Professor Richard Marais talks about his research on melanoma
November is a big month in the UK cancer research calendar, as hundreds of scientists gather for the annual NCRI Cancer Conference in Liverpool.
Set in a huge conference centre looking over the River Mersey, the 4-day meeting is a chance for researchers to meet up and discuss the latest and greatest advances in preventing, diagnosing and treating cancer.
Delegates started arriving this afternoon to hear the welcome address from our CEO and Chair of the NCRI, Harpal Kumar, and the first of no doubt countless fascinating talks – which we sum up below.
The media is always interested in the conference, and we’ve already spotted a couple of important stories triggered by research being presented at the meeting. The Guardian covered new data showing that deprivation is responsible for 450 breast cancer deaths each year.
And the BBC reported on research showing that girls from ethnic minorities are less likely to be vaccinated against HPV, the virus behind almost all cases of cervical cancer.
In the first talk of the day, Cancer Research UK’s Professor Gerard Evan was a last-minute replacement for Professor Neal Rosen (who had a good excuse – he was busy becoming a grandfather). In his talk about ‘finding the best targets for treating cancer’, Professor Evan posed a fundamental question that “foxes us all” – why is cancer so difficult to cure?
He went on to say that despite obvious significant progress in treating many different types of cancer, the challenge of completely curing the disease is still yet to be met. He says the reason lies in the “higgledy piggledy” genetics of disease – that is, even within a single tumour, often there can be many different genetic faults ( something we’ve written about before ), making it hard to develop treatments that quash the effects of all these faults.
A second and associated challenge, he said, is that “cancer cells compensate and evolve to treatment”. His vision therefore is to find central ‘nodes’ in the cell’s circuits that are “non-redundant”- that is, that cells can’t evolve ways to outsmart.
He believes targeting such nodes could usher in an era not of ‘personlised’ medicine (one of the buzzwords in research circles at the moment), but an era of “impersonlised medicine” of treatments that can be used across a range of tumour types.
He went on to talk about his lab work to understand the effects of targeting a gene called Myc, which was known to be an “accelerator” (oncogene), responsible for driving the growth of cancer cells. He showed compelling research that targeting Myc can have profound effects on tumours.
But a big challenge remains – developing drugs that mimic the effects of his work in the lab. This is “not trivial” but Professor Evans thinks it’s possible. It was also nice to hear Professor Evan’s view that “in the UK, which is driven mostly by private enterprise and charity, we can chase these tough challenges”.
Professor Peter Sasieni then shifted the focus from treatment to prevention. In his talk about cervical cancer prevention, he began with the message that while the HPV vaccine may one day wipe out cervical cancer, we must remember it’s “today’s solution for tomorrow’s problem”. Women born before 1990 won’t be protected, and neither will women in the third world where the vaccine is unaffordable and which accounts for a large proportion of the global burden of cervical cancer.
While we await the wipe out of this disease, we continue with screening. Professor Sasieni pointed out that we must remember that there are both benefits and harms involved. The benefits of screening decrease with age, as do the protective effects. But it’s difficult to decide at what age to stop. As for when to start, the aim of screening is to start as late as possible to prevent over treatment, while still preventing cancer.
On balance, the evidence shows the benefits of screening women in their early 20s doesn’t outweigh the risks. He pointed out that in young women low-grade disease will often go away on its own.
He finished a wide-ranging talk with a positive message: when it comes to cervical cancer “overall it’s good news”. Death rates have come down substantially since the 1960s, with around 2,500 fewer deaths from this disease.
Professor Richard Marais from our Manchester Institute gave the final talk of the day. A 5pm talk on a Sunday isn’t the easiest time to enthuse an audience, but Professor Marais’ presentation about melanoma skin cancer was engrossing.
Even though around eight in 10 cases are successfully treated by surgery, the two in 10 people whose disease is caught later are much harder to treat. Professor Marais talked about his work to translate biological insights in the lab into progress in treating patients. His work on BRAF underpinned the development of vemurafenib, a drug (or “beautiful little compound” according to Professor Marais) that can give valuable extra month’s of life to patients with advanced skin cancer.
But vemurafenib still isn’t a cure for these patients, and in his talk Professor Marais took us through his research to better understand the molecular mechanisms that allow skin cancer to eventually resist the treatment.
These resistance mechanisms “turn out to be incredibly complicated” – highlighted by the fact that more than 30 scientific papers have been published describing different ways melanoma cells can evolve resistance – but the overriding theme of this and all the talks of the day is that research is fighting back against cancer’s resistance to treatment.
Professor Marais described his work to develop a “precision medicine platform” that can predict resistance mechanisms in a tumour before a patient relapses, so they “can pre-emptively treat resistance before it appears”.
It’s only the first day and we’ve already heard some great research. Research that we know will lead to even more progress against cancer.
We look forward to hearing about even more over the coming days, and sharing our highlights with you.
If you want to keep up with what’s happening at the conference, you can follow the #NCRI2013 hastag on Twitter.