Imagine being able to harness the power of people’s immune systems to find and destroy cancerous cells. Thanks to the work of trailblazing researchers, immunotherapy has become a viable treatment for some patients.
But this innovative new approach doesn’t work for everyone. So, in order to unlock its full potential, researchers need to figure out why it’s more effective for some people and cancers than others. And that’s where discovery research comes into play.
Put simply, discovery research is about finding clues in fundamental cancer biology – from the processes involved in the regulation of cell division, to how cancers evolve, adapt and interact with the immune system – that might lead to the development of innovative new cancer cures. It spans a huge range of specialisms, including biology, chemistry and data science, which bring different perspectives to overcome challenging problems.
This work predominantly occurs in the lab, typically using cells or model systems such as yeast, fruit flies, nematode worms and mice. Promising results are further developed with translational research, which turns insights from the discovery stage into something practical, such as a new drug. Clinical research – the end stage of the cancer research journey – checks the safety and benefit of new treatments, testing them on people through clinical trials.
However, as there are still so many unanswered questions about cancer, any exciting new cancer treatment relies on strong research at the discovery stage, which ultimately leads to the solutions. “There’s still a lot of discovery research that needs to be done,” says Dr Lynn Turner, director of research at the UK-based charity Worldwide Cancer Research. “Without it, we won’t get the knowledge and the breakthroughs that we need.”
Funding a cure
Given the importance of discovery research and rising global cancer rates, it’s worrying that funding for it has declined by 25% globally since 2006. This is partly because it’s hard to predict which projects will lead to a gamechanging cancer treatment and which will hit a brick wall. Many governments and charities therefore prefer to fund clinical research with clearly identifiable results, often related to one type of cancer. But by only backing “safe” ideas, others with real potential to become revolutionary cancer interventions can be left behind.
Worldwide Cancer Research takes a different approach: it focuses on discovery research across all types of cancer. “Our scientists are asking the big questions,” says Turner. “They are confident that their ideas will lead to new ways to diagnose, prevent and treat cancer.” This approach can be risky, she adds, “as these ideas sometimes don’t work out the way they think they will”. Nonetheless, big intellectual risks can also lead to unexpected findings that save lives.
But why is cancer so hard to cure in the first place? Firstly, it’s because “cancer” is actually a catch-all term for more than 200 different diseases. Each broad cancer type has many subtypes, and each subtype is different on a genetic and molecular level. In fact, there are countless genetic mutations that alter the way cancers form, grow, and spread.
Treatments may kill all of one type of cell in a tumour, but resistant ones sometimes survive and multiply again. These genetic mutations are also why, if not spotted early, cancer spreads to other places in the body: a new mutation gives a new line of cancer cells the ability to survive in the bloodstream and move elsewhere.
“Even if you’ve got two people with the same type of cancer, how it behaves in their bodies can be quite different,” says Turner. “How they’re going to respond to treatments could be quite different too. So unfortunately, a drug that works for one person may not work for another.”
Thinking outside the box
Although cancer cells are hard to kill, the breakthroughs that could lead to cures could come from anywhere. “We believe very passionately that diversity of thought brings more innovation,” says Turner. “We often receive [funding] applications from researchers who don’t have a cancer background.”
Worldwide Cancer Research also funds discovery research anywhere in the world, not just the UK. “Cancer is a global problem … [and] the whole ethos of our charity, from the beginning, was that we would fund the best, the most innovative research, wherever it came from,” says Turner. “And that’s what we continue to do today.”
Since being established in 1979, the charity has invested more than £200m in more than 2,000 projects, spanning 35 countries. Although every project that receives funding needs to show “clear logic”, says Turner, many of them are highly creative and original.
One team of researchers is currently trying to understand how the beating of our hearts helps to make cancer so rare in this organ, for example, and then develop a wearable device that mimics this process to stop the spread of cancer. Turner says the lead researcher, Dr Serena Zacchigna, has developed some promising preliminary data that indicates that the constant pumping of the heart “means that the cells don’t develop into cancer cells”.
A growing number of funding applications also focus on the relationship between the human microbiome and cancer. “We know so little about what is happening in a healthy person’s microbiome,” says Turner, so research that explores how it affects cancer “could potentially be really exciting”.
Research that could help to develop new cancer immunotherapies is also underway. One team, led by Prof David Withers, has developed an innovative new way to track the movement of immune cells in and out of tumours and between different tissues in the body. They are using this approach to better understand the cells that orchestrate the anti-tumour response. “Normally the cancer manages to damp down the activity of those cells, and he’s looking at how we can reactivate it,” says Turner. In time, with further research, this could help to improve current immunotherapies so that they work for even more patients.
Cures are desperately needed to stop lives being cut short by cancer – and that will only happen through the funding of more discovery research leading to more breakthroughs. “We’re understanding cancer better,” says Turner. “But there’s still a lot to discover.”
Help the search for new cures
Find out more about the search for new cures being funded by Worldwide Cancer Research and how you can support the charity’s work at worldwidecancerresearch.org/donate
