March 2008

4. Invited speaker National Cancer Research Network, Leeds, March 2008

5. Oral presentation RCPCH Spring Meeting, York, April 2008

6. Invited speaker TYA Frontier Meeting, Cambridge, April 2008

7. Oral presentation 5th Teenage Cancer Trust Conference, London, June 2008

8. Invited speaker 40th Congress of SIOP, Berlin, October 2008

9. Invited speaker ESO-SIOPE Masterclass in Paediatric Oncology, Ascona, Switzerland, November 2008

10. Invited speaker Children & Teenagers Scottish Cancer Network (CATSCAN) conference, Edinburgh, June 2009

11. Invited speaker 13th Annual Conference of Paediatric Haematology/Oncology Chapter of Indian Academy of Paediatrics,

Chandigarh, India, November 2009

12. Invited speaker 12th International Paediatric Haematology & Oncology Update Meeting, Edinburgh, April 2010

13. Invited speaker 14th International Symposium on Paediatric Neuro-Oncology (ISPNO) Conference, London, June 2010

14. Session chair 6th Teenage Cancer Trust Conference, London, June 2010

15. Invited speaker 42nd Annual SIOP Congress, Boston (USA), October 2010

16. Invited speaker Youth Conference, Oslo, November 2010

17. Invited speaker Consensus Conference on Paediatric Neurosurgery, Paris, February 2011

18. Invited speaker RCPCH Spring Meeting, Warwick, April 2011

19. Session Chair European Multi-disciplinary Cancer Congress, Stockholm, Sweden, September 2011

20. Invited Speaker TYAC Spring Education Day, Nottingham, April 2012

21. Invited Lecturer European Paediatric Neurology Society Training Course, Sarajevo, Bosnia, May 2012

22. Invited Speaker 13th International Paediatric Haematology & Oncology Update Meeting, Edinburgh, May 2012

23. Invited Speaker European Association of Neuro-Oncology (EANO) Meeting, Marseille, France, September 2012

24. Invited Speaker SIOP 2012 Congress, London, October 2012

25. Keynote Speaker Mestitz Memorial Lecture, Brighton Children's Hospital, October 2012

26. Invited Speaker Turkish Paediatric Oncology Society Antalya Turkey April 2013

27. Session Chair BNA 2013: Festival of Neuroscience, London, April 2013

28. Plenary Session Royal College of Paediatrics & Child Health Annual Conference, Glasgow, June 2013

29. Invited speaker

& Session Chair European Clinical Cancer Organisation (ECCO) Amsterdam October 2013

30. Invited Speaker World Federation Neuro-Oncology (WFNO) San Francisco November 2013

31. Invited lecturer ESTRO PROS Training Course for Paediatric Radiotherapy December 2013

32. Session Chair International Symposium Paediatric Neuro-Oncology (ISPNO 2014) June 2014 Singapore

33. Invited speaker European Association Neuro-Oncology Turin, Italy October 2014

34. Invited speaker SIOP Annual Conference Radiotherapy Group Toronto Canada October 2014

35. Invited speaker Columbus Children's Hospital Ohio US October 2014

36. Invited Speaker Norwegian Paediatric Oncology Society, Tromso, January 2015

Research Summary

Co-Director of the Children's Brain Tumour Research Centre. The centre's activities are described on their website (www.cbtrc.org).

Principal Investigator, HeadSmart Campaign (www.headsmart.org.uk). A public awareness campaign aimed at reducing the interval between symptom onset to diagnosis in the UK to be equivalent to the best reported worldwide. The programme is focussed upon children and young people < 18 years of age.

Selected Publications

Past Research

Research Publications

Researchgate

· Impact points 597.69

· 1502 citations

· Index 38.86 >95% centile

This section has been structured by themes of publications, which are listed with most recent publications first

· Education: This section summarises output in the form of peer-reviewed publications, book and chapters, conference leadership and keynote invited lectures

· Changing Practice: This group of publications covers communications directed at describing factors influencing the introduction of new clinical practice in paediatric oncology. (n=43)

· Clinical outcomes: This sections contains research directed at developing and evaluating new methods for measuring clinical outcomes in clinical trials in neuro-oncology. (n=13)

· Clinical trials: Reports of clinical trials with which I have been involved (n=15)

· Tumour bio-characterisation and developmental biology: Childhood cancer arises in growing tissues this area of work described scientific observations related to the characterisation of normal and tumour tissues factors (n=14)

· Drug Delivery: This work illustrates the work describing theoretical and clinical basis for optimising drug delivery to the brain, with a focus on intra-CSF directed chemotherapy. (n=9)

· Early Diagnosis: This describes work that has driven the evidence to support the HeadSmart Be Brain Tumour Aware Campaign which was a REF Case study in 2014 and mulit-award winning public and professional awareness campaign. (n=7)

Future Research

The focus for next 3 years is:

Converting the HeadSmart Be Brain Tumour Aware campaign to a national enhanced awareness programme which reduces the interval from symptom onset to diagnosis from 3 to 1 month at most across the UK.

To propagate this theme for international health services research.

To launch a phase 1 intrathecal infusion drug trial to explore the value of such an approach to patient care in disseminated brain tumours.

To develop a novel clinical trtial design to explore the optimised methods for selecting childhood patients with Optic Pathway Glioma associated with NF1 as well as those arising sporadically for trials of non surgical treatments aimed a saving vision.

To explore methods for selecting patients with cerebellar tumours at greatest risk of post operative mutism snd exploring methods for reducing the risks of the syndrome

School of Medicine

University of Nottingham
Medical School
Nottingham, NG7 2UH

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