Cancer patients could benefit from more targeted treatment due to discoveries made by Cardiff University researchers.
Cancer patients in the UK could benefit from treatment which enables their own immune system to find and destroy cancer cells, thanks to research from Cardiff University.
The research showed that the immune system’s white blood cells, called T-cells, are better able to locate cancerous cells when they are given a specific receptor.
“Cancer is good at hiding from the immune system because tumours have a disorganised arrangement of blood vessels, so therapy doesn’t reach the cancer through the bloodstream”, says Professor Ann Ager of Cardiff University.
Whilst this can be combatted with drugs which restore the blood vessels to a normal state, the immune cells have not yet been able to locate tumours in different areas of the body.
The key discovery made by the team was of a protein called a TCR or T-cell receptor which enables the immune system to find a wider range of cancers.
“The T-cell receptors discovered recently can differentiate between the protein on a healthy cell and one on a cancerous cell,” Professor Ager says.
“Here in Cardiff, we are working on improving the ability of T-cells to locate cancerous cells.
Clinical trials already exist for immunotherapy treatments which prevent cancer cells from ‘switching off’ the immune system but research is also being conducted into the use of vaccinations in combination with these therapies for diseases such as late-stage colorectal cancer.
“Attempts at producing vaccinations for cancers not caused by viruses have largely failed,” Professor Ager explained. “Vaccines usually work when an infection isn’t already present.” However, when used alongside immune-boosting therapies, a virus vector can theoretically be used to deliver antigens which have the potential to target cancer cells.
Cancer: a challenge through the ages
Historically, a diagnosis of many cancers has been considered a death sentence, with ‘kill or cure’ chemotherapy and radiotherapy being the main treatment options. For many, these cause severely unpleasant side effects.
One of the greatest hurdles for the development of universal cancer treatments is that cancer is an umbrella term for a wide range of diseases which behave differently. Forms of leukaemia, of which there are numerous, are different to forms of lung cancer.
Additionally, people with the same type of cancer do not always respond in the same way to the same treatment. Whilst chemotherapy or radiotherapy may work for one person, they may be ineffective in controlling or killing the cancer cells in another individual.
Ordinarily, cancer cells evade destruction by T-cells by impairing their function, which is why our immune systems don’t destroy tumours. However, the 2018 Nobel Prize-winning discovery of checkpoint blockade therapy, a way of stopping T-cell inactivation, heralded a breakthrough for immunotherapy treatments.
Cardiff’s research follows the use of CAR-T therapy, where a receptor is added to immune cells.
This has proven particularly effective the US for blood cancers in children. Some patients have entered remission, something Professor Ager describes as a “wow moment”.
CAR-T therapy is now being used on patients at the University Hospital of Wales in Cardiff with relapsed or refractory diffuse large B cell leukaemia (DLBCL), the most common form of non-Hodgkin’s lymphoma.
The advances in T-cell locating made by Cardiff researchers could mean that the therapy will be available for other cancers in the future.
“We are just around the corner”
Mavis Nye was diagnosed with pleural mesothelioma in 2009.
Caused by exposure to asbestos dust on her husband’s clothes, the cancer is considered terminal. It carries a poor prognosis and limited treatment options. Mavis was originally given just three months to live.
Nearly eleven years on, Mavis is a spokesperson for those with asbestos cancer and has helped countless people access clinical trials, crediting her own survival to the immunotherapy drug Keytruda, which she works tirelessly to make available for mesothelioma patients.
Mavis expressed optimism at the news of the research at Cardiff. “It’s amazing. I’m following the researchers and praying they do carry on. We are just around the corner from finding the answers.”
“Waves of breakthrough”: An exciting future?
Cardiff’s immunotherapy research is at an early stage and, importantly, has yet to go through clinical trials.
It’s a “slow process from the lab”, according to Cardiff researcher Professor Awen Gallimore, but the process is “getting faster” as advances in research are made globally.
Efforts are being made by research staff to bring facilities to the university which will enable immunotherapy treatments to be administered to patients in Cardiff, which Professor Gallimore says may improve survival rates.
There are various hurdles to overcome before these treatments become as much a staple in the fight against cancer as chemotherapy, such as the difficulty in predicting which patients will respond to treatment and the natural aging of the immune system.
However, this research has incredible potential. The “explosion of interest” in immunotherapy described by Professor Ager helps to draw funding to further research. Science is a continuous endeavour and the pieces of the cancer treatment puzzle are gradually falling into place.