Blog
CANCER EXPERTS MEET IN LIVERPOOL
November 16, 2011
November has arrived and with it my annual jaunt to the NCRI (national cancer research institute) conference, held once again at the impressive BT Convention Centre in Liverpool. The conference brings together scientists, clinicians and consumer groups from around the world to showcase the latest advancements and achievements in cancer research and patient care. This year saw the organising committee assemble another high class and multi-disciplinary programme that covered all stages of the patient pathway from prevention and causes of disease, early detection, through to, treatment and end of life care.
The conference allows an accurate assessment of where the Cancer Research Wales (CRW) research portfolio sits within the rapidly shifting landscape of cancer research. Such information helps guide the CRW scientific committee, ensuring that we continue to fund projects that are timely, yet novel and are able to make meaningful contributions that add vital pieces to the complex cancer jigsaw.
Every year the launch of the NCRI conference coincides with the release of several high priority press articles. This year the conference story that grabbed all the headlines in all the major tabloids was the report that the rates of cervical cancer in the U.K. for 20-30 years olds has risen significantly during the last two decades. The vast majority of cervical cancers are caused by persistent infection with the usually harmless Human Papilloma Virus (HPV). To tackle this problem the government has started a national vaccination programme that seeks to inoculate all 12-13yr old school girls, against HPV16/18 (the two major strains that cause up to 70% of all cervical cancers) before they become exposed to the virus. On this note, CRW currently funds a HPV baseline project in Wales, where samples collected from cervical smears are analysed in anonymous fashion to determine the infection rates of HPV in Welsh women. These results are then correlated with disease severity and HPV subtype. This project is essential to measure the success of any vaccination programme in Wales. Importantly, the study will also inform on the degree of cross-protection given against other non HPV16/18 strains and help identify any other cancer-causing strains that may surface and replace those not targeted by the current vaccine design.
An underlying and recurrent theme that ran through a lot of presentations and podium talks at this years meeting was the important role that the tumour microenvironment plays in the development of cancer and its aggressive features, irrespective of tumour type. The tumour microenvironment is viewed as the non-cancerous cell types that surround and/or infiltrate the tumour and influence its behaviour. An analogy would be a plant within a flowerbed, where the tilled and fertilised soil of the flowerbed (which provides support and supplies nutrients to both the roots and plant as a whole) represents the stroma, and the growing plant, the tumour. Both the stroma and tumour, just like the plant and soil are involved in a dynamic symbiotic relationship. Therefore it is timely that a recently CRW funded programme grant is focussed on understanding the precise role that the stroma of prostate cancers has in fuelling prostate cancer progression.
Scientists based at the CRW laboratories within Velindre are revealing novel mechanisms by which factors released by prostate cancer cells manipulate and alter the function of the stroma and visa versa, thereby, promoting tumour growth and spread. As part of this work, the researchers have identified tiny lipid-like droplets termed exosomes, which in essence are well ordered conglomerate of complex chemicals and growth factors, secreted by tumour cells. Prostatic exosomes have the ability to activate the supporting cells of the stroma, and also suppress the function of infiltrating immune cells that are mobilised to eradicate the tumour. This work has also shown that activated prostate stromal cells are programmed to secrete additional important immune modulators in response to certain biological cues, that further sway the immune response in favour of the tumour. These cells also acquire the ability to transform into tumour blood vessels in order to supply the tumour with essential nutrients and oxygen and provide a means by which cancer cells can escape the tumour and form secondary tumours. Pictured is Dr Jason Webber at this years NCRI conference, where he presented a poster of his work. In this he describes the transforming properties that exosomes have on the stromal cells of prostate tumours. In an effort to reveal novel drug targets and develop more effective therapeutic strategies, the same programme of research also seeks to understand how existing treatments such as anti-hormone therapy and radiotherapy alter the tumour-stroma dynamic in prostate cancer.
There is currently great excitement in the cancer area on the utility of cancer biomarkers for prognostication (defines natural history of disease) and prediction (the likelihood of response to a specific therapy) and this was clearly evident at the conference. Pathologists have long classified cancers according to their size, grade and stage, amongst other conventional parameters that can be easily assessed through a microscope. It is now accepted that most cancer types can be further sub divided into different categories according to their molecular profiles. It is these differences that are primarily responsible for the varying treatment responses and clinical outcomes witnessed in patients that have the same tumour type and stage. Biomarkers can take many guises from the expression pattern of certain genes and proteins within tumours to secreted molecules or shed whole cancer cells present in blood, sputum or urine. The hope is that the correct molecular characterisation of an individuals’ tumour will allow them to be matched to the most suitable drug. Such strategies are particularly important in the era of biologic therapies, where drugs are rationally designed and developed to specifically target the molecular defect in cancer cells. The use of biomarkers in this setting will prevent people having to undergo inappropriate treatment and also improve the cost efficiency of using these newer expensive agents.
CRW is a major stakeholder in the Wales Cancer Bank, a depository of tumour tissue, blood and other biologically relevant samples collected from every consenting cancer patient in Wales. These samples form comprehensive and well defined cohorts that cover most tumour sites that will help scientists in Wales and beyond unearth much needed biomarkers of disease progression and treatment response. It is hoped that in time such discoveries will impact upon clinical practice and allow oncologists to make more informed treatment decisions and tailor therapies to better suit an individuals needs.
After a long and intense 3 days it was reassuring and satisfying to see that the current research undertaken by CRW sponsored projects is indeed pioneering and appropriately aligned at the forefront of cancer research. This work is made possible and can only continue through the kindness and generosity of the people of Wales. WE THANK YOU!