The molecular basis of cancer

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Published: 12 Nov 2013
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Dr Gerard Evan - University of Cambrige, UK

Dr Gerard Evan talks to ecancer at the 2013 NCRI Cancer Conference in Liverpool about methods for discovering new targets for treating cancer and the continuing move towards a more personalised approach to treatment.

Read the conference report of the NCRI 2013 meeting for free.

I’m very interested in the molecular basis of cancer and there’s a lot of interest at the moment in how different cancers are from one another; everybody’s cancer is different from everybody else’s and actually even within one cancer the cells are all different because they evolve spontaneously in different directions. What has been obscured in this is that there’s an awful lot in common amongst many cancers, probably all cancers. There are many drivers but there are only a few engines and so my talk is about the engines and the commonalities in cancers and the idea that you could hit them therapeutically and end up with drugs, therapies, treatments that would work against many, many different cancers without cancers becoming able to evolve resistance to drugs, so real cures for cancer. It’s a little bit theoretical, I work with models but these models show us that this is absolutely possible.

The endgame would be the ideal game, it sounds like science fiction, is you go to the doctor with a lump and the doctor says, ‘I don’t need to know where it is or what it is or anything about it, what tissue it’s in. Take this, it will go away.’ Now that does sound like science fiction but there’s some good molecular reasoning to suggest that that is a possibility. How we target these engines, we don’t know how to do that yet, we don’t even know really what those engines, all of them, are but I certainly feel that if we could target those engines we could have very, very broadly active anti-cancer agents that probably wouldn’t have terrible side effects as well, though that again would need to be sorted out.

Could we potentially go back to seeing cancer as one disease?

Correct, and that’s just a reflection of the fact that the molecular tool box that all cells use to replicate and survive, which is what gets hijacked in cancer is pretty much the same in all cells. There are variations on a theme but you can either get side-tracked into the variations or you can focus on the commonalities. Humans love the differences and the patterns and the colours, yes, that’s fine, but if you think about it bacteria, they’ve been infecting and growing in our bodies for millennia, for millions of years, in our forebears. If you looked at them they’d all be genetically different, they’re very genetically heterogeneous and they do horrible things like move their genes around to become resistant, this, that and the other but if you hit them hard at the right place you can wipe them out. So we would like a sort of cancer antibiotic; as I say, it’s a theory, a little bit more than a theory, quite a bit more than a theory, but we’re a long way from practice yet.

Could the cancers become resistant to the drugs over time?

Yes it could but it has taken seventy or eighty years for the world’s population of bacteria to become resistant to antibiotics and in the interim billions of people have had their lives saved. I would be OK for a century of being cancer free because by then I think we would have found other ways of tackling cancer.

What were the highlights at the conference?

For me the most wonderful thing about this conference is that cancer research is a broad church, it involves people who care for cancer patients, cancer patients themselves, scientists, doctors, nurses, carers, all sorts of people and they all come together at this meeting and they all share. They share a common aim which is a wonderful feeling to be there with lots and lots of people who share a common goal; a lot of warmth, a lot of positivity and very, very broad and very, very eclectic. So I love wandering around just learning about… I mean, I knew that cancer patients would be depressed, I didn’t realise how serious a problem depression was in cancer patients, very naïve but I’m not a doctor. So I learned a lot about that at this meeting, I learned a lot about what’s happening in current treatment of lung cancer, I’ve learned a lot about the diversity of cancers and how cancers evolve, they’re like species and when you clobber a cancer it’s like lobbing an asteroid at the Earth and wiping out the dinosaurs but then the birds and the mammals grow back out and they’re like the tumours that come back when patients relapse. So I’ve learned an awful lot about that. You can’t start anywhere and you can’t stop anywhere at this meeting, you just run, run, run, just information overload and the warmth of the people around you.