A series of projects and publications were completed with the combined work of several specialists. Professor Paul Maddison, Dr Bethan Lang, Dr Paul Gozzard and many others have in recent history received funding from myaware to research lung cancer presence and prediction in patients with LEMS. One publication based on the efforts of the three named above along with Dr Matthew Grainge, was previewed in the American Academy of Neurology in 2017. In this paper, the improved survival of patients with LEMS-SCLC compared to those with cancer and no neurological illness was studied. It had long been reported that patients whose cancer stemmed from LEMS had better survival rates than those whose diagnosis was purely cancer-related. A specific type of antibody related to the channels in cells that allow passage of calcium in and out was the focus of this work. Voltage-gated calcium channels (VGCC) are found in the membranes of cells and enable calcium to move in and out of cells. The antibody for these channels was suggested in the paper to be causal for reducing the ability of SCLC tumour cells to grow, thereby reducing the ability of the cancer to spread or get bigger and further affect the body. What this research has provided for people living with myasthenia is progress in the design of future therapeutics. By studying the biology of VGCCs in relation to improved survival of patients with LEMS-SCLC, it suggests that a promising avenue for exploration would be medications that regulate VGCCs.

Prediction of cancer in patients with LEMS is a significant focus of researchers in this field. This is largely due to the associated improved survival rate of small cell cancer patients with early diagnosis. Maddison et al published another three papers between 2019 and 2020 that analysed different approaches in developing methodology for this type of clinical estimation.

Screening for SCLC in patients presenting with LEMS is an important part of their care. There have been various clinical scoring systems developed to assist with this. As around 60% of LEMS patients have an associated SCLC, screening systems such as these are also used to distinguish between SCLC-LEMS patients and non-tumour LEMS (NT-LEMS) patients. The developing scoring system, DELTA-P was assessed with an alternative cohort to the one it was developed alongside through a project funded by myaware. It was found during this study that DELTA-P was very effective in predicting SCLC in a new cohort of LEMS patients, confirming its reliability.

To read more about Professor Maddison’s work in myasthenia, click here to visit his page at the University of Nottingham website.  

Past Research Projects