November 2009 podcast transcript

Hello, I’m Dr Kat Arney. In this month’s podcast we’ll be bringing you the highlights from the NCRI Cancer Conference held in Birmingham at the beginning of October - it’s the biggest conference of its kind in the UK.

Every Autumn, cancer researchers, doctors, nurses and patient groups from the UK – as well as the rest of the world – gather together for the annual NCRI Cancer Conference. It’s a great opportunity to share the latest findings, from discoveries made in the lab to the results of clinical trials.

We’ve been covering the most exciting stories from the conference on our Science Update blog – that’s scienceblog.cancerresearchuk.org – as well as producing a series of videos featuring speakers from the conference, which you can watch on YouTube – that’s youtube.com/ncrivideo

1:08
One of the most interesting talks of the conference was from Professor Larry Norton, from the Memorial Sloane Kettering Cancer Centre in New York, who has a new way of thinking about how cancer spreads. So I asked him to explain more about his ideas.

“One of the things we found that is really remarkable is that cancers don’t just grow by cell division, they also grow by “seeding”. And we know that cancers can seed metastatic sites – they can go from the breast to the bone, or the lung, or the liver – but we’re discovering that cancers can also go back to themselves. The metastatic cells can spread back to the tumour itself.

So the growing tumour is not like an oak tree – an organised collection of cells – but more like a weed bed, with a lot of little plants that are all stuck together. Each one needs its own blood supply, each one needs its own supporting cells that it brings from the bone marrow. And it explains a lot about cancer that was rather mysterious before.”

2:11
Another fascinating talk came from Cancer Research UK’s Professor Caroline Dive, from the Paterson Institute in Manchester. She’s studying escapee cancer cells in the blood, to find out how well treatments are working.

“One of the things the group is really quite passionate about is the development of biomarkers, or tests, that we can perform in patient blood samples that give us some understanding when they go through a clinical trial of a novel drug, whether that drug has hit the target in the tumour, and whether the tumour is responding well, or otherwise, to that new agent.

So we need very simple tests that we can perform in the bloodstream, because the patient is very happy to give us a sample of their blood before the new drug, and several times after the new drug treatment, so we can monitor as best we can what’s happening inside their tumour.

One of the things we can measure is circulating tumour cells, those tumour cells that have left the primary tumour, gone round the bloodstream and perhaps lodged somewhere else to form a secondary or metastatic tumour. We would like to know how many of these circulating tumour cells there are in a patient, because that might tell us how quickly their tumour is likely to develop.

The number of circulating tumour cells might also tell us how likely they are to respond to therapy... it’s like looking for needles in haystacks, because in the bloodstream there are lots and lots of blood cells, and we’re trying to look for the very few, but potentially very dangerous, tumour cells in the bloodstream.

So if we can monitor that number, and look at the number before a new treatment and then again afterwards, what we’d like to see is the number of circulating tumour cells come down. And that might tell us something about whether that patient is responding well to therapy.”

3:58
Many researchers use the NCRI Cancer Conference as an opportunity to present the results of clinical trials. It’s important to remember that trials aren’t all about testing cancer drugs. Cancer Research UK is funding a trial called PARSPORT, testing a new way to give radiotherapy to people with head and neck cancer.

The new technique, called IMRT, can help to reduce side effects of the treatment. Dr Chris Nutting, from the Royal Marsden Hospital, talks about the trial.

“Intensity Modulated Radiotherapy [IMRT] is a much more focused way of delivering radiation to the tumour, thereby avoiding some of the salivary tissue which hopefully would then recover after treatment. So with standard radiotherapy for head and neck cancer, usually lateral fields are applied from both sides of the patient’s head, which covers the tumour very adequately but damages the salivary glands which are situated in the cheek on both sides.

With IMRT, we bring in multiple radiation beams from different directions around the patient, and by doing that we can swerve the radiation dose around the salivary glands, allowing them hopefully to regain function after treatment.

So we randomised 94 patients, all the patients had tumours of the throat – mostly tonsil or tongue cancers. Patients were allocated to either the standard radiotherapy treatment, or to the test arm of the trial, which was IMRT. We had very detailed assessments about patients, both what the doctors felt the patients said to them, and also what the patients reported independently in quality-of-life questionnaires.

So the study showed that both the patients reported rates of dry mouth were drastically reduced by 60% at 18 months after radiotherapy. We actually collected saliva from the mouth of all of those patients, both before they started radiotherapy and afterwards, and that confirmed that saliva flow was maintained in IMRT-treated patients. 

And then thirdly we had independent patient-reported quality-of-life questionnaires with questions on individual symptoms related to oral health. And again, this study...showed improvements as well.”

6:00
And finally, there was an inspiring talk from Professor Paul Workman, from the Cancer Research UK Centre for Cancer Therapeutics at the Institute of Cancer Research. He and his team are designing and testing the cancer drugs of the future.

Here he outlines some of the projects they’re working on, and where we’re heading with new cancer treatments.

“The most advanced one is what we call PI3 kinase inhibitors – it’s a technical term, but it’s drugs that we’ve developed that are now in the clinic. I talked about some of the early promising results from the clinic in fact, where one of these genes that causes the disease, we’ve developed a drug against that and now it’s showing activity in the clinic.

I also talked about a different class of drugs [that we’ve developed] that are also quite exciting, and also in the clinic, and these are called Hsp90 inhibitors. These are inhibitors of a complicated system called chaperones. Putting it very simply, they work by protecting the genes that cause cancer, or the pathways that cause the cancer. So if you can block those chaperones, you can have a really powerful effect on the cancer.

I think we’ve come an incredibly long way. [In my award lecture] I talked about how when I did my PhD thesis in the 1970s we really didn’t understand very much about cancer, the causes of it. And therefore the drugs we developed at that time were quite poisonous, you know they had a lot of side effects – and many of them still do, although they are effective. 

I talked about how in a thirty year period we’ve come a huge way. We understand many of the genes that cause the disease, we’ve got drugs against many of those genes and pathways. I think in the next five to ten years we’ll see the completion of that.”

07:43
We’ve reached the end once more so we hope you’ve enjoyed this month’s podcast. You can keep up to date with all the latest progress in research from our science blog, that’s http://scienceblog.cancerresearchuk.org

And please let us know what you think of this podcast by leaving feedback on the blog, or emailing your comments to podcast@cancer.org.uk .

Finally, after three years, we’re changing the format of the podcast. We’ll still have all the latest news, but listen out next month for something a bit different!