Billy Down

research interests

There are many emerging therapies in oesophageal cancer such as immunotherapy that have demonstrated promising results in trials, however at present disease recurrence is very common.  My research focuses on the use of blood-based sequencing methods to detect oesophageal cancer recurrence at the earliest possible stage and to monitor how tumours are responding to treatment in real time.  Earlier detection of recurrent disease could allow earlier treatment, and identification of genetic or epigenetic patterns of treatment response and failure would allow switching of treatment before progression occurs.

To achieve these goals, I am using a novel epigenetic sequencing technique called TET-assisted pyridine borane sequencing (TAPS) to analyse circulating tumour DNA (ctDNA) in patient blood samples. By examining DNA methylation patterns and other genomic features, I will investigate whether we can sensitively track tumour burden and treatment response over time. My work aims to determine whether changes in ctDNA methylation can reveal recurrence earlier than imaging, and whether dynamic molecular profiles can guide therapeutic switching for patients who are not responding to first-line treatment.

Background

I completed an undergraduate degree (BSc) in Pharmacology at the University of Leeds in 2012 before qualifying as a doctor in 2019 and moving to Oxford.  I am now on the higher surgical training pathway to becoming a consultant general surgeon.  I am currently taking time out of programme for research into oesophago-gastric cancer.