A day in the life: The Precision Medicine in Aggressive Lymphoma consortium
The team of clinicians, bioinformaticians and lab-based researchers tells us about their research into lymphoma and how analysing genetics can help match the right treatment to each individual.
What is your role in the PMAL team?
Tom Cummin: I’m a Clinical Research Fellow based in Southampton at the Centre for Cancer Immunology and Southampton Clinical Trials Unit. Initially my role involved linking the clinical trials and the research labs involved in this collaboration. This has changed more recently as I do more work in the lab to determine how different types of lymphoma can be targeted with new drugs.
Francesco Cucco: I am a researcher at the University of Cambridge, and I identify genetic errors in samples taken from people with diffuse large B cell lymphoma (DLBCL).
Jude Fitzgibbon: I am a professor at Queen Mary University of London. In our lab, we’re looking at the genetic profile of samples collected at the times of diagnosis and relapse from the same patient. Our experiments provide a measure of the complexity of a patient’s lymphoma and knowledge of changes that contribute to disease relapse after treatment.
Laura Lopez Pascua: I’m a biologist and bioinformatician based at the University of Oxford. I’m developing a new test that allows us to detect cancer DNA from a blood test. This test should allow us to obtain accurate information about the lymphoma without taking a sample from the lymphoma itself, which can be painful for the patient.
Sharon Barrans: I am a clinical scientist in the Haematology Malignancy Diagnostic Service (HMDS) at Leeds Teaching Hospital. My role involves co-ordinating the laboratory testing of samples from patients, which we use to find out what kind of lymphoma someone has.
Sharon (centre, just behind woman holding certificate) with the rest of the HMDS team.
What do you do at work on a day-to-day basis?
Jude: As a professor, I now rarely spend time in the laboratory. Instead, I lead a group of researchers and set the direction of our research as we unravel the complexity of lymphoma and leukaemia.
Sharon: I coordinate a small team of technicians who process samples from people who’ve taken part in clinical trials. I also spend time looking down the microscope at patient samples to decide which tests to do.
Tom: Some days I’m seeing patients with blood cancers in the clinic but increasingly I am in the lab, testing the effectiveness of new lymphoma drugs.
Laura: I spend a lot of time testing different technologies on samples to find the best tests and create complex computer programmes to analyse our data.
Francesco: I spend most of my time in the lab, for example when I am preparing DNA for a test. I also do computer-based work, for example to identify genetic errors.
Francesco doing some computer-based work.
What are you working on right now that you are excited about?
Laura: I’m testing different methods for detecting and analysing lymphoma DNA in the blood. In the past, we have monitored how people respond to treatment by taking biopsies, which involve taking samples from the solid lymphoma tumour. I know patients can find repeated biopsies very stressful, so being able to monitor patients and their response to treatment with blood samples instead is a fantastic development.
Laura at work in the lab.
Tom: We have discovered a way of classifying a new high-risk group of lymphomas and are working with collaborators in Canada to figure out how to routinely identify them in the clinic. I am really excited about this, as it may lead to new ways to treat this set of patients.
Jude: We have a list of about 300 genes whose activity changes between diagnosis and relapse. These genes may somehow promote ‘disease resistance’ and provide a clue as to why some patients are permanently cured after treatment and some relapse.
Jude also researches acute myeloid leukaemia; here he is presenting some findings about the genetics of AML at the largest European conference on blood disorders.
Why do we need the research you do?
Sharon: Collectively, we are striving to find out more about the different genes that are involved in different types of lymphoma. This helps us to learn more about the biology of the disease, leading to better treatment options for patients based on their cancer’s specific genetics.
Tom: New treatments for cancer don’t work for everyone, which has led to a precision medicine approach: selecting new drugs based on the biology of the individual’s cancer. This is not straightforward and requires us to really understand the disease’s nuts and bolts, which is what PMAL is achieving.
Tom in the lab.
What does your work mean for people who have blood cancer?
Francesco: My work means that we have a better understanding of what is happening at a molecular level in blood cancer, both in individual terms and in group terms. By doing so, I’m contributing to PMAL’s important goal of developing precision medicine for people affected by blood cancer.
Sharon: We provide a comprehensive report on the patient’s lymphoma to the clinician treating the patient, which helps them decide which treatment to use. The information gathered also helps drive future clinical trials testing new treatments.
Tom: The work being carried out by PMAL means that patients in the UK diagnosed with lymphoma are receiving new treatments which they would not otherwise be getting.
Is there anything you’d like to say to Bloodwise supporters?
Sharon: Without funding from Bloodwise, we would not be able to continue our important research. We are extremely grateful to Bloodwise supporters for providing resources enabling us to do this.
Laura: We are all very grateful for all the support you give for research. Hopefully between us we can continue to improve outcomes and the quality of life of all our loved ones.