Professor Gary Middleton MB, BS, MD, FRCP

Professor Gary Middleton

Institute of Immunology and Immunotherapy
Professor of Medical Oncology

Contact details

Institute of Immunology and Immunotherapy
University of Birmingham
B15 2TT
Day in the life of a Professor of Medical Oncology

Gary Middleton is Professor of Medical Oncology in the Institute of Immunology and Immunotherapy. He plays a pivotal role in the strategic delivery and translation of cancer immunology and genomics science at Birmingham, as Cancer Research UK Birmingham Centre Clinical Director between 2017-2022 and Director of the Birmingham Experimental Cancer Medicine Centre. Committed to developing a vibrant next generation of academic oncologists, Gary leads the CRUK Centre’s Clinical Academic Training Programme.

A key area of Gary’s expertise is the development of novel clinical trials, particularly in lung and colorectal cancer, translating Birmingham-led discovery science into patient outcomes. He is Chief Investigator (CI) for PePS2, whose outcomes were published in Lancet Respiratory Medicine, and ANICCA-Class II, both delivered by the University’s CRCTU.

As CI for the Birmingham-led, multi-arm, molecularly stratified National Lung Matrix Trial, Gary’s research is driving forward the agenda in Precision Medicine oncology. Its results have been published in Nature (DOI: 10.1038/s41586-020-2481-8).

Synergising with this clinical focus on stratified treatment approaches, Gary is particularly interested in how the genetic/molecular phenotype of patients’ tumours correlates with the immunobiology of the tumour microenvironment. He is also investigating how the genomic, transcriptomic and immunological context of cancers impacts on response to targeted therapy. His translational research focuses at present on the dynamics and importance of MHC class II expression in colorectal cancer and defining predictive biomarkers for toxicity from checkpoint blockade. Finally, he has a programme working on how best to target squamous cell lung cancer.

Gary is Co-Lead of the UK Coronavirus Cancer Monitoring Project, which tracks cancer patients from over 60 centres nationally, who have tested positive for COVID-19. The consortium has published on outcomes for these patients, notably on the impact of chemotherapy and immunotherapy, in The Lancet and Lancet Oncology (DOI:10.1016/ S0140-6736(20)31173-9; DOI: 10.1016/S1470-2045(20)30442-3).


Postgraduate supervision

Gary is currently supervising six PhD students and is particularly interested in training students on tumour immunobiology and defining novel targets for the treatment of lung cancer.


Research interests

  • Class II expressing microsatellite stable colorectal cancer
  • Class II dynamics in colorectal cancer
  • Immunobiology of the tumour microenvironment
  • Myeloid-derived suppressor cells
  • COVID mortality risk to cancer patients
  • BRAF mutant colorectal cancer
  • Cancer Genomics

Therapeutic areas of interest

  • Precision Medicine and the genomics of lung cancer
  • Advanced cellular therapies
  • Stratified Immunotherapy
  • Checkpoint blockade therapy

Other activities


Recent publications

Gary Middleton, Helen Robbins, Fabrice André, Charlie Swanton (2021, Nov 19; DOI: /10.1016/j.annonc.2021.11.004). A state-of the-art review of stratified medicine in cancer: towards a future precision medicine strategy in cancer. Annals of Oncology

Lennard Y.W. Lee, Thomas Hill, Oliver Topping, Michael Tilby, Mark Baker, Julian Greig … Gary Middleton, on behalf of the UK Birmingham Chemotherapy Cancer COVID-19 Project (2020, Sept 14; DOI: 10.1016/j.ccell.2020.07.009). Utility of COVID-19 screening in cancer patients. Cancer Cell

Lennard Y W Lee, Jean-Baptiste Cazier, Thomas Starkey, Sarah E W Briggs, Roland Arnold … Gary Middleton, Rachel Kerr, on behalf of the UK Coronavirus Cancer Monitoring Project Team (2020 Oct 1; DOI: 10.1016/S1470-2045(20)30442-3). COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics. Lancet Oncology

Gary Middleton, Kristian Brock, Joshua Savage, Rhys Mant, Yvonne Summers, John Connibear … Lucinda Billingham (2020, Sept; DOI: 10.1016/S2213-2600(20)30033-3). Pembrolizumab in patients with non-small cell lung cancer and a performance status of 2 (PePS2): a single-arm phase II trial. Lancet Respiratory Medicine.

Oliver J Pickles, Aneta Drozd, Louise Tee, Andrew D Beggs, Gary W Middleton (2020, Aug; DOI: 10.18632/oncotarget.27681) Paradox breaker BRAF inhibitors have comparable potency and MAPK pathway reactivation to encorafenib in BRAF mutant colorectal cancer. Oncotarget

Gary Middleton, Peter Fletcher, Sanjay Popat , Joshua Savage , Yvonne Summers … Charles Swanton, Lucinda Billingham (2020, July 15; DOI: 10.1038/s41586-020-2481-8). The National Lung Matrix Trial of personalized therapies in lung cancer. Nature.

Lennard YW Lee, Jean-Baptiste Cazier, Vasileios Angelis, Roland Arnold, Vartika Bisht, Naomi A Campton … Gary Middleton, on behalf of the UK Coronavirus Cancer Monitoring Project Team (2020, June 16; DOI: 10.1016/S0140-6736(20)31173-9). COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments. The Lancet

Oliver J. Pickles, Lennard Y. W. Lee, Thomas Starkey, Luke Freeman-Mills, Anna Olsson-Brown, Vinton Cheng … Gary Middleton (2020, June 16; DOI: 10.1038/s41416-020-0930-7). Immune checkpoint blockade: releasing the breaks or a protective barrier to COVID-19 severe acute respiratory syndrome? British Journal of Cancer

Valerie Pestinger, Matthew Smith, Toju Sillo, John M. Findlay, Jean-Francois Laes, Gerald Martin, Gary Middleton, Phillipe Taniere, Andrew D. Beggs (2020, June 1; DOI: 10.1007/s40291-020-00462-x) Use of an Integrated Pan-Cancer Oncology Enrichment Next-Generation Sequencing Assay to Measure Tumour Mutational Burden and Detect Clinically Actionable Variants. Molecular Diagnosis and Therapy

Gary Middleton, Yiqun Yang, Catarina D. Campbell, Thierry André, Chloe E. Atreya, Jan H.M. Schellens … Ryan B. Corcoran (2020, Feb 11; DOI: 10.1158/1078-0432.CCR-19-3579). BRAF-mutant transcriptional subtypes predict outcome of combined BRAF, MEK, and EGFR blockade with dabrafenib, trametinib, and panitumumab in patients with colorectal cancer. Clinical Cancer Research

Akshay J. Patel, Alex Richter, Mark T. Drayson, Gary W. Middleton (2020, Jan 4; DOI: 10.1007/s00262-019-02461-2). The role of B lymphocytes in the immuno-biology of non-small-cell lung cancer. Cancer Immunology, Immunotherapy

Livingstone F., Panetti S., Margaret N., Collins P., Graef S., Nagy S., Booth S., Lenton R., Noyvert B, Shannon-Lowe C., Middleton G., Mussai F., De Santo C. (2019, Sept; DOI: 10.1016/j.ebiom.2019.08.025) MDSC targeting with Gemtuzumab ozogamicin restores T cell immunity and immunotherapy against cancers. Ebiomedicine

Swati Khanna, Suzanne Graef, Francis Mussai,  … Gary Middleton (senior author), Carmela De Santo, Raffit Hasan (2018, March 30: DOI: 10.1158/1078-0432.CCR-17-3757) Tumour-derived GM-CSF promotes granulocyte immunosuppression in mesothelioma patients. Clinical Cancer Research

Neeraj Lal, Brian S White, Ghaleb Goussous, Oliver Pickles, Mike J Mason, Andrew D Beggs … Gary W Middleton (2017, Oct 23; DOI: 10.1158/1078-0432.CCR-17-1090). KRAS mutation and Consensus Molecular Subtypes 2 and 3 are independently associated with reduced immune infiltration and reactivity in colorectal cancer Clinical Cancer Research

Neeraj Lal, Andrew Beggs, Benjamin Willcox, Gary Middleton (2015 Apr 2; DOI: 10.4161/2162402X.2014.976052) An immunogenomic stratification of colorectal cancer: implications for development of targeted immunotherapy. Oncoimmunology.

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