Our research in Southampton has a strong focus on CLL, but we are also supporting a clinical trial that is looking for new ways to treat amyloidosis – a rare bone marrow condition that causes a build up of a protein called amyloid. We are also funding an ambitious project that aims to personalise treatment for people with aggressive lymphoma, and have research that aims to improve our understanding of the genetics behind myeloma and MPN so we can improve the way these blood cancers are treated.
Targeted treatments – drugs that target specific pathways that drive cancer - are transforming the way cancer is treated. But not everyone will do well on these drugs, so doctors are searching for ways to select the best treatments to the individual person, an approach called ‘personalised medicine’. Professor Johnson and his team are working with other researchers across the UK to design a test that will enable doctors to individually tailor treatments for people with lymphoma based on the genetic profile of their disease and additional clinical characteristics.
Chronic lymphocytic leukaemia (CLL) affects certain white blood cells called B cells. The exact causes of CLL are unknown, but molecules on the surface of B cells called B-cell receptors are now thought to play a key role. Two of our research projects in Southampton are focussing on the BCR. Dr Francesco Forconi is searching for new genetic markers associated with BCR activity. Because new drugs that block the activity of the receptor are only effective if the BCR is active, understanding this relationship is important, and could help doctors predict who will respond to new BCR-inhibitors. It’s also becoming apparent that CLL cells can find ways to overcome drugs that inhibit the BCR pathway.
Dr Forconi is also directing a CLL biobank, which collects biological samples from people with CLL. Samples from this bank have been used in research projects that are driving the discoveries in CLL.
People with CLL are usually treated with chemotherapy and immunotherapies, such as rituximab. Although this approach works for many people, some become resistant to their treatment. Dr Stephen Beers and his team want to explore the mechanisms of drug resistance to rituximab, and investigate possibilities for reversing it. And Dr Andrew Steele is also interested in ibrutinib resistance, and wants to find out how this happens, and what can be done to overcome this.
Dr Kim Orchard is running a clinical trial called TRALA in a rare condition called AL amyloidosis. This is where the bone marrow makes abnormal plasma cells, which produce a protein called amyloid. Amyloid can build up in body tissues, affecting the way organs work, and can be fatal if left untreated. People with amyloidosis are usually given high dose chemotherapy, followed by a stem cell transplant. Although this approach works well, many people will suffer serious side effects, such as severe infections. The TRALA clinical trial wants to see if targeted radiotherapy has less side effects than standard treatment.
Multiple myeloma is nearly always preceded by the non-cancerous blood cell disorder termed monoclonal gammopathy of undetermined significance (MGUS). But not all people with MGUS will develop myeloma, and the reasons why only some people with MGUS progress to myeloma are poorly understood. Dr Surinder Sahota’s project wants to map the different patterns of gene changes that happen when MGUS changes to myeloma, and how these differ between individuals. This project could help doctors decide what treatments would work best for each individual affected by myeloma.
Based at The Wessex Regional Laboratory Service in Salisbury, Professor Nick Cross is also looking at genetic changes, but in MPN. This project wants to explore how these gene changes vary between people, and what influences this variation. Information gathered from this research will be used to develop new diagnostic and therapeutic strategies for people living with MPN.