UCLH clinician scientist wins major international prize for pioneering tumour research

A UCLH clinician scientist has won a prestigious international award for his groundbreaking work on how tumours evolve, which is helping to explain why cancer treatments sometimes fail and paving the way for more precise, personalised therapies.

Professor Charles Swanton, a consultant medical oncologist at UCLH, has been awarded the 2026 Sjöberg Prize, worth US$1 million to his lab programme, “for discoveries concerning clonal evolution of cancer cells and its importance for tumour growth and metastasis”.

The award honours Professor Swanton’s research into how tumours change over time, develop resistance to treatment, and spread throughout the body. His work is already influencing cancer diagnosis, monitoring and treatment worldwide.

It has long been known that cancer starts when a cell mutates and begins dividing aggressively, but researchers have not known the details of what happens inside the tumour and how natural selection operates for tumours to evade drugs and the immune system as cancers progress.

“He started with a fairly simple experiment, where he divided a kidney tumour into pieces and then analysed each one. He saw that they were all different, so there must have been a process that led to mutations that only exist in specific parts of the tumour,” said Urban Lendahl, secretary of the Sjöberg Prize Committee at the Royal Swedish Academy of Sciences.

This may explain why some treatments fail to completely eradicate a cancer.

“A great number of researchers followed hundreds of cancer patients for many years. Swanton’s focus was lung cancer, and the project allowed him to study tumours from the initial diagnosis all the way through treatment and any relapses,” says Lendahl.

The genetic landscape of a tumour can be likened to a family tree. The mutations that occur early in development are in the tree’s trunk; these are lasting and are found in all the tumour’s cells and in all regions of the tumour that are sampled. Over time, other mutations occur; these are in the tree’s branches. Cancer treatment usually only removes some of the branches, while others unfortunately survive. This means the entire tumour is not eliminated.

This discovery has transformed scientific understanding of cancer as an evolutionary process, helping explain why treatments may initially work but later fail.

Much of this research has been carried out through TRACERx (TRAcking Cancer Evolution through therapy), a major UK-wide study led by Professor Swanton and funded by CRUK, run by the UCL Cancer Trials Centre, with UCLH as a major recruiting study site.

TRACERx follows hundreds of patients with lung cancer over many years, tracking how their tumours change from diagnosis through treatment and, in some cases, relapse. The study involves hospitals across the UK including UCLH and integrates clinical data with detailed genetic analysis of tumour samples and blood tests.

The project aims to understand how genetic diversity within tumours influences treatment response, relapse and survival, with the goal of developing better diagnostics and more effective, personalised therapies.

Professor Swanton’s team has also pioneered blood tests that can detect tiny fragments of tumour DNA circulating in the bloodstream. These tests can identify early signs that cancer is returning — often before symptoms appear — allowing treatment to begin sooner.

This approach has the potential to significantly improve long-term outcomes for patients by enabling closer monitoring and more timely intervention.

Alongside his role treating patients at UCLH, Professor Swanton is Chief Clinician at Cancer Research UK, Royal Society Napier Professor of Cancer, and deputy clinical director at the Francis Crick Institute. He also co-directs CRUK’s Lung Cancer Centre of Excellence.

His work has earned multiple international honours and has reshaped how scientists and clinicians think about cancer progression and drug resistance.

Professor Swanton plans to use the Sjöberg Prize funding to investigate the very earliest steps in cancer development, with the hope of finding ways to stop tumours forming in the first place.

“I hope this prize money is going to allow us to really understand how that very first step in tumour initiation and evolution occurs. If we can understand that process, I hope we can intercept it and prevent it from happening and therefore prevent cancers from emerging,” he said.

“I also want to take this opportunity to acknowledge the extraordinary thoracic oncology team at UCLH who have been incredibly supportive of TRACERx and our team, UCLH BRC for funding support, UCL and the UCL Cancer Trials Centre for their support and oversight of TRACERx and TRACERx EVO, the Crick for supporting my laboratory, and CRUK for funding our work since 2008, for what is an immense group effort to improve outcomes for patients.”

The Sjöberg Prize is awarded annually by the Royal Swedish Academy of Sciences in partnership with the Sjöberg Foundation. It recognises scientists who have made decisive contributions to cancer research.

The prize will be formally presented in Sweden on 31 March 2025.