Cancer is supported by complex ecosystems within the body which can be disrupted by cutting-edge new treatments and cures, world-leading cancer researchers conclude.
Scientists and clinicians have come together to identify cancer’s reliance on the ecosystems of our body’s cells and signals as a major opportunity in the next five years of research and treatment.
This insight opens exciting new opportunities to treat cancer, including using viruses together with radiotherapy to supercharge the immune system, drugs that target the healthy tissue that supports tumours, and AI-guided design for drug combinations and dosing strategies.
The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust today (Tuesday) reveal exciting plans to unravel and disrupt cancer ecosystems – by directing research against the cells, signals and immune response in the tissue environment that nurtures tumours.
The new strategy aims to implement new approaches to target cancer – by setting up streamlined processes to prioritise potential drug targets from across the horizons of research and employing state-of-the-art technology to eradicate cancer proteins from cells
Scientists will also employ AI to design new ways to combine drugs or cleverly adjust their dosing – with the aim of confronting cancer’s evolution within its ecosystem and increasing the length of time that people can survive with advanced cancer. Using these approaches, researchers are confident that doubling survival of people with advanced cancer within a decade is a realistic goal.
The Institute of Cancer Research (ICR) and The Royal Marsden have identified a series of projects as being fundamental to the approach of targeting and disrupting the cancer ecosystem:
Predicting how cancer evolves within different ecosystems – and devising low-dose strategies that avoid selecting for drug resistance, or drug combinations that cut off cancer’s escape routes.
Revealing how different types of cells within a tumour can team up and work together to shape their ecosystems – potentially opening up new targets for treatment.
Seeking ways to target the once healthy tissue co-opted by the cancer within the tumour ecosystem with drugs to make the body inhospitable for the cancer.
Exploring how to identify cancer earlier or detect its return much sooner using tests which spot minute amounts of the tumour’s DNA within the bloodstream.
Finding ways to use viruses, targeted drugs, and radiotherapy together to give the immune system the edge in its evolutionary arms race with cancer.
Their joint, five-year research strategy aims to unravel cancer’s ecosystem, diagnose cancer better and earlier, target cancer’s weaknesses and treat cancer more precisely. The two organisations will carry out world-class research with the aim of building ever closer connections between the ICR’s discovery science to unravel the genetic and molecular basis of cancer, the cancer ecosystem, translational research to diagnose and target cancer more effectively, and clinical studies in partnership with The Royal Marsden to build evidence for advances in patient care.
While the strategy offers a fresh approach in targeting cancer, it builds on hundreds of years of research. In the late 1800s Stephen Paget noticed that breast cancers were not spreading randomly but took root in particular locations within the body. He concluded then that those organs and tissue types must have a favourable “local ecosystem” that helps the cancer to spread.
Technology has advanced exponentially since Paget’s observations and has provided a molecular and cellular framework for understanding cancer ecosystems. By further investing in cutting-edge genomic, proteomic, epigenetic, immunopeptidomic, and microscopy technologies, the scientists aim to examine cancer cells, molecules, and ecosystems at unprecedented resolution.
The ICR – both a charity and a research institute – believes tackling the cancer ecosystem requires the strongest possible research ecosystem.
The new strategy brings together the ICR’s revolutionary research with The Royal Marsden, a world-leading cancer centre, its internationally regarded education programme, and ‘knowledge exchange’ to grow impact for patients. The ICR also seeks to increase funds for research, invest in new collaborative research centres, and form stronger partnerships with industry and academic institutions, both in the UK and globally.
Professor Kristian Helin, Chief Executive of The Institute of Cancer Research, London, said:
“Our leading scientists and clinicians have identified cancer’s evolution within a complex ecosystem as a major challenge and opportunity for the next five years.
“We have created a really exciting plan to unravel and disrupt cancer’s ecosystems, with new immunotherapies, drugs to target the tissue environment, and clever new anti-evolution combinations and dosing strategies.
“Research has been a driver for remarkable improvements in treatments in recent decades, but we believe we can go even further and eradicate some cancers by targeting the ecosystems required for their growth, or tipping the balance in favour of the immune system. We’re also confident that through the use of artificial intelligence in combination with detailed biological insights, we can find ways of combining existing treatments to control cancer’s evolution within its ecosystem and significantly increase the overall survival of cancer patients.”
Dr Naureen Starling, Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust and Senior Lecturer at The Institute of Cancer Research, London:
“Many cancers are difficult to detect, often because they are deep in the body or do not become symptomatic until they’re at a late stage. Yet, the earlier cancer is detected, the more possible and effective treatment is likely to be with a greater the chance of survival. This means finding better and faster ways to detect and diagnose the disease is critical. To tackle this challenge, we are pioneering research into improved screening approaches, biomarker testing to identify individual risk as well as innovative diagnostic tools. For example, we are currently using liquid biopsies – blood tests which can identify genetic information shed by the tumour - to personalise treatment and identify recurrence earlier. However, we believe this technology also has the potential to transform cancer diagnosis, particularly for traditionally hard-to-detect tumour types like pancreatic, so could lead to rapid improvements in patient outcomes.”
Dr Olivia Rossanese, Director of Cancer Drug Discovery at The Institute of Cancer Research, London, said:
“Newer, more personalised treatments are helping people with cancer to live well for longer, but some types of the disease remain very difficult to treat, and once cancer has spread it is still often incurable.
“We plan to open up completely new lines of attack against cancer, so we can overcome cancer’s deadly ability to evolve and become resistant to treatment. We want to discover better targets within tumours and the wider ecosystem that we can attack with drugs. We’re finding powerful new ways to eradicate cancer proteins completely and discovering smarter combination treatments that attack cancer on multiple fronts. Together, this three-pronged approach can create smarter, kinder cancer treatments, and offer patients longer life with fewer side effects.”
Professor Kevin Harrington, Professor of Biological Cancer Therapeutics at The Institute of Cancer Research, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, said:
“Immunotherapy has begun to revolutionise treatment for some cancer patients – we’re even starting to see cures in people with advanced disease who, until recently, were destined to die of their cancers. But unfortunately, immunotherapy doesn’t work for all patients or all cancer types, and we need to do much better both at predicting whether it will work, and increasing the effectiveness of treatment.
“We believe that there are huge opportunities to use combinations of immunotherapy and other treatments like radiotherapy to disrupt cancer’s ecosystem. We are aiming to tilt the balance in favour of the immune system and make the environment inhospitable to cancer cells and favourable for elements of the immune system that can attack them, so that we can make the disease extinct within the body. We’re even using viruses to accurately target cancer cells and draw a powerful immune response to them. We think the reward will be immunotherapy that works for many more patients, and that increasingly gives even those with advanced cancer the hope of a cure.”
Find out more about the ICR and The Royal Marsden’s new research strategy at ICR.ac.uk/strategy
The World Cancer Declaration recognises that to make major reductions in premature deaths, innovative education and training opportunities for healthcare workers in all disciplines of cancer control need to improve significantly.
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