by Spotlight on Dr Carles Escriu, Consultant Medical Oncologist and Expert Witness
Spotlight on Dr Carles Escriu, Consultant Medical Oncologist and Expert Witness
Recent press coverage of Clatterbridge Private Clinic highlights the pace at which lung cancer treatment is advancing in the UK. Patients are travelling from across the North West, and further afield, to access therapies that are not yet routinely available on the NHS, reflecting how quickly emerging evidence and newly licensed treatments are being translated into clinical practice.
The clinic, which operates from sites in Liverpool and the Wirral alongside Clatterbridge Cancer Centre, has built a reputation for rapidly integrating cutting-edge research into routine care, particularly in lung, prostate, breast and haematological cancers.
Much of this progress in lung cancer is being driven by Consultant Medical Oncologist and Senior Clinical Lecturer, Dr Carles Escriu, whose work bridges frontline clinical practice, academic research and clinical trials, alongside his role as an expert witness at McCollum Consultants.
His research has contributed to a growing shift towards neoadjuvant treatment approaches, in which chemotherapy and immunotherapy are administered prior to surgery. This strategy has been associated with a reduction in recurrence rates at three years, from approximately 55 per cent with chemotherapy alone to around 35 per cent when immunotherapy is added, with local data from Liverpool mirroring wider European findings.
Dr Escriu is also a co-author of the international NeoADAURA study, which demonstrated that short-course targeted therapy with agents such as osimertinib, given before surgery, significantly improves complete response rates in patients with EGFR-mutated non-small cell lung cancer.
The clinic was also among the first in the UK to administer tarlatamab, a novel bi-specific immunotherapy for small-cell lung cancer, led by Consultant Clinical Oncologist Dr Niladri Ghosal. Although approved by the MHRA, it is not yet routinely funded on the NHS. In the DeLLphi-304 study, the treatment demonstrated a median overall survival of 13.6 months compared with 8.3 months for standard chemotherapy.
It is this combination of early access to novel therapies and a strong focus on evolving treatment pathways that is drawing patients to Clatterbridge Private Clinic from beyond the immediate region. Through a private care pathway, patients are able to access treatments that may be unavailable or delayed elsewhere, supported by a dedicated patient liaison team providing coordination of travel, appointments and clinical support.
Academic oncology in practice
Dr Escriu is a thoracic medical oncologist specialising in lung cancer, with a strong focus on clinical trials and translational research. He leads the lung cancer research portfolio within his centre, coordinating early phase and portfolio studies across multidisciplinary teams and working closely with national and international research collaborators.
A key feature of his work is ensuring that clinical trial access is embedded within routine care, so that patients are offered opportunities to participate in studies regardless of stage of disease or line of treatment.
His research spans:
- Neoadjuvant (pre-operative) treatment strategies in lung cancer
- Immunotherapy and combination systemic therapies
- Targeted therapies for molecularly defined subgroups
- Early phase studies and investigator-led trials
- Emerging personalised approaches, including cancer vaccines
He also leads work in a dedicated clinical service focused on patients with mutation-driven lung cancers, supported by a multidisciplinary team including consultants, research nurses, pharmacists, palliative care specialists and associate physicians. This model has been established over a decade and is designed to provide structured, sub-specialised care for patients with specific molecular tumour types, for whom clinical trial opportunities are maximised.
What the research is showing – and why it matters clinically
Much of Dr Escriu’s recent work reflects a broader shift in oncology: moving treatment earlier in the disease pathway and tailoring therapy more precisely to tumour biology.
In lung cancer, this includes:
- Neoadjuvant immunotherapy and chemotherapy (treatment before surgery), aimed at shrinking tumours and improving surgical outcomes
- Targeted therapies in the peri-operative setting, including tablet-based treatments for genetically defined cancers
- Combination strategies in advanced disease, where novel biological agents such as bi-specific antibodies, antibody-drug conjugates, or cancer vaccines are combined with standard immunotherapy.
These approaches are part of a wider international evidence base suggesting that earlier and more biologically targeted intervention can significantly alter recurrence risk and treatment response.
Dr Escriu has also contributed to global collaborative studies alongside experts from across Europe, the United States and Asia. He has worked on trial designs evaluating tablet-based targeted therapy given before surgery in early lung cancer, with findings indicating improved tumour shrinkage and response rates compared with standard approaches alone.
Immunotherapy, resistance, and personalised cancer vaccines
Dr Escriu’s current research focuses on resistance to immunotherapy. Although immunotherapy has transformed the treatment of lung cancer, many patients eventually develop resistance and their cancers grow again.
To address this, he is involved in a unique study where a personalised cancer vaccine is offered to patients with advanced disease, designed to:
- Take tumour samples from individual patients
- Generate a tailored vaccine to stimulate immune response
- Modify the interaction between the immune system and cancer cells
- Improve the durability of response to immunotherapy
Why this matters in clinical negligence and serious injury litigation
From a medico-legal perspective, oncology is one of the fastest changing specialties in medicine. Treatment pathways that were considered standard even a few years ago may now be obsolete, replaced by targeted therapies, immunotherapy combinations or trial-based interventions.
For solicitors and expert witnesses working in clinical negligence, this creates several challenges:
1. Determining breach of duty against a moving standard of care
What constitutes reasonable practice in lung cancer management can change rapidly as NICE guidance, MHRA approvals and trial data evolve.
2. Causation and lost opportunity arguments
In oncology cases, outcomes often depend on whether earlier referral, different systemic therapy, or molecular testing would have altered prognosis.
3. Evolving access to treatment
Private, trial-based or early access therapies may not yet be routinely available on the NHS, but may still be relevant when assessing what a competent body of oncologists might have considered.
4. Prognostic uncertainty
As survival improves in some subgroups, historical survival figures may no longer reflect current outcomes, particularly in immunotherapy-responsive or genetically defined cancers.
The value of academic clinicians in expert evidence
Dr Escriu’s dual role as a clinician and academic researcher is central to his medico-legal work. His involvement in ongoing clinical trials and international collaborations ensures that his expert evidence is grounded in current practice, experience and expertise.
He also highlights that academic engagement supports a more structured and analytical approach to case review, particularly in complex and emotionally charged litigation. This includes:
- Focusing on objective clinical standards and evidence-based guidelines
- Evaluating care pathways against contemporaneous practice
- Considering systemic factors alongside individual clinical decision-making
- Maintaining independence and impartiality in opinion formation
The pace of change in oncology means that expert interpretation of clinical care must be continuously updated. As new therapies move from trials into standard practice, and as personalised approaches become more common, the threshold for reasonable care continues to evolve.
Clinicians such as Dr Carles Escriu, who combine frontline oncology practice, academic research leadership and expert witness work, play an important role in ensuring that medico-legal analysis reflects the reality of modern cancer treatment.
For those involved in clinical negligence litigation, particularly in oncology, engagement with up-to-date specialist expertise is increasingly essential to properly assess breach, causation and outcome in an area of medicine where the standard of care is anything but static.
To instruct Dr Carles Escriu:
Tel: +44 (0)161 218 0223
Email: info@exp-w.com