A top Newcastle University scientist has discovered how so-called "chameleon cancers" which affect children can change the kind of cancer they are to evade treatment.
Dr Simon Bomken, a clinical scientist and honorary consultant based at the university and the Newcastle Hospitals NHS Trust, has been part of an international team investigating the rare and terrifying scenario where some kinds of leukaemia fight back against treatments - sometimes even by "switching to become a different type of cancer".
Dr Bomken - along with experts at the Princess Maxima Center in Utrecht in the Netherlands, and at the University of Birmingham - has identified the gene which allows a common kind of cancer called B-cell acute lymphoblastic leukaemia (ALL) to resist potentially life-saving treatments.
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Treatment for children with ALL has improved rapidly over the past 50 years, and now nine in 10 children with the disease are cured. However for some young patients - whose cancer does not respond to conventional treatments - medics hope that new immunotherapies could save their lives.
These include treatments like with CAR T-cells, which target the surface of leukaemia cells to eliminate cancer. However doctors have observed these cancer cells evading therapies by stopping the production of proteins on their service or even by "switching" to become a different kind of blood cancer.
Now, the scientists have published a paper in the journal Blood which explains how this relapse happens - and provides hope for treating the patients concerned. Dr Bomken said: "ALL cells carrying this chromosomal rearrangement have long been known to be able to relapse as a different type of blood cancer, acute myeloid leukaemia (AML). When this switch occurs, the leukaemia becomes extremely difficult to treat."
The top medic explained that the study had found how the "switch" can happen in blood cells throughout their development in bone marrow, and added: "Importantly, the switch can be a result of additional genetic changes that can be caused by chemotherapy itself. As a consequence, some leukaemias completely ‘re-programme’ themselves and switch identity from one cell type to another."
This "re-progamming" is driven by genetic changes - and Dr Bomken said identifying this had "important implications" for understanding the diseases and how to treat them. He added: "[The results] begin to enable us to identify which patients are at greatest risk of relapse, thereby informing the choice of which treatments to use and when.
"In time specific therapies may become available to help prevent or overcome leukaemic switching and prevent the chameleon from changing its colours."
The research was funded by Cancer Research UK, Blood Cancer UK and the Kay Kendall Leukaemia Fund.
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