It’s been a busy year here at The Institute of Cancer Research, London. From new drug approvals to prestigious awards, a prime time documentary to new research about elephants and cancer, we couldn’t possibly tell you about everything that’s gone on this year, but thought I’d share a few of my personal highlights.
Can You Cure My Cancer?
2015 began well, with an episode of Panorama focused entirely on the pioneering work of the ICR and our hospital partner, The Royal Marsden.
‘Can You Cure My Cancer?’ was shown on BBC One and told the stories of cancer patients as they underwent clinical trials of new drugs at the ICR, demonstrating how our bench-to-bedside approach drives the development of personalised medicine. We worked with Fergus Walsh, medical correspondent from the BBC, and his producer for almost two years and they were able to capture on film our work to develop innovative treatments targeted at specific mutations in individual patient’s cancer. You can watch the programme here.
We were proud to receive a highly commended award at the end of 2015 from Understanding Animal Research, recognising our efforts to communicate openly about animal research in the Panorama programme.
Immunotherapy
Immunotherapy was a buzzword in cancer research in 2015, and our research has helped move these treatments closer to the clinic. In May, we announced the results of a phase III clinical trial which was the first to definitively show patient benefit for a viral immunotherapy for cancer. The international trial was led in the UK by researchers at the ICR and The Royal Marsden and involved a treatment called T-VEC - a modified form of herpes simplex virus type-1 which multiplies inside cancer cells and bursts them from within. The virus has also been genetically engineered to produce a molecule called GM-CSF, which stimulates the immune system to attack and destroy the tumour.
In an exciting step towards this treatment being made available to patients, the therapy was approved by the European Medicines Agency this week for advanced melanoma – the first viral immunotherapy to be approved in Europe.
Cancer imaging for improved diagnostics and treatment
The ICR has been at the forefront of advancing radiotherapy techniques to help improve treatment for many years. In 2015 building work started on the site of our new multimillion pound MR Linac machine – a joint project with our partner hospital The Royal Marsden. The machine combines a state of the art radiation machine, known as a linear accelerator, with an MRI scanner.
In July Professor Uwe Oelfke, Head of the Joint Department of Physics at the ICR and Royal Marsden described the potential of the MR Linac in a press briefing: "The MR Linac will allow us to constantly image the tumour during radiotherapy and allow us to adapt the treatment in real time. This would be a truly new practice and we would be entering into a new era of personalised radiotherapy.”
The project has involved a close working relationship with Elekta, the developer of the pioneering radiotherapy system, Philips, the MRI technology provider, and the Medical Research Council who funded the project. The site is now being prepared for parts of the machine to arrive in the first couple of months of the new 2016.
2015 also saw the start of a pioneering clinical trial using focussed ultrasound therapy to heat-treat cancer pain. High-intensity focused ultrasound (HIFU), concentrates high-power sound waves to create heat in the same way that a magnifying glass can concentrate sunlight to burn paper. Ultrasound waves can be focused so intensely that they can destroy tissue when precisely targeted within the body. The technology is coupled with MRI guidance to identify, target and track treatment in real time. Researchers at the ICR and The Royal Marsden have started treating a small number of patients with advanced cancer with bone metastases and have seen encouraging reductions in the pain they were experiencing from bone tumours.
Precision medicine
In May, scientists in the UK and the US unveiled prostate cancer’s ‘Rosetta Stone’ – publishing a study demonstrating that almost 90 per cent of men with advanced prostate cancer carry genetic mutations in their tumours that could be targeted by either existing or new cancer drugs. Researchers said doctors could now start testing for these ‘clinically actionable’ mutations and give patients with advanced prostate cancer existing drugs or drug combinations targeted at these specific genomic aberrations in their cancers. The study was led in the UK by scientists at ICR, in collaboration with researchers from eight academic clinical trials centres around the world.
Professor Johann de Bono, Professor of Experimental Cancer Medicine at the ICR and Consultant at The Royal Marsden, said at the time: “We’re describing this study as prostate cancer’s Rosetta Stone – because of the ability it gives us to decode the complexity of the disease, and to translate the results into personalised treatment plans for patients.” The study was also a great example of ‘team science’ with researchers from different disciplines and locations working together to solve a complex research problem.
In October a landmark clinical trial led by researchers at the ICR showed that the pioneering drug olaparib could benefit men with advanced prostate cancer. Olaparib is the world’s first drug to reach the market targeted against inherited cancer mutations, and was developed to treat women with inherited cancers. The trial is a milestone in cancer treatment as the first to show the benefits of ‘precision medicine’ in prostate cancer – with treatment matched to the particular genetic characteristics of a man’s tumour.
This month olaparib was approved for use in women with BRCA-mutated ovarian cancer by NICE. The development of olaparib was underpinned by translational research at the ICR, which was instrumental in developing the innovative concept of targeting BRCA-mutated cancers with drugs of its type.
As a result of our work discovering and developing new cancer drugs, in December we were presented with a UK Pharmacology on the Map award – recognising the ICR as a top spot for pharmacology and drug discovery in the UK.
To be able to personalise medicines to individual cancer patients, doctors need to understand the genetic make-up of tumours. Traditionally this has been done by biopsy, where small samples of tumour are taken for analysis, but over the last year research has progressed in the area of liquid biopsies, where tumour DNA is extracted from blood.
In August a study led by Dr Nicholas Turner, researchers developed a test capable of detecting small numbers of residual cancer cells that have resisted therapy by detecting cancer DNA in the bloodstream. They hope that by deciphering the DNA code found in blood samples, it should be possible to identify the particular mutations likely to prove lethal to that patient – and tailor treatment accordingly.
Cancer evolution – elephants and other stories
Professor Mel Greaves from The Institute of Cancer Research, London, has been awarded the Cancer Research UK Lifetime Achievement Award for his work investigating the causes and clonal evolution of childhood leukaemia. His work has pioneered the application of evolutionary biology to cancer, working principally with childhood leukaemia but expanding on this work to apply the same Darwinian principles to cancer in general. He became the first Director of the Centre for Evolution and Cancer at the ICR in January 2014.
2015 was also the year of the elephant – with researchers in the US revealing that elephants have at least 20 copies of the p53 gene which may explain why elephants have mysteriously low cancer rates, and could provide some intriguing clues for preventing cancer in humans.
In an accompanying commentary, scientists at the ICR said the research provided a plausible explanation for the famous Peto’s Paradox – that bigger animals with more cells don’t necessarily have higher cancer rates.
In summary
Even this brief look at back at 2015 shows how much has happened over the last year at the ICR, and how our research is helping to improve the lives of cancer patients. For a more comprehensive look at our top research stories, our research directorate picked their most exciting discoveries over the last year, you can find the full list here. With the new year just round the corner, we look forward to sharing more scientific discoveries with you in 2016!
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