Research into blood cancer: leading the way in cancer treatment
A fascinating new article by Professor Mel Greaves from The Institute of Cancer Research in London makes the case that research into blood cancers has historically been at the forefront of advances in cancer treatment.
In a fascinating article in the journal ‘Nature Reviews Cancer’, Professor Mel Greaves from The Institute of Cancer Research in London makes the case that research into leukaemia and related blood cancers has historically been at the forefront of advances in cancer treatment. Professor Greaves’ pioneering work into the origins of childhood leukaemia has been funded by Bloodwise for over 30 years.
Insights into the biology of cancers have been essential for the design of more effective treatments, including the development of drugs that target specific genetic characteristics of cancer cells and new ways to turn the immune system against rogue cells. Breakthroughs in the understanding of cancer development, which have gathered pace since the latter half of the 20th century, give hope of a future where ‘blunderbuss’ treatments like traditional chemotherapy will be a thing of the past.
Below are just four examples given by Professor Greaves of discoveries initially made in the field of blood cancer research that have gone on to have a wider impact on cancer treatment and medicine in general:
Combination chemotherapy: Until well into the middle of the twentieth century, childhood leukaemia was considered incurable, with many doctors regarding treatment as pointless and unethical. Thanks to the pioneering use of different drug combinations in the 1950s and 1960s, childhood acute lymphoblastic leukaemia became one of the first types of cancer to be cured with chemotherapy. The use of multiple drugs concurrently to tackle complex cancers has become the model for successful chemotherapy treatment. Chemotherapy is now widely used in cancer treatment, such as to reduce the size of a tumour before surgery or to prevent the disease coming back.
Cancer biology: The first specific genetic abnormality linked to a particular cancer was the ‘Philadelphia chromosome’. It is a shorter version of chromosome 21 first identified in 1960 as the cause of chronic myeloid leukaemia (CML). This set us on the way to understanding cancer as a disease driven by faulty genes. Many other genetic abnormalities have since been linked to different cancers, often forming the basis for successful targeted treatments for these diseases.
Stem cell transplantation: The first ever bone marrow transplant was carried out in 1969 to treat a patient with leukaemia. Regenerative medicine now offers the prospect of effective treatment for many other medical conditions, including blindness and spinal cord injury. Stem cell transplants still represent the best chance of a lifelong cure for some specific types of blood cancer.
Immunotherapy: The introduction in 1997 of the antibody drug rituximab to treat lymphoma was the first drug to successfully demonstrate that the immune system can be harnessed to kill cancer cells. Other drugs based on antibodies have since been developed for more cancers and researchers are now even directly modifying immune cells to fight the disease, an approach once again being pioneered in blood cancers. Immunotherapy has become one of the most exciting fields of cancer treatment in recent years.
‘Punching above their weight’
The reason researchers and clinicians in the field of blood cancers have been at the forefront of so many medical breakthroughs can be explained in a large part by the nature of these diseases, says Professor Greaves. For example, compared to ‘solid’ tumours, blood and bone marrow are more accessible and single blood cells can be isolated and manipulated relatively easily in a laboratory.
The amount of investment made into laboratory research and clinical trials for blood cancers such as childhood acute leukaemia has also been hugely significant, Professor Greaves argues. An almost certain death sentence in 1960, nine out of 10 children diagnosed with acute lymphoblastic leukaemia – the most common form of childhood cancer – will now survive.
Referring specifically to the huge investment Bloodwise has historically made in this area, Professor Greaves says: “Leukaemia has, for a long time, been funded particularly well….Success breeds success. Better research begets more funding; more funding attracts more and better researchers. Advances in clinical trials encourage more endeavour and persistence in the challenge to outwit the disease.”
Prof Greaves’ article, ‘Leukaemia ‘firsts’ in cancer research and treatment’ was published in the journal Nature Reviews Cancer http://www.nature.com/nrc/journal/v16/n3/full/nrc.2016.3.html