Our researchers are continually making advances that have the potential to change the world for blood cancer patients.
As it's Blood Cancer Awareness, here’s a quick run-down of just some of key discoveries reported this year, and the promise for the future.
Understanding the biology of blood cancers
When trying to mend a broken clock, it really helps if you know how it should work and what can cause it to go wrong. And likewise in cancer, when something goes wrong in cells, to tackle it it’s crucial to understand how the machinery should work and what goes awry to cause these cells to grow out of control.
To get to grips with the biological nut-and-bolts of blood cells, Dr David Kent, a Bloodwise Bennett Fellow, and Prof Bertie Göttgens used state-of-the art technology to create a map of the molecular symphony that directs the developmental ‘decisions’ of immature blood cells in mice embryos. This lays the groundwork to identify the key molecular signals that transform a small clump of cells into a fully working and diverse blood system.
Moving on to what can go wrong, Dr Katrin Ottersbach, another Bloodwise Bennett Fellow in Edinburgh, identified the cells responsible for an aggressive form of acute lymphoblastic leukaemia (ALL) that affects babies. Using mice, her team discovered a critical time window that DNA damage occurs in certain developing blood cells in the womb, pointing to when
and how the foundations for leukaemia are laid.
In a similar vein, Prof Michelle West and her team in Sussex focused on how a virus can hijack the inbuilt control over cell growth to trigger the development of Burkitt lymphoma, a type of non-Hodgkin lymphoma. They discovered that the virus interferes with the control switches of two genes that help regulate normal cell death, allowing the infected cells to survive.
Targeting treatments at blood cancer
Knowing the key signals in cells that can go rogue and disrupt the normal controls on cell growth, gives researchers new targets to aim for when developing more precision treatments.
Along these lines, our researchers at King’s College London, identified two genetic faults that are critical to the development of a particularly rapidly growing blood cancer, acute myeloid leukaemia (AML). Prof Eric So’s team found that, in mice, drugs that selectively block these molecular pathways could be highly effective in treating this disease, where new treatments are desperately needed.
A collaboration between Bloodwise teams led by Prof Tessa Holyoake in Glasgow and Prof Tony Whetton in Manchester, found two proteins that acted as master regulators to maintain the survival of chronic myeloid leukaemia (CML) stem cells. Testing specific drugs that hit these two signals successfully killed the stem cells at the root of the cancer and eradicated the disease in mice, offering a possible route to a cure for this type of leukaemia.
Also striving to develop precision treatments, Dr Suzanne Turner, a Bloodwise Senior Lecturer in Cambridge reported a gene fault at the root of anaplastic large cell lymphoma (ALCL), an aggressive blood cancer that mainly affects children and younger adults. And Dr Dan Tennant in Birmingham revealed potentially important changes in signals from supportive cells in the bone marrow that may play a role in the progression of monoclonal gammopathy of undetermined significance (MGUS) to the more aggressive myeloma.
All of these results, while promising, will need more lab work to understand the full range of biological effects these treatments may have and whether they’re likely to be safe in patients. And ultimately, they will need to go through careful, systematic testing in human clinical trials before we’ll know whether they’ll be able to be used more routinely.
Tailoring treatments for patients
Once a treatment is used more routinely, it’s vital to carry on research to understand how they might be optimised, which patients are most likely to benefit, and how well patients are responding once on treatment.
Diagnosing AML involves a series of time-consuming, complex tests to analyse various features of the disease’s genetic signature. In an attempt to better guide these decisions for AML and the related myelodysplastic syndromes, Dr George Vassiliou and his Cambridge colleagues have devised a fast and simplified new method to produce the same genetic snapshot as the current array of tests. This single method detects the range and type of DNA errors present, which can flag patients who are most likely to benefit from certain targeted drugs and those who may need more intense chemotherapy or a stem cell transplant.
Looking ahead to when a patient has received chemotherapy, Prof David Grimwade at King’s led work to develop a simple blood test capable of detecting trace levels of AML cells remaining. The test can predict which patients with AML are at risk of their cancer returning in the future, helping to guide doctors on what further treatment may be needed.
And our researchers in Newcastle have made important advances in more accurately predicting the likelihood of relapse in children with AML. Prof Christine Harrison’s team found that a certain genetic alteration raises the risk of the cancer returning after treatment, suggesting these patients should be monitored more intensely for signs of relapse so that doctors can intervene earlier.
Another key finding from the Newcastle team, this time led by Prof Anthony Moorman and Dr Julie Irving, pinpointed a variety of genetic abnormalities that predicts how children with ALL whose cancer returns after treatment are likely to respond to further treatment. This suggests some patients may benefit from more intense treatment, while others may respond well to certain targeted drugs.
New research to beat blood cancer
We are continuing to drive the research that leads to these kinds of advances. This year, we’ve renewed our support for Prof Tariq Enver’s work at University College London, focusing on how signals in developing blood cells are corrupted in leukaemia development. The goal is to design more effective, safer treatments for children with leukaemia, especially for those whose disease sadly returns after the first treatment.
Our Trials Acceleration Programme (TAP) has helped to boost the number and speed of blood cancer clinical trials that assess promising new treatments. Four new TAP trials have opened this year – three are testing new targeted drug combinations for chronic lymphocytic leukaemia (CLL), myeloma and myeloproliferative neoplasms (MPNs), and one is testing whether a breast cancer drug can help patients with MPNs. There are a total of 18 trials being run through TAP, with over 800 patients so far taking part.
In partnership with Cancer Research UK, we are supporting a new clinical trial to test in patients for the first time a new targeted immunotherapy drug developed by Bloodwise researchers. The trial, which is due to open this Autumn, will recruit non-Hodgkin lymphoma patients, mainly those with mainly diffuse large B-cell lymphoma and also CLL, and will focus on testing safety and understanding side effects.
And another trial due to open at end of this year, led by Dr Stephen Daw at University College Hospital, will run the UK part of a large international clinical trial for children, adolescents and young adults with newly diagnosed Hodgkin lymphoma. The trial aims to reduce the use of radiotherapy in patients who respond well to initial chemotherapy, and to reduce the intensity of radiotherapy in those patients who still need it while improving the quality of life for as many patients as possible.
We hope you have enjoyed reading our research highlights – stay posted for further updates.
You can find out more about our exciting research here.
Find out more about Blood Cancer Awareness Month and our 3&5 campaign here.