It’s an exciting time for blood cancer research: we understand so much about the biology of how blood cancers develop, we have access and the means to analyse huge amounts of data on patients, we’re making major progress with targeted treatments that are tailored to individuals, and our patient-centric approach is closing the gap between the lab bench and the bed-side. We know more than ever about what we need to fund to have the greatest impact for people affected by blood cancer.
We currently have over £90 million invested in research projects and we’re delighted to tell you about some of the 18 new and exciting research projects that we’ve added to our portfolio.
Deciding what to fund
Scientists from all over the UK, and internationally, can apply for our research grants. With so many applicants and a limited budget, we have to make some tough decisions. The road for research to gain approval is long and stringent. We have an expert committee who interrogate applications (and applicants) and our board of trustees chew over their recommendations before making a decision. The research eventually chosen to receive funding is all informed by our Prioritisation of Patient Need (PPN) project. PPN has brought together the views of 1,725 people affected by cancer, spanning 19 focus groups across 17 cities, with 21 medical professionals consulted – it’s providing ground-breaking insight into the needs of blood cancer patients.
Prioritisation of Patient Need
PPN has already highlighted several areas of particular importance for our research, and ten of the new research projects are concerned with the greatest contributors to the number of lives lost within five years of diagnosis (myeloma, diffuse large B-cell lymphoma, acute myeloid leukaemia, chronic lymphocytic leukaemia and myelodysplastic syndromes).
What’s more, two more projects are aiming to tackle graft-versus-host disease (GvHD), an all too frequent and life threatening complication following a stem cell transplant. Stem cell transplant is a therapy relevant to some AML, MDS, myeloma, DLBCL and CLL patients.
Out of the seven projects on AML, it is great to see that two are addressing AML and MDS together, bringing in a prevention element. For example, Tom Coats, a talented junior haematologist at King’s will use his research training to better understand the role of the immune system in the progression of MDS to AML, which will be important in designing interventions to halt this.
Here are a few more studies I want to highlight:
Precision medicine for aggressive lymphomas
Peter Johnson at Southampton is leading a national consortium of haematologists, pathologists and scientists working together with industrial partners. The goal is to design a genetic test to identify, in advance, those patients who might be suitable for particular targeted drugs if and when they relapse.
A major focus will be high-grade DLBCL, but other aggressive B-cell non-Hodgkin lymphomas will be included. In these diseases, success rates have improved greatly with many patients being cured. For those who do relapse, however, the outlook is poor. The aim of this programme is to improve the prospects for these patients by developing and validating robust predictive tests to direct individual patients to the best available drugs.
Improving quality of life for young people with Hodgkin lymphoma
Stephen Daw at UCL is going to run the UK part of a large international clinical trial for children, adolescents and young adults with newly diagnosed Hodgkin Lymphoma. This single award sings our strategic goals: stopping people dying from blood cancer; improving the lives of people with blood cancer; and, stopping people getting blood cancers in the first place.
The numbers of younger patients surviving Hodgkin lymphoma has improved greatly over the decades. But cure often comes after gruelling treatment, and at the expense of long-term health problems because of the side effects of the treatment, particularly radiotherapy. The trial aims to reduce the use of radiotherapy in lower risk patients who respond well to initial chemotherapy, and to reduce the intensity of radiotherapy in patients who still need it. The goal is to carry on saving lives, but to improve the quality of life for as many patients as possible, both during their treatment and long after. If successful, this will reduce the numbers of patients who get second cancers (including blood cancers) later in life as a consequence of their treatment, thereby bringing in another prevention approach.
This trial comes hot on the heels of our RAPID trial that looked at treatment de-escalation in older patients with Hodgkin lymphoma–the results of which have recently been accepted for publication and are likely to be practice changing.
Supporting the UK’s childhood leukaemia research
We are renewing our support of the Childhood Leukaemia Cell Bank – a central UK biobank for samples of bone marrow and other tissues donated by children with leukaemia for use in specialist research projects. The bulk of the samples come from the large national childhood acute lymphoblastic leukaemia (ALL) trial (UKALL 2011) that is also funded by Leukaemia & Lymphoma Research. Together this trail and the ongoing success of the biobank will underpin the UK as a major player in childhood ALL research. It will be vital if we are to develop biological therapies to replace the current aggressive and toxic chemotherapy approaches. Samples from the bank have already been used to make important new discoveries about how leukaemia develops and improved ways of managing the disease in children.
Crossing the disease boundaries
Some of the projects highlight how traditional boundaries between diseases and their treatment continue to be broken down. Guido Franzoso at Imperial, for example, is using a new drug that has shown promise in myeloma and has entered into clinical testing, but which his group will now carry out lab studies to test it in DLBCL. Similarly, both Michelle West at Sussex and Olaf Heidenreich at Newcastle will investigate how a regulator protein, RUNX1, is corrupted in blood cancers – Michelle will primarily focus on certain non-Hodgkin lymphomas whereas Olaf will study AML.
Even this snapshot of research highlights the fact that biological therapies are changing the way we look at blood cancers. More and more we are defining diseases by biochemical pathways that we can hit with drugs, rather than the traditional definitions based on the symptoms patients present with at diagnosis and what their cells look like down a microscope. This means we are starting to collate patients into groups by virtue of their likelihood to benefit from differing therapies. This is a trend across cancer research, and shows once again how blood cancer research and we as a charity are at the forefront.