News from Around the Globe

Research is constant.  Every day we are learning more about how to fight cancer in all of its forms.  Here are the latest news articles from some of the leading cancer organizations.  Check back often to stay up to date.

news from around the world

Photo by brotiN biswaS from Pexels

Stronger Than Cancer has shared these news articles for information purposes only.  It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

Talk Cancer: How to have conversations that could save lives

10 hours 49 minutes ago

Science blog

“How can I reduce my risk of cancer?”

Over 40,000 people in the UK Google that or something similar each year. But despite thousands of us turning to the web for answers, it’s something many don’t feel comfortable talking about.
But we want to change that.

Around 1 in 2 people in the UK will be diagnosed with some form of cancer during their lifetime. However, around 4 in 10 of those cancers are preventable, largely through making healthy changes.

That means there’s a large proportion of cancer cases each year, more than 135,000 in the UK in fact, where we do have some control over the cause and there’s a potentially life-saving action people can take.

And for the proportion of cancers that aren’t preventable, there are still actions we can take that can make all the difference. Spotting cancer at an early stage can save lives, as the chances of successful treatment are much higher.

Conversations about cancer prevention and early diagnosis aren’t easy, but we’re here to help.

Our Talk Cancer training programme equips people with the knowledge, skills and confidence to have supportive conversations with people about what causes cancer and what healthy changes they could make to reduce their risk, as well as the importance of spotting cancer early.

It looks at strategies you can use to break down barriers that people might have for taking positive action for their health as well as dispelling some of the fear, fatalism and myths that surround cancer.

How can you help people reduce their risk of cancer?

Causes of cancer can be placed into roughly 2 camps: things we can control and things we can’t. The latter includes things like getting older and our DNA.

But there are plenty of things we have some control over, including:

  • Stopping smoking
  • Maintaining a healthy weight
  • Eating a healthy diet
  • Being active
  • Enjoying the sun safely
  • Cutting back on alcohol

Approaching conversations about making these changes can be difficult. People may have barriers that prevent them from taking action. However, there are some key skills and methods that can help you feel more equipped and confident to talk to people and support them to reduce their cancer risk with healthy changes, including:

  • Knowing key facts around cancer prevention
  • Listening well
  • Empathising
  • Identifying healthy and sustainable ways to make changes
  • Being non-judgemental
  • Signposting to relevant information and support services

Our Talk Cancer workshops help people working in the community to build these skills. In a recent questionnaire, 100% of trainees report feeling confident to discuss things that can reduce peoples’ risk of cancer after training, compared to 68% before.

I felt more empowered, I felt I could share information in a way that didn’t frighten people but gave them knowledge about how they could reduce their risk of cancer.

– Julie, Talk Cancer trainee and health improvement practitioner

Prevention is not a promise. We can’t say for sure that someone not smoking or keeping a healthy weight or avoiding alcohol won’t get cancer, but it will help stack the odds in their favour.

Why is encouraging action for an early diagnosis of cancer so important?

Cancer that’s diagnosed at an early stage, when it isn’t too large and hasn’t spread, is more likely to be treated successfully and a person’s chances of survival are much better.

For example, more than 9 in 10 bowel cancer patients will survive the disease for 5 years or more if diagnosed at the earliest stage, compared to only around 1 in 10 if diagnosed at the latest stage. Similarly, almost all (98%) of women diagnosed with breast cancer at the earliest stage survive their disease for 5 years or more compared to around 1 in 4 (26%) if diagnosed at the latest stage of the disease.

So how can our conversations help people get an earlier diagnosis?

Firstly, we need to encourage people to listen to their body and to speak to their doctor if they spot anything unusual for them. Helping people understand the importance of taking charge of their health and not putting off seeking help if they’re experiencing any unusual changes in their body.

Our training looks at some common barriers people might have around speaking to their doctor and ways you can help people overcome these, which could lead to an early diagnosis of cancer where chances of successful treatment are much higher. It’s not always possible to get an early diagnosis, but by helping someone get medical advice sooner rather than later we could make all the difference.

Secondly, we raise awareness of the National cancer screening programmes and the important role they can play to in finding cancers at an early stage, or even preventing them. Being equipped with the right information about what these screening programmes are, who they’re for and the importance of taking part can give you the confidence to discuss this with people.

99% of Talk Cancer trainees report feeling confident to discuss the National Cancer Screening programmes with people after a workshop, compared to just 44% beforehand.

It was really worth going to find out real facts and it gave me loads of confidence to speak to people much more openly about cancer and cancer screening. It really changed my view about cancer and how much difference it can make if you find it early.

– Ingrid, Talk Cancer trainee

Starting the conversation

Talk Cancer is a cancer awareness training programme for people who work or volunteer to improve the health of others in their community. Groups can commission interactive workshops, plus we also have a funding scheme to offer free workshops to eligible groups or organisations that don’t have budget for training.

We also have training options for individuals, including our open-access live online workshops and free online course for self-directed learning. Find out more about the programme on our website.

Emma Fox is a senior health community engagement officer at Cancer Research UK

The post Talk Cancer: How to have conversations that could save lives first appeared on Cancer Research UK - Science blog.

Read more

COVID-19 vaccine and cancer – latest updates

11 hours 2 minutes ago

Science blog

Ever since the coronavirus pandemic brought the world to a standstill back in March 2020, there’s been talk of a vaccine.

COVID-19 vaccines have been badged as our biggest opportunity to control the virus and return to normal. And for the last year, researchers and scientists across the world have been racing to make that a reality.

With over 300 vaccines in development and 3 being rolled out across the UK, we want to make sure everyone has access to information about the COVID-19 vaccine and what it could mean for people with cancer, so we’ll be updating this blog post as new data and information emerges.

Over-45s in England invited to book vaccine

As the country’s vaccination programme enters Phase 2, people in England over the age of 45 are now eligible for their COVID-19 vaccination.

This comes as the programme reached its target of offering a first dose to the 9 most vulnerable groups including the clinically vulnerable and those with other conditions that put them at higher risk.

People in this group can book their appointment online. In addition to this, text messages from local vaccination centres are set to go out.

With over 32 million people in the UK having had their first vaccine dose, Prime Minister Boris Johnson has said the programme is on track to offer a first dose of a vaccine to all adults in the coming months.

He was quoted as saying “we will now move forward with completing essential second doses and making progress towards out target of offering all adults a vaccine by the end of July.”

6 April – JCVI recommends adults living with immunosuppressed people be prioritised alongside priority group 6

The Joint Committee on Vaccination and Immunisation (JCVI) has advised the government to prioritise vaccinating people who are over 16 and living with adults who have weakened immune systems alongside priority group 6, who are now receiving invites.

This includes (but is not limited to) adults living with people undergoing immunosuppressive treatments (including chemotherapy) and those with blood cancer.

In a letter to the Government, the JCVI stated that adults with weakened immune systems (or who are immunosuppressed) are more likely to have severe COVID-19 symptoms and that the vaccine may be less effective for these groups.

The JCVI’s advice does not currently extend to:

  • Household contacts of immunosuppressed children
  • Children who are household contacts of immunosuppressed adults

Information on this prioritisation has been sent to GPs, who will contact anyone who’s now eligible for a COVID-19 vaccination. Dr Mary Ramsay, Head of Immunisation at Public Health England, said that “our surveillance systems and research studies are showing that the COVID-19 vaccines can reduce asymptomatic infection and limit transmission of the virus. By vaccinating those who live with adults who are immunosuppressed, we can further help protect vulnerable people.”

Your GP will be in contact to book a vaccination appointment if you currently live with an adult who is immunosuppressed.

18 March – shielding for ‘clinically extremely vulnerable’ to end in April

From 1 April, those considered “clinically extremely vulnerable” who have been following shielding advice during the pandemic will no longer be advised to shield.

Anyone affected will receive letters from today with updated guidance on steps they can take to reduce their risk of getting COVID-19, including maintaining strict social distancing and working from home where possible.

Following the Government’s ‘COVID-19 Response – Spring 2021’ roadmap, letters and emails will be sent out to more than 3.79 million people who can begin to follow the national lockdown restrictions.

The update comes alongside the news that more than 9 in 10 people who are considered clinically extremely vulnerable have received a first dose of a vaccine.

16 March – Health charities back vaccine drive for at-risk groups

Cancer Research UK has joined 17 other health charities to encourage people with underlying health conditions (including cancer), learning disabilities and their carers to book a COVID-19 vaccination.

More than half of priority group 6 have already received a vaccine and it’s hoped that this open letter will increase uptake. GP services are already contacting people in this cohort, but those who have not yet received a letter can get a quick appointment at by using the national booking system or calling 119. The NHS have sent text messages to people in this group with a link so they can book their appointment.

https://scienceblog.cancerresearchuk.org/wp-content/uploads/2021/03/Social_Media_Post_16x9.mp4

 

The underlying health conditions included in priority group 6 include:

  • chronic respiratory, heart, kidney, liver disease and neurological conditions, including multiple sclerosis (MS) and epilepsy
  • stroke
  • vascular disease
  • diabetes mellitus
  • immunosuppression due to a health condition or treatment
  • asplenia or dysfunction of the spleen
  • morbid obesity
  • severe mental illness
  • sickle cell
  • lupus
  • those on GP learning disability registers

Additionally, this group includes carers who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who’s at increased risk of severe COVID-19.

Minister for Vaccines Nadhim Zahawi said that “the vaccine is our way out of this pandemic and offers the chance to protect yourself and others – that’s why it’s vital that people get their jab. This open letter should help to reassure those with any concerns the vaccine is safe and supported by more than twenty of our most trusted charities. I would like to thank them all for backing this life-saving campaign and offering their expertise and assistance to support the largest medical deployment in British history.”

11 March – Initial data suggests single dose of Pfizer vaccine less effective for people with cancer

Awaiting independent review by other scientists, initial data from the world’s first reported trial examining the level of immune protection conferred to cancer patients after the Pfizer–BioNTech vaccine has been released today.

The results have been covered by BBC News and others, suggesting that people with cancer may not get the same level of protection after the first dose as people without cancer. While this information may be worrying for people with cancer, there are some things to take into consideration when looking at the results, as our head information nurse explains.

“This is an interesting study and it’s important to assess how cancer patients are responding to the vaccines being rolled out. But at this stage, we are looking at data that hasn’t been peer-reviewed, where other experts in the field would flag errors and limitations within the results,” said Martin Ledwick, head information nurse at Cancer Research UK.

“The numbers of patients looked at in the study are also relatively small, particularly for those with blood cancers. We know that this information could be worrying, but anyone undergoing cancer treatment should continue to follow the advice of their doctors, and we encourage all who can to take up the vaccine.”

What did the study find?

Led by researchers at The Francis Crick Institute and Kings College London, the SOAP study involved 205 volunteers – 54 without cancer and 151 with solid cancers, such as breast, lung and blood cancers who were undergoing immunosuppressive treatment.

Researchers measured the level of antibodies in the volunteers’ blood to examine their immune response to the COVID-19 virus. The study has shown that detectable antibody responses at week 3 following the first dose of the vaccine were found in:

  • 39% of the group with solid cancers
  • 13% of the group with blood cancers
  • 97% of the group without cancer

The study found that when the second dose was given at this point (3 weeks after first dose), immune responses were found in 95% of the group with solid cancers 14 days later (5 weeks after the first dose). Not enough participants with blood cancer received a second dose to know if this improved their response.

In contrast, those with cancer who did not get this second dose at 3 weeks saw no real improvement at 5 weeks:

  • 43% of the group with solid cancers
  • 8% of the group with blood cancers
  • 100% of the group without cancer

The researchers suggest these results could show that a gap of 12 weeks between doses of the Pfizer-BioNTech vaccine could leave many cancer patients vulnerable to severe COVID-19. The study does not suggest that people who were treated for cancer some time ago might be less likely to have a positive response to a single dose the vaccine.

When looking at the results, there are some caveats to take into consideration. The study only focused on one of the available vaccines, and many of the participants with solid tumour were in an older age group and had more advanced cancer (meaning that it is difficult at this stage to know if the results will be the same for all cancer patients undergoing cancer treatment).

There are other studies, such as the OCTAVE study, which are also looking into how well the vaccines work in people with cancer.

24 February – COVID-19 vaccine priority groups 4 and 6

There has been some confusion around what COVID-19 vaccine priority groups have meant for people with cancer. In January, we received communications from NHS England that set out that people with cancer who weren’t prioritised in group 4, such as those treated a long time previously and who were treated surgically, would be covered by priority group 6.

This information was initially published as an update on our blog post on the 28th January (which has since been amended). However, it appears that this guidance has not been communicated in any public setting, and unfortunately we have been unable to get further confirmation from NHSE that this guidance still holds true.

We’re very sorry for the confusion and frustration this has caused at this unsettling time. We encourage people to continue following the advice set out by The Joint Committee on Vaccination and Immunisation (JCVI) and the Green Book as follows:

Those who fall into group 4, and who are considered Clinically Extremely Vulnerable (CEV), include:

  • People with cancer who are undergoing active chemotherapy
  • People with lung cancer who are undergoing radical radiotherapy
  • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • People having immunotherapy or other continuing antibody treatments for cancer
  • People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

According to page 11 of the Green Book, anyone with lowered immunity due to disease or treatment who is not in group 4 will be in group 6, including:

  • Patients undergoing chemotherapy leading to immunosuppression.
  • Patients undergoing radical radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients.
  • Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil.
  • Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults.
  • Anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma.

Individuals who are about to receive highly immunosuppressive treatment, or those whose level of immunosuppression is about to increase may be re-prioritised and be able to have vaccination sooner, if therapy can be safely delayed or there is sufficient time before therapy starts. Those who have had cancer, or have cancer, but who are not part of group 4 or 6 will have the vaccine with their age group, depending on their circumstances.

If you have any concerns or questions about when you will be invited for a COVID-19 vaccine, please speak to your GP or cancer specialist.

18 February – Updated shielding guidance

This week the Government has updated its shielding advice, asking a further 1.7 million people to stay at home at all times and only going out to exercise or attend medical appointments. Of the people recently identified as now needing to shield, only half have been vaccinated. GPs will now urgently prioritise those who haven’t been vaccinated but who do need to shield.

The new shielding advice takes into account someone’s ethnicity, whether they live in a deprived area and their weight. As well as their age, prescribed medications and underlying health conditions. Underlying health conditions taken into consideration include:

  • Lung or oral cancer
  • Blood and bone marrow cancers
  • If someone has received chemotherapy in the last 12 months
  • Whether someone had been prescribed prednisolone or immunosuppressants 4 times or more in the last six months.

All of these measures are taken together to assess someone’s risk of becoming seriously ill if they caught COVID-19.

If you now fall into the extended shield category you will be sent a letter by the NHS informing you of your new status. This status means you are entitled to statutory sick pay, prioritisation for shopping slots online and assistance collecting medication.

16 February – Advice for people with lymphoedema or people who have received lymph node treatment following breast or skin cancer

A known side effect of the Moderna and Pfizer-BioNTech vaccines is lymph node swelling. If someone has lymphoedema in their arm or leg due to cancer treatment, it’s advised they get the vaccine in the opposite arm or thigh to their existing swelling.

The British Lymphology Society has also advised that those who have received cancer treatment that involves treating the lymph nodes directly, for example radiotherapy or surgery to the lymph nodes for breast or skin cancer, should have the vaccine in the opposite arm or leg to where they received their lymph node treatment. If they have received treatment on both sides they should receive their vaccine in the thigh. If you have any concerns, we’d recommend chatting to your vaccinating team, GP or cancer specialist.

8 February – Oxford-AstraZeneca vaccine shows 76% protection between doses

The University of Oxford has revealed that the efficacy of a single dose of the Oxford-AstraZeneca vaccine reaches 76% after 22days, and remains at this level until at least day 90. The Government has stated that leaving longer between doses than the three weeks used in clinical trials, combined with initial prioritisation of the first vaccine dose, would increase vaccine supply in the short term, and allow for more first doses to be delivered to more people earlier.

Researchers at the University of Oxford published an analysis of further data from the ongoing trials of the vaccine, in Preprints with The Lancet.

This draft write-up hasn’t yet been scrutinised by independent scientists, but is currently under review at The Lancet. The report highlights that there might be benefits to increasing the time between doses, with vaccine efficacy increasing from 54.9% with an interval of less than 6 weeks, to 82.4% when spaced 12 or more weeks apart.

The study also looks at the potential for the vaccine to reduce transmission of the virus. Analysis of COVID-19 tests taken weekly by UK participants suggests that the vaccine schedule being used in the UK (two standard doses) can reduce transmission, with a 49.5% reduction in positive tests in people who had the vaccine.

In other news, scientists have found that the Oxford-AstraZeneca vaccine offers “minimal protection” against mild cases caused by a variant of the COVID-19 virus called the South African Variant. Over 100 cases of this variant have been found in the UK. The results came from a recent study, which has not yet been peer-reviewed, involving around 2,000 people. Professor Sarah Gilbert, the lead Oxford-AstraZeneca vaccine developer, has confirmed that the vaccines should still protect against severe cases of the disease. She added that they were working on a modified version of the vaccine to be ready by the Autumn to increase protection against the South Africa variant.

5 February – UK regulator confirms COVID-19 vaccines are ‘extremely safe’

Data published by the UK’s independent drugs regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has confirmed that both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines are extremely safe.

The MHRA assessed safety reports from nearly 7 million doses of the vaccine given up to 24 January – the majority of which were the Pfizer-BioNTech jab.

Results found that approximately 22,820 suspected reactions were reported, the equivalent to approximately 3 in every 1,000 people vaccinated.

Almost all cases were mild and include sore arms, headaches and chills. These after–effects are not the disease itself, but are caused by the body’s response to the vaccine.

28 January – More clarity on priority groups for people with cancer

The Joint Committee on Vaccination and Immunisation (JCVI) has prioritised the following groups for vaccination:

  1. Residents in a care home for older adults and their carers
  2. All those 80 years of age and over and frontline health and social care workers
  3. All those 75 years of age and over
  4. All those 70 years of age and over and clinically extremely vulnerable individuals
  5. All those 65 years of age and over
  6. All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
  7. All those 60 years of age and over
  8. All those 55 years of age and over
  9. All those 50 years of age and over

But there has been a question mark over who would fall into group 4 and group 6. According to communications we received from NHS England, priority group 4 includes people who are clinically extremely vulnerable and will include people having many types of active cancer treatment as well as many in follow-up.

The communications also set out that all other cancer patients such as those treated a long time previously and who were treated surgically would be covered by priority group 6. However, this information has not yet appeared online and we’ve heard from some people with cancer and some GPs that they have not had this information. We understand that this is frustrating and have relayed this to NHS England.

If you have any questions about when you will be invited for a COVID-19 vaccine, please speak to your GP or cancer specialist.

21 January – COVID-19 vaccination centre opens at London’s Francis Crick Institute

As part of the country-wide vaccination programme, University College London Hospitals have partnered with the Francis Crick Institute to set up a new, large scale vaccination centre set to open by the end of January. Equipment and unused space within the research institute – of which Cancer Research UK is a major funder – is being used to create a vaccination centre that will be administering doses 7 days a week.

At maximum capacity, the centre has been designed to deliver just over 1,000 vaccinations per day (from 8am – 8pm). However, the number of people that can be invited will depend on the level of vaccine stocks received by the centre. Our news report has the details.

18 January – Vaccine rolled out to over-70’s and “clinically extremely vulnerable” in England

From today, those aged 70, and over and those considered “clinically extremely vulnerable”, will begin receiving invitations for a COVID-19 vaccination. People considered “clinically extremely vulnerable” are those who were asked to shield at various points during the pandemic, and include:

  • People with cancer who are undergoing active chemotherapy
  • People with lung cancer who are undergoing radical radiotherapy
  • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • People having immunotherapy or other continuing antibody treatments for cancer
  • People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

The Department of Health and Social Care have acknowledged that those in the top 2 prioritisation groups – care home residents, those over 80 years old and front-line health care workers – will remain as the top priority to receive the vaccine.

The announcement today means that areas that have already vaccinated the majority of people in the top 2 priority groups will now be able to keep up the momentum and start vaccinating additional groups.

15 January – Guidance on the COVID-19 vaccine for patients receiving Systemic Anti-Cancer Therapy

The UK Chemotherapy Board has produced a comprehensive document of FAQs on the Pfizer–BioNTech and Oxford-AstraZeneca COVID-19 vaccines for healthcare professionals treating patients on systemic anti- cancer therapies (SACT) such as chemotherapy, antibody therapy or immunotherapy.

The document outlines that all patients receiving SACT should be considered for a COVID-19 jab.

These FAQs were produced in response to questions by cancer specialists about giving the vaccine to people with cancer receiving SACT. They may be used by cancer specialists, along with any local guidelines, to help decide the best timing for giving the vaccines in people receiving SACT.

You can talk to your GP or cancer specialist when you’re offered the vaccine to discuss timings. We’ve got further information about the different vaccines, summarising the guidance from the UK Chemotherapy Board, here.

11 January – Government publishes latest vaccine delivery plan

The Government has set out its latest vaccine delivery plan to administer at least 2 million vaccinations per week, as part of the ‘largest vaccination programme in British history’.

The plan includes the commitment set out last week by Boris Johnson to offer the first vaccine dose to all those in the top 4 priority groups, as recommended by the Joint Committee of Vaccination and Immunisation (JCVI), by 15 February. This includes those considered “clinically extremely vulnerable” including people with cancer who are undergoing chemotherapy, people with cancers of the blood or bone marrow, and people with lung cancer who are undergoing radical radiotherapy. You can find a complete definition of clinically vulnerable groups, on the Government website.

8 January – Third vaccine approved for rollout across the UK

A vaccine made by Moderna – a US based biotech company – has become the third vaccine to be approved for mass rollout across the UK, although supplies are yet to arrive in the country and may not do so for several months.

This vaccine is the latest to have been approved by the Medicines and Healthcare products Regulatory Agency (MHRA). Similarly to the Pfizer-BioNTech vaccine, which was approved in December 2020, the Moderna vaccine is not a ‘live’ vaccine, but contains a molecule called mRNA, which contains genetic information that causes the body to produce tiny fragments of a molecule made by the coronavirus.

In trials with more the 30,0000 people, the Moderna vaccine was assessed to see whether it could prevent symptomatic infection and was found to have an efficacy of almost 95%. There were also no cases of severe COVID-19 in the group that had the vaccine. It is unclear at this stage what impact the vaccine might have on infection without symptoms. The Moderna vaccine can be stored at –20°C (normal freezer temperature) for up to 6 months.

7 January – Study examines immune response to COVID-19 in people with cancer

The news that 2 COVID-19 vaccines have been approved and are now being rolled out offers hope of a return to normal life in 2021. For people with cancer this could mean less anxiety about attending hospital appointments, fewer changes to treatment and shorter waiting times. At this stage, although we can’t be sure whether the vaccines will work quite as well in people having cancer treatment because of the effect that cancer treatment can have on the immune system, experience with other vaccines suggests that the COVID-19 vaccines should offer protection against COVID-19 for people with cancer.

Studies looking at how people with cancer have responded to the virus that causes COVID-19 may also provide some clues. Results just published from one of these studies – the SOAP study – suggest that patients with solid cancers have a similar immune response to the virus as people without cancer. Those with blood cancers were found to have a more variable response, with some people responding similarly to people with solid cancers, while others didn’t manage to clear the virus or develop antibodies against it. The numbers in this study weren’t big enough to determine whether patients with particular blood cancers or receiving particular treatments had a poorer response.

These findings may have implications for COVID-19 vaccination, for example it may be that some people with cancer would benefit from more frequent boosters or monitoring to check their response. The SOAP study plans to investigate this in the next phase of their project, which will look at the immune response to the vaccine in people with different type of cancer.

It’s important to remember that some protection is better than none and that people with cancer are encouraged to take the vaccine when it is offered. As with other vaccines, the timing of COVID-19 vaccination may depend on the type and timing of cancer treatment.

5 January – COVID-19 vaccine and questions about safety for people with cancer

Are these vaccines safe? And which vaccines are most appropriate for people living with cancer? These are questions we’re frequently being asked, and understandably so.

While we’re not able to comment on individual circumstances, we’ll continue to update this blog post as new findings and information are released.

To get an ‘on the ground’ view, we recently spoke to Dr Neil Smith, a GP based in Lancashire, about how he is advising his cancer patients in his clinic. “My general advice is yes, it is, safe. You’ve got to understand your individual circumstance, but for people with cancer, or for people who have previously had treatment for it, it is safe. For most people, it’s much safer to have it than not have it. And because it’s not a vaccine that uses a ‘live’ virus, it doesn’t pose a threat to somebody’s immunity, instead It helps them to produce their own immunity against the coronavirus.”

The Medicines and Healthcare products Regulatory Agency (MHRA) – the organisation which grants licenses to companies to sell their medicines in the UK – have confirmed that both the Pfizer-BioNTech vaccine, and the Oxford-AstraZeneca vaccine, are safe for rollout across the country. Whilst doses of the other vaccines have been purchased, they are yet to be approved by the MHRA.

Similarly, another government body – the Joint Committee on Vaccination and Immunisation (JCVI), which advises UK health departments on immunisation – commented that the Pfizer-BioNTech vaccine “appears to be safe and well-tolerated, and there were no clinically concerning safety observations,” and that the Oxford-AstraZeneca vaccine “appears to have a good safety profile.” These comments apply to the general population – but what about people affected by cancer?

Some people who were asked to shield during the pandemic (and who are considered “clinically extremely vulnerable”), which includes a number of cancer patients (please see the update from 28 November for the complete list), will be prioritised to receive their first dose of vaccine as soon as possible. However, the JCVI thinks that others who are considered “clinically extremely vulnerable” and who also have some degree of immunosuppression, or are immunocompromised, may not respond as strongly to the vaccine – despite this, the vaccines will, they think, still offer these people some protection. So the COVID-19 vaccines are likely to be made available to cancer patients at some point. However, these people, including those on chemotherapy, have been advised to continue to follow Government shielding advice to reduce their risk of infection, even after vaccination.

Whatever their situation, people invited for vaccination will be able to discuss their concerns with a doctor. “When people arrive at a COVID-19 vaccine centre, they’ll go through a normal consent process. And within that consent process, if there’s any specific issues, they’re often advised beforehand to contact the GP, and so a GP will be in contact with several patients wanting a bit more information,” says Smith. “But in my experience of that, it’s been a very positive conversation where I’ve been able to reassure people – ‘Yes, the vaccine for you is safe, and you should go ahead’.”

Smith is extremely hopeful for the vaccine. “It’s one of the best things I’ve seen in my 30 years of the NHS, and the main thing it does, is it makes the world a better place and makes us safer. So what I’m hoping going forwards, it’s safer for me to see patients and it’s safer for patients to feel confident they can see me to talk about cancer again, and to talk about the fears and concerns, it’s safe for me to refer them and to do investigations, and it becomes much safer for people to carry on having the cancer treatments early. The COVID-19 vaccine will help us to continue to diagnose and cure cancer and save people’s lives.”

30 December – Oxford-AstraZeneca vaccine approved for use and rollout next week

The Oxford-AstraZeneca vaccine has been approved for use in the UK. It is the second jab to be approved in the UK after the Pfizer-BioNTech vaccine was given the go-ahead earlier this month.

This vaccine contains a weakened form of a common cold virus (harmless to humans) that has been modified to include the gene for the coronavirus spike protein. Once injected, this primes the immune system to attack without exposure to the full virus. This is then followed by a second dose – up to three months later – for maximum protection.

16 December – Fifth vaccine begins clinical trials in UK

Speciality vaccine company Valneva is the latest to begin clinical trials of their COVID-19 vaccine, currently being developed in West Lothian in Scotland.

The Valneva trial will begin by testing the safety and efficacy of the vaccine on volunteers at 4 sites across the UK and is currently enrolling 150 healthy participants aged 18 to 55.

The Valneva vaccine is what’s known as an “inactivated whole virus” vaccine. While the vaccine does hold some of the same virus particles that cause COVID-19, they are weakened and made inactive so that they cannot give you the virus. But they are able to prime the immune system to be able to recognise and destroy the virus responsible for COVID-19, which may prevent you from getting sick if you’re exposed to the virus in the future.

15 December – Latest COVID-19 vaccine trial data published

Results from the clinical trial of the vaccine developed by Pfizer/BioNTech – currently being rolled out across the country – have been published in The New England Journal of Medicine, showing that the vaccine may provide protection as early as 12 days after the first dose.

The phase 3 trial involved 42,000 people, with around half receiving the vaccine and the others a dummy vaccine (placebo). 170 people developed COVID-19, with 8 cases in the vaccinated group and 162 in the placebo group, demonstrating that the vaccine has an overall efficacy of 95%.

Efficacy or effectiveness – what do we mean?

Efficacy looks at whether an intervention (e.g. a drug or a vaccine) works under optimal conditions (such as a clinical trial). As an example, some of the COVID-19 vaccines are being tested in healthy participants or in people who are at higher risk of catching the virus because of their job, rather than being tested in the whole population.

Effectiveness looks at whether an intervention works in the ‘real world’. Vaccines will continue to be monitored after they’ve been rolled out. The data collected helps experts understand how well they work in different groups of people (looking at factors such as age, ethnicity, people with health conditions, etc) and how long the protection given by the vaccine lasts.

The AstraZeneca Oxford vaccine have also been published, this time in The Lancet, with data suggesting that the vaccine is safe and offers protection against COVID-19. The results are a combination of 2 clinical trials in the UK and Brazil. When the interim trial results were released a few weeks ago, the vaccine had an efficacy between 62 and 90% depending on how doses were administered.

This paper shows that the vaccine offers protection against symptomatic COVID-19 when the 2 doses are administered with a 6-week gap between them. This could mean that this vaccine could take longer to roll out than others, with the Pfizer vaccine being given in 2 doses spaced as little as 3 weeks apart. However, it doesn’t need to be stored at –70 degrees, meaning that it might be easier (and perhaps cheaper) to deliver.

11 December – Progress of COVID-19 vaccine vs cancer research

The development of multiple COVID-19 vaccines over an extraordinary 10-month period has brought up some questions about why there haven’t been similar transformative leaps in treating cancer.

Cancer is a highly complex disease, with over 200 different types that vary in biology, genetic make-up and behaviour. Not only that, but each person’s cancer is unique with its own set of challenges, so it’s very unlikely there will ever be one single cure that can be applied to everyone.

One of the biggest challenges our researchers face is that cancer can evolve, adapt and diversify and eventually outwit the immune system. For now, COIVD-19 doesn’t appear to rapidly change its make-up like cancer. And with COVID-19, researchers have been able to define specific targets that are found on the virus, which makes it much easier to treat than cancer.

Much of the science behind the development of the recent COVID-19 vaccines have been underpinned by previous research to understand the body’s immune system for other diseases, including cancer. And the extraordinary progress of the COVID-19 vaccine is in part because scientists, governments, industry and academic institutes around the world turned their focus to this one goal. To further accelerate development, different phases of vaccine trials and production have overlapped.


Copy this link and share our graphic. Credit: Cancer Research UK.

Although progress against cancer might not look as quick or dramatic as that against COVID-19, we have made great strides. Thanks to our research, we’ve helped cancer survival double over the last 40 years.

But there’s still more to do, and the technologies and insights that have come from the COVID-19 vaccine work could help us with future advancements in cancer research. We are relentless in our ambition to beat cancer and will continue to fund ground-breaking research to find new ways to prevent, diagnose and treat cancer.

8 December – Vaccine rollout begins across the UK

90-year-old Margaret Keenan has become the first person to receive the Pfizer-BioNTech COVID-19 vaccine, as mass rollout begins across the UK. BBC News has the latest.

50 hospitals in England have been selected to receive the first doses of the vaccine and deliver the first rounds of the vaccination programme. Scotland, Wales, and Northern Ireland are also set to begin their vaccination programmes from hospitals today.

With the first 800,000 doses arriving this week, limited quantities will be available until further doses arrive. To begin, elderly people who are hospital outpatients, as well as those who are being discharged after a stay in hospital, will be among the first to be offered the vaccine. Each individual will require two jabs, administered within 21 days of each other, so the initial 800,000 doses will vaccinate 400,000 people.

Prioritisation groups are based on who has the greatest risk of becoming seriously ill or dying from the virus.

2 December – Pfizer–BioNTech vaccine approved for use in the UK and to be rolled out next week

The UK has become the first country to approve the Pfizer–BioNTech vaccine for widespread use, after the Medicines and Healthcare products Regulatory Agency (MHRA) confirmed that the vaccine is safe for rollout across the country.

The mRNA vaccine, which trials suggest offers up to 95% protection against COVID-19, should be available to those who need it most, including elderly and care home patients and staff, within the week. Protection from the vaccine should stop people from becoming ill with the virus. So far, the UK has ordered 40 million doses, enough to vaccinate 20 million people, with the first 800,000 doses arriving early next week.

The vaccine will be distributed from Pfizer centres in Germany, Belgium and the USA. Approximately 50 hospitals across the country have been prepared to deliver the first of the vaccination programme. Specialist vaccination units in spaces such as conference centres are also being set up and some GPs and pharmacists may have access to vaccines, if they have the available cold storage facilities required to store the jab.

To find out more, head to BBC News.

30 November – Final results from Moderna confirm vaccine is 94% effective

The final results from Moderna’s vaccine trials have confirmed that their vaccine showed 94% efficacy against COVID-19, and nobody who received the vaccination developed a severe case of the virus. The latest news has initiated an approval process with regulators around the world who will study the trial data for the vaccine and decide if the data on its safety and effectiveness are robust enough to be recommend for roll out.

The UK has now bought 7 million doses of the vaccine, which are expected to arrive in the UK in March. On top of that, the UK has pre-ordered 40 million of the Pfizer/BioNTech vaccine and 100 million of the AstraZeneca Oxford vaccine. Full trial data has not yet been released but you can read more about the Moderna vaccine at BBC News and The Guardian.

28 November – Extremely vulnerable given high priority for COVID-19 vaccine in UK

The provisional priority list published by Public Health England has listed people aged 18 years and over who are deemed “clinically extremely vulnerable” as the same priority as the over-70s to receive a COVID-19 vaccine.

People considered “clinically extremely vulnerable” are those who were asked to shield during the pandemic, and include:

  • People with cancer who are undergoing active chemotherapy
  • People with lung cancer who are undergoing radical radiotherapy
  • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • People having immunotherapy or other continuing antibody treatments for cancer
  • People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

Although this prioritisation list is subject to further potential changes as the vaccine is still waiting approval from the Medicines and Healthcare products Regulatory Agency (MHRA), those considered “clinically extremely vulnerable” have now been placed in priority group 4 of 9. Based on these changes, the interim guidance, advised by the Joint Committee on Vaccination and Immunisation (JCVI), says the order of priority should be:

  1. Older adults in a care home and care home workers
  2. All those 80 years of age and over and health and social care workers
  3. All those 75 years of age and over
  4. All those 70 years of age and over and the clinically extremely vulnerable individuals, excluding pregnant women and those under 18 years of age
  5. All those 65 years of age and over
  6. Adults aged 18 to 65 years in an at-risk group
  7. All those aged 60 and over
  8. All those 55 and over
  9. All those aged 50 and over
23 November – Initial results of AstraZeneca-Oxford vaccine announced

The day’s big news was of results from clinical trials in Britain and Brazil of the vaccine led by drug company AstraZeneca and researchers in Oxford. The trials involved over 20,000 individuals and showed differing levels of protectivity depending on how the doses were administered (between 62 and 90%). Like all the recent results, these findings were announced in a press release and have not yet been independently verified.

COVID-19 vaccines in development

There are more than 300 vaccines in developments, many in the final stages of testing. The vaccines are all aiming to protect people against developing COVID-19, but they’re produced in different ways.

The main vaccines that have reported results so far are:

  • The Pfizer-BioNTech vaccine: Contains a tiny fragment of the virus’s genetic code made in the lab – called RNA – that codes for a part of the virus called the ‘spike protein’, which sits on the outside of the virus. When the RNA is injected into the body it can instruct cells to produce these proteins, priming the immune system to be able to recognise and destroy the coronavirus, without exposing the body to the virus itself. This vaccine must be stored at -70°C.
  • Moderna vaccine: Like the Pfizer-BioNTech vaccine, the Moderna vaccine contains RNA that codes for the virus’s spike protein. It can be stored at –20°C (normal freezer temperature) for up to 6 months.
  • Oxford-AstraZeneca vaccine: Contains a weakened form of a harmless virus that usually causes the common cold in chimpanzees but doesn’t grow in humans. The virus has been modified to include the gene for the coronavirus spike protein protein. Injecting this virus aims to prime the immune system to attack without exposing the body to the full virus. The vaccine can be stored at fridge temperature.

The trials explicitly excluded people with a history of cancer apart from a few exceptions; those with localised prostate cancer (where the cancer is contained in the prostate and has not spread to anywhere else), non-melanoma skin cancer that has been treated, cervical carcinoma in situ (pre-cancer) that has been treated, or those with a low risk of either their cancer coming back, or spreading to other parts of the body.

So far, we haven’t seen any data about how effective the vaccine was in these people, nor how many were on the trials – we’ll be looking out for this information as it emerges.

The UK government has already pre-ordered 100 million doses of this vaccine.

23 November – Last trials of COVID-19 ‘antibody cocktail’ treatment begin

In addition to vaccine development, AstraZeneca have started large-scale trials of an “antibody cocktail” aimed at providing short-term protection to people with a weakened immune system, who would be unlikely to develop immunity after a vaccine. Antibodies form a key part of the immune system’s response to infection and it’s hoped that these antibodies developed in the lab will help the immune system to fight off the virus. AstraZeneca have described it as “almost like a passive vaccination.”

5,000 people around the world will be taking part in the trial of this treatment that scientists hope could give individuals immediate protection lasting up to 1 year. If successful, this may make up part of the UK’s wider COVID-19 treatment portfolio and be available to people whose immune systems are compromised.

23 November – Experts react to COVID-19 vaccine news

Like most of us, Cancer Research UK-funded experts have been following the news closely and have called the progress ‘exceptional’.

News of an effective COVID vaccine is great to hear. Having a vaccine will make the world safer, which means it will be safer for people with cancer too and it will become much easier for cancer treatments to continue.

We look forward to getting a better understanding of the best time to give the vaccine to cancer patients to give them the best level of protection.

– Martin Ledwick, Cancer Research UK’s head information nurse

Normal drug or vaccine development would take in the range of 5-10 years, sometimes much longer, so these developments have been extraordinary.

But experts have been keen to emphasise that the rapid turnaround of the COVID-19 vaccines isn’t because standards have dropped. In fact, the COVID-19 trials have involved more people than standard vaccine trials and have been able to draw on cutting-edge developments in technology and data analysis.

The extraordinary progress is in part because scientists, governments, industry and academic institutes around the world have turned their focus to this one goal. And to further accelerate development, different phases of vaccine trials and production have overlapped.


Copy this link and share our graphic. Credit: Cancer Research UK.

Finally, while the initial results are extremely promising, it’s early days yet. Preliminary data from one vaccine trial led by Pfizer suggested the vaccine offered 90% protection against developing COVID-19, whilst more recent data revealed the vaccine was 94% effective in over-65s. Initial reports from a second vaccine trial made by Moderna disclosed similar figures.

Experts expect more results – including important safety data – to materialise in the next 4 to 6 weeks. Vaccination will only be approved once it has passed the usual high standards set by the Medical and Healthcare products Regulatory Agency (MHRA) in the UK.

You can read more about the various COVID-19 vaccines in this piece by journalist Tom Chivers, who’s taking part in the Oxford-AstraZeneca vaccine trial.

23 November – Who’s taken part in COVID-19 vaccine trials?

We don’t have information on how many people living with cancer, or with a history of cancer, have been involved in COVID-19 vaccine trials so far. But some people with cancer have been able to take part in these trials, although who can take part varies from trial to trial.

For example, the earliest phase of the Pfizer trial involved healthy people aged 18 to 55 or 65 to 85. People with pre-existing conditions were able to take part as long as they didn’t require a significant change in therapy or hospitalisation for worsening disease in the 6 weeks prior to enrolment.

In later phases of the trial (phases 2 and 3) the lower age limit was reduced to 16 years old and individuals identified as being in a ‘high-risk’ group based on their use of public transport, being a frontline essential worker or other factors were included. Although people with cancer weren’t explicitly excluded from this list, those who are immunocompromised or receiving immunosuppressive therapy were not able to take part, and anyone taking part needed to have stable disease prior to enrolment.

For the late phase trials of the Oxford vaccine, anyone over the age of 18 who’s considered to be ‘medically stable’ – someone who’s not expected to be hospitalised or change their therapy less than 3 months before enrolment – could enrol in the trial. The criteria for the Oxford trial explicitly excludes anyone with a history of cancer, apart from a few cancer types, or those with a low risk of either their cancer coming back following curative treatment or spreading to other parts of the body.

Another vaccine that’s hit the news recently is the Moderna vaccine. Similar to the Oxford vaccine trial, medically stable people aged 18 or over were able to take part in the Moderna vaccine trials. However, those who are immunocompromised or have taken immunosuppressive treatments in the 6 months before the trial were not able to enrol.

Beyond vaccine trials, studies looking at how people with cancer’s immune systems respond to COVID-19 may also provide useful information on if the vaccine will be effective for people with specific types of cancer.

Lilly, Katie, Angs and Lyndsy

COVID-19 has slowed us down, but we will never stop. Donate today to help us continue life-saving research.

Donate

The post COVID-19 vaccine and cancer – latest updates first appeared on Cancer Research UK - Science blog.

Read more

Digging for early detection success in our sandpit workshops

12 hours 7 minutes ago

Research Feature

By bringing a variety of researchers together, our early detection sandpit workshops foster innovative, interdisciplinary thinking. But what is it like to take part in one? We get the inside story from past participants.

Detecting cancer earlier is not easy. In fact, only 25% of cancers in the UK are detected and diagnosed at stage 1, when treatments are more effective and lead to improved survival rates.

In order to detect more cancers at earlier stages, we need innovative ideas to solve many complex biological and technological problems. To do this we need to inspire those with different types of expertise to work alongside cancer researchers to create new interdisciplinary research teams. That can be a challenge when these researchers are yet to even meet.

Since 2018, Alexis Webb, research programme manager for early detection and diagnosis, and her team at Cancer Research UK (CRUK) have run a series of sandpit innovation workshops designed to overcome this very problem. “Our sandpits have united researchers from chemistry, engineering, physics, and computational sciences backgrounds with cancer biologists, epidemiologists, pathologists, and clinicians,” she says. 

Over the course of a three-day workshop, sandpit participants meet new collaborators, generate lots of new ideas, and have a chance to be awarded seed funding to tackle a challenge in cancer early detection.

“A strategic vision for CRUK is to bring together engineering and physical sciences with biology and medicine,” says Alexis. “Uniting a variety of perspectives in new ways will result in novel technology for early detection steeped in an understanding of the biological and clinical problems, which is much more likely to have real impact."

To run these innovative events, we’ve partnered with other funders including the Engineering and Physical Sciences Research Council, the Science and Technologies Facilities Council, and Pancreatic Cancer UK. This helps us reach into new communities and build new relationships with researchers who haven’t previously worked in cancer.

So, what is it like to take part in a sandpit workshop? We invited some previous participants to tell us just that…

sandpit_thumbnail_photos.png Dr George Mylonas: “After two very intense days filled with various activities, suddenly order was born out of chaos” – A robotic engineer’s perspective

When I found out that my application to attend the CRUK sandpit was successful, my expectation was that this would be like any other workshop. There was every chance, I thought, I’d be yawning my way through endless talks and slides, only to be woken by the occasional break-out session and coffee break.

How wrong I was.

On the first morning, things immediately looked different. The initial task was to pair-up and draw each other… without looking at our hands, whilst making sure we didn’t lift the pen from the paper. I won’t give away any of the other activities that followed over the next three days of the workshop, but I have to say the ‘weirdness’ factor never left us.

After two intense days filled with various activities, and me failing to identify any emerging patterns that would help figure out the organisers’ mysterious plans, suddenly order was born out of chaos. An initial project idea I’d suggested had now attracted four potential co-investigators. Each, by bringing their unique experiences and academic background, was able to breathe life into it and give it a new spin. Together, we conceived the Vibr-O-scope. This is a concept based on using soft robotics and sensors for multimodal early detection of premalignant and malignant colonic lesions. 

Since its conception, the Vibr-O-scope project has kept us busy and creative, with some encouraging early results. Our seed funding will allow us to run preliminary experiments to test how our prototype works, which will help provide evidence to submit for follow-on funding for further investigations.

The sandpit was a very interesting and rewarding experience on many levels, which I highly recommend. What initially felt like a collection of scattered activities magically turned out to be a well-orchestrated and well-conducted process. And it was one that certainly managed to generate ideas and approaches that resonated amongst participants from diverse backgrounds.

George is a lecturer in robotics and technology in cancer at Imperial College London in the Faculty of Medicine. In 2019, he attended a CRUK sandpit on robotics, and was part of a team designing a vibrating probe for endoscopes that could help detect flatter lesions which are harder for endoscopists to spot.

 

sandpit_thumbnail_photos_1.png Dr Pilar Acedo: “The creation of interdisciplinary and revolutionary projects in just a few days was only possible because of the unique environment” – A biologist’s perspective

Participating in the sandpit scheme was a unique opportunity for me to build innovative projects from scratch, sharing my expertise in a multidisciplinary atmosphere. I’m glad I got to take part in this early on in my career.

I attended a virtual workshop, but despite this we still had many opportunities to interact with all the participants, mentors and facilitators – and the support team was fantastic. It really was a great learning experience and, also, a real adventure.

One of the things that I was most impressed by was the freedom to mould research ideas. I liked that everyone’s research inputs had the same value, from early career researchers to those made by senior participants. It was great to be part of a group of scientists from a variety of disciplines working together, racing against time, to identify new possibilities.

The creation of interdisciplinary and revolutionary projects in just a few days was only possible because of the unique environment provided by the sandpit. By the end of the sandpit, I was involved in three multidisciplinary projects.

I’ll be leading the EDPAN feasibility study aiming to improve early detection of pancreatic cancer through personalised assessment of risk. It’ll use clinical and demographic information combined with non-invasive infrared spectroscopy and immuno-profiling of urine and blood samples from different cohorts.

I’m also a member of the EXPAND project, which will identify and characterise volatile organic compounds contained in extracellular vesicles produced by pancreatic tumours, and its associated microbiome.

I will also participate in the PANANOMRI project. This will combine imaging, nanotechnology, cell biology and AI, to improve magnetic resonance imaging in patients with premalignant pancreatic cancer.

If you think you might like to be involved in a future sandpit, I would recommend being open-minded and listening to other participants; their ideas will improve yours. The process is demanding but it is highly rewarding.

Pilar is a senior research fellow at University College London’s Institute for Liver & Digestive Health. In 2020, she attended a sandpit on pancreatic cancer. She is leading one funded team and participating in two others that also received funding.

 

sandpit_thumbnail_photos_2.png Professor Bhavik Patel: “The event should be considered as something broader than just funding. It helps change your mindset” ­– a chemist’s perspective

The workshop I attended was, in a word, liberating. Being in a new environment and immersing yourself in something very different from normal research activities fostered real creativity.

I was keen to apply as the sandpit seemed to offer a great chance to meet new people, forge collaborations and provide some out-of-the-box thinking for a specific area.

And I was certainly right about that. It made me consider different ways of exploring the boundaries of my own research and how these interface with other disciplines.

The sandpit approach was both refreshing and intense at the same time. It really did make me think in a new way about how to approach developing research ideas. I would have most likely never met or reached out to work with people from such a wide range of disciplines.

One of the surprising things about the process was how it was possible to generate such great ideas in such a short time. Also, it really did give me a new perspective on how to work with multidisciplinary groups. Finding common ground without compromising was an essential part of the way that projects came together to be highly exciting and, hopefully, impactful.

The project I’m working on that grew out of the sandpit is based on using sensor technology in liquid biopsies through the determination of extracellular vesicles. Technologies that can determine the specific cargo within an extracellular vesicle could, potentially, provide a route towards the early detection of cancer.

Without the sandpit, there is no way I would have even considered working on a project of this nature or with the other members of the team who have developed into amazing collaborators. 

If you have an interest, then just get involved. The event should be considered as something broader than just funding. It helps change your mindset.

Bhavik is a professor at the University of Brighton’s School of Pharmacy and Biomolecular Science. In 2018 he attended a CRUK sandpit focussing on liquid biopsies. His team developed new technology that is currently being assessed by our Commercial Partnerships team for patentability.

 

sandpit_thumbnail_photos_3.png Chris Macdonald: “The format made me rethink my preconceived and relatively conventional approaches to funding research” – a research funder’s perspective

Coming into this I had very little idea of what to expect. Organising an event like this as a funder is one thing but getting the community to engage with it is quite another. That can be a source of sleepless nights.

There was also the added anxiety in 2020 of how to make the format work when the workshop was virtual. So, I was thrilled to see a community seize the freedom to innovate with both hands and collaborate with other researchers from very different areas of expertise.

It was fascinating to see participants feel their way into discussion, cautiously gauge one another and then embrace this way of working. On reflection, I would say that those who are most capable of deconstructing their predilections towards what you research and how you conduct that research, fare best in this environment.

You also had to commit. I think I clocked up over 50 hours of Zoom time in four days, while some of the participants will have spent even longer. Although it may have been intense, that same intensity drove the development of incredibly innovative approaches towards detection of pancreatic cancer.

As much as we challenged the researchers who participated, I was challenged as well. The format made me rethink my preconceived and relatively conventional approaches to funding research. To drive real innovation through research funding schemes is actually really difficult. All of the usual approaches ensure very pragmatic decisions are made, and that is right for most schemes, but innovation and pragmatism don’t always sit well together. It can be a challenge to get the right balance. However, this format encouraged innovation and bold thinking, recognised it in the review process and, crucially, rewarded it.

Would we do it again? In just over three days, we got five unique and innovative multidisciplinary studies that have brought new people, expertise, relationships and energy into our field. That, I am convinced, can bring about more effective detection of pancreatic cancer faster than before. Do it again? I have already started planning the next one…

Chris is head of research at Pancreatic Cancer UK; the charity partnered with CRUK on developing and delivering the pancreatic cancer sandpit.

Early detection of pancreatic cancer sandpit winning teams

In December 2020, Cancer Research UK teamed up with Pancreatic Cancer UK and The Engineering and Physical Sciences Research Council to run a sandpit workshop on the early detection of pancreatic cancer.

Here are the funded teams:

Team PANANOMRI: Early detection of premalignant pancreatic cancer using multifunctional targeted nanoparticles for MR imaging with super-resolution reconstruction and MR fingerprinting

This project will undertake the development of magnetic nanoparticles and novel magnetic resonance techniques to improve diagnostic potential for early pancreatic lesions.

Team EXPAND: Enriched exosomal signatures for pancreatic cancer early detection

This project will deploy in vitro and in vivo models to study exosomal biomarkers and the microbiome, and will test detection of volatile organic compounds from extracellular vesicles as a biomarker for pancreatic cancers.

Team RETHOMS: Real-time high-sensitivity optrode metabolic sensor for pancreatic cyst fluids

This project will build and test optrodes, optical sensors with integrated electrodes for chemical transductance, to detect metabolic products indicative of early cancer from pancreatic cell lines and pancreatic cyst fluid.

Team EDPAN Screening tool: Earlier detection of pancreatic cancer through personalised assessment of risk combined with non-invasive infrared spectroscopy

This project will generate a personalised pancreatic cancer risk stratification strategy, combining clinical and demographic information with infrared spectroscopy-based analysis of serum and urine samples, together with immune profiling.

Team PANC-CYS-GAN: A multimodal longitudinal generative adversarial network (GAN) to discriminate high-risk cysts for the early detection of pancreatic cancer

This project will build a generative adversarial network (GAN) explainable machine learning algorithm, to generate and validate plausible hypotheses using data from patients (e.g. symptoms/signs, demographic, medical history, medications, CT/MRI-based radiomics analysis, lifestyle, etc.) for detecting transformation from pancreatic cysts into cancers.

Download the pancreatic sandpit report

If you’d like to take part in one of our early detection sandpit workshops, or would like further information then please get in touch with the team at early.detection@cancer.org.uk.

Find out more about our sandpit workshops

 

Read more

Do Cell Phones Cause Brain Tumors?

16 hours 51 minutes ago
What does the world’s leading authority on carcinogens have to say about mobile phones? Do cell phones cause cancer? That’s a question billions of people […]

How UK researchers commercialised CD25 as an immunotherapy drug target

1 day 10 hours ago

Research Feature

For years, CD25 was written off as a cancer drug target. But after Sergio Quezada’s team discovered a new way to target this receptor, a whirlwind process of drug discovery ensued.

In 2008, working as a postdoc, Sergio Quezada published a paper that helped consign CD25 – a receptor found primarily on immune cells – to the large scrapheap of “molecules-that-scientists-formerly-considered-exciting-targets-for-cancer-therapy”.

Adding to issues other labs had uncovered, Quezada found that an antibody against CD25 prevented tumours from forming in mice if it was given when they were cancer free, but if it was given – as it would be in the clinic – after a tumour had taken hold, the antibody was powerless.

But then, in 2010, the picture began to change. New data from cancer immunotherapy studies Quezada had been running in his newly established lab together with his colleague Karl Peggs, caused them to reconsider CD25. It looked like it hadn’t been the target that was wrong… it had been the antibody.

Fast forward to 2021 and Quezada is just about to address the meeting of the American Association of Cancer Research to describe promising early results of how an anti-CD25 antibody can indeed trigger an immune response that causes tumours to completely disappear in mouse models.

Harnessing the immune system against cancer by targeting CD25 !

Content not working due to cookie settings.

Manage your cookie settings here Placeholder content

Watch the anti-CD25 antibody harness the immune system to target cancer   CD25’s relaunch as a drug target was owed to experiments – done in Quezada’s and Peggs’s labs at the UCL Cancer Institute and supported by Cancer Research UK (CRUK) – that demonstrated the importance of a sub-set of T cells known as regulatory T cells in inhibiting immune responses to cancer cells. Quezada worked with CRUK to secure patents on the approach. Then, in 2016, with CRUK’s help, he partnered with a small UK biotech called Tusk Therapeutics to develop a drug.   cd-25_sergio.png In an early meeting with Tusk, Quezada was asked if the antibody his team had used was the best he could provide? Taken aback, he replied: “We spent 10 years figuring out this thing, and now you want something better?"   But this conversation sparked an insight that changed everything, ultimately leading to a drug that was instrumental in Roche paying up to $798 million to acquire Tusk in 2018. Reflecting on the work with Tusk, Quezada says, “It was a delight – one of the best collaborations I’ve ever had.”   Professor Sergio Quezada, pictured on the right, is group leader at The Immune Regulation and Tumour Immunotherapy group at the UCL Cancer Institute. He received a CRUK career development fellowship in 2010, and a CRUK senior cancer research fellowship in 2016.   Redefining CD25

Quezada’s early work on CD25 was conducted in Jim Allison’s lab at Memorial Sloan-Kettering Cancer Centre in New York. The immunotherapy revolution unfolding there was founded on the fact that the human immune system normally destroys cancerous cells – but that as certain tumours grow and evolve, they start to evade immune surveillance.

Allison had shown how, as a tumour develops, mechanisms emerge which suppress a critical population of T cells, known as effectors, that normally recognise cancer cells and tag them for destruction. Some of the signals that inhibit T effectors in tumours act at checkpoint receptors – receptors that ordinarily function to keep any immune response proportionate to the need for them. And Allison’s demonstration that blocking these checkpoint receptors disinhibited T effectors, allowing them to destroy patients’ tumours, won him a share of a Nobel Prize.

Allison’s focus was T effector cells, their interaction with cancer cells and how this is regulated by checkpoint receptors. But Quezada was interested in a third player: regulatory T cells or Tregs. These T cells function to suppress T effectors and thus regulate immune responses. Quezada asked whether Tregs inhibiting T effectors within tumours are also critical for cancer cells escaping the immune system? Gradually, he convinced himself and Allison that this was an essential piece of the puzzle.

But an equally important legacy of his time in the Allison lab, was Quezada witnessing first-hand how the clinical success of checkpoint inhibitors was achieved by basic researchers and clinicians working in constant dialogue. “That's when I started seeing the power of taking basic research and being very smart on how you analyse its impact as it gets into the clinic,” he says. “I said, ‘This is exactly what I want to be doing. I want to be working at this interface’.”

At this point, Karl Peggs, a clinical fellow with whom Quezada had worked with in Jim Allison’s New York lab, was instrumental in recruiting him to UCL. Peggs had already moved to London and he told Quezada that if he moved to UCL, he could plug a gap between clinical trials and basic immunology research.

A grant from CRUK was instrumental in securing the position. “We first supported Sergio through a CRUK career development fellowship back in 2010,” says Matt Kaiser, Head of Careers and Discovery Research at CRUK. “This allowed him to bring his expertise to the UK and establish his own research group.”

Yet, despite his and CRUK’s translational ambitions, Quezada didn’t arrive at UCL with a specific drug in mind. “I don't think that's how it works,” he says. “These things are organic. It's like a little plant, they emerge.”

A seed, however, had been planted in New York with the Treg work. The checkpoint inhibitors that had entered the clinic were thought to act by directly disinhibiting T effectors. But Quezada’s group – controversially ­­– found evidence that these drugs could also deplete Tregs in tumours and that this was a vital part of their action.

This reignited interest in CD25 because – unlike checkpoint receptors – it is expressed abundantly on Tregs and only at low levels on T effectors. Designed the right way, he and his group postulated, anti-CD25 antibodies might offer a way to powerfully and selectively deplete Tregs and liberate T effectors to attack cancer cells. Then came the moment the team had been dreaming of – they found their newly designed antibody caused a stronger immune response against the cells it bound to – which in turn caused tumours to shrink. “That was kind of the eureka!” Quezada says.

Designed the right way… anti-CD25 antibodies might offer a way to powerfully and selectively deplete Tregs and liberate T effectors to attack cancer cells.

Crucially, this antibody had antitumour effects when administered to mice after a cancer had grown. The idea for a drug, formed as a seed in Quezada’s mind in New York, had taken root in London.

Forming partnerships

Regular discussions of translational opportunities were a key part of Quezada’s CRUK fellowship, and soon after he’d grasped the potential of CD25, he and the charity explored ways to successfully file patents. The problem was, the earlier excitement around CD25 and the development of antibodies against it to treat graft versus host disease and T cell lymphomas, meant there were already many patents concerning CD25. In order to secure a patent, he and CRUK needed to demonstrate that their new antibody represented a genuinely novel invention.

While they worked on this, Tusk Therapeutics became excited by the CD25 data, and told Quezada if he could patent it, they would license it. CRUK and UCL redoubled their efforts and found a way to file IP and establish a collaboration with Tusk.

Tusk Therapeutics became excited by the CD25 data, and told Quezada if he could patent it, they would license it.

An essential element of this deal was a provision allowing Quezada’s lab to continue research on CD25 and anti-CD25 antibodies, allowing him to continue his academic career. He was delighted with the arrangement they reached. “To me,” he says, “it was corporate drug development without having to leave my beautiful academic job.”

Then, came the fateful meeting where Quezada was asked by Tusk if he could produce a better antibody.

The insight this question sparked came from considering CD25’s function. To date, Quezada had seen CD25 primarily as simply an antigen on Tregs, to which an antibody could bind to induce cell death. Because CD25 was expressed sparsely on T effectors, these cells were spared death.

But CD25 is more than just an antigen. It is the receptor for interleukin 2 (IL2), an important activator of T effectors, especially within the tumour microenvironment. Discussing this, everything suddenly fell into place. The antibody Quezada was using blocked CD25’s ability to function as a receptor for IL2. This meant that while it was depleting Tregs (thereby, disinhibiting T effectors), it was simultaneously limiting T effector activation by preventing them being stimulated by IL2.

Immediately, the lab set out to generate a new mouse antibody that would stick to CD25 without blocking IL2 signalling. Tested in mouse cancer models, Quezada says the data were amazing. And these results were right on time to tell Tusk to change the criteria by which they judged a candidate human antibody: it still had to bind CD25 and kill Tregs but, now, it had to also spare IL2 signalling.

The speed with which this all happened would have been impossible working solely as an academic, Quezada says. Throughout the project, the partners shared a will to move quickly, and this allowed them to optimise the division of work between Quezada’s and Tusk’s labs. As the partnership generated ever more promising data, Roche expressed an interest in acquiring Tusk.

Roche would take the drug though toxicological screening and into phase 1 clinical trials, but CRUK was careful to ensure Quezada retained complete freedom to work with mouse antibodies in order to continue to drive the science underpinning this target. He also secured a relationship with Roche in which his team and Roche continue to investigate the mode of action of anti-CD25 antibodies and inform the drug’s development.

Finding a new path

Asked what advice he’d give academics considering translational endeavours, Quezada says, “First, you need to want to do it.” He’s frank about the fact that investing time on such efforts can affect researchers’ purely academic work, but he believes that a happy balance can be struck. “The biggest challenge is to find the right partner that is going to help you get it to where you want to get it,” he says. “And, second, you need to know where it is that you want to get to.”

The CD25 project entailed a constant conversation about Quezada’s involvement, with both Tusk and Roche. The resolution of which has seen Quezada both publish influential papers on the molecule’s biology and make crucial contributions to the drug’s development.

“The most important thing is to get this drug to the clinic. We translational scientists need to understand that there are different goals and also different ways of measuring success,” he says. He believes that academic institutes and funders are increasingly valuing accomplishments in drug development and real-world impact.

The most important thing is to get this drug to the clinic. We translational scientists need to understand that there are different goals and also different ways of measuring success.

It's certainly his intention to carry on making such contributions and his ongoing interaction with CRUK fuels and facilitates this. A relationship, he says, that was productive from the start. "Immediately CRUK were super supportive," he says. “Their system of aiding with translation means they really help you see what aspect of your work could have an impact. I think that significantly accelerates your chances of identifying something that could be transformational.”

CRUK’s Kaiser says it’s been a pleasure to watch the charity’s ongoing support allow Quezada to become a leader in the burgeoning field of cancer immunotherapy. “He’s a real team player when it comes to sharing and collaborating. It’s been particularly exciting to see him really push forward the translation of his findings – and we’re keen to continue to encourage and recognise him and others in these efforts.” 

Today, Quezada continues to look out for ways in which his research might lead to new therapies. What’s vital for Quezada is that opportunities to save patients’ lives are not lost. Speaking of why he’s dedicated to increasing the profile of translational work, he cites examples of basic biology that he believes have major implications for further honing the effectiveness of immunotherapy – but which nobody has yet turned into therapeutic strategies. “There is a large number of very good basic scientists,” he says, “that just haven't seen it. It's not that they don't care. They just haven't realised that some of their findings, that they might think are very minuscule, could have a humongous impact.”

 

Charting a course

cd-25_alessia.png As CRUK’s Regional Translational Lead for London, Alessia Errico is in constant conversation with researchers, including Quezada.

She ensures CRUK is on hand to help to identify possibilities for developing new therapeutics. Errico will then work with academic researchers, throughout the translational process to maximise the odds of success. This may involve partnering with biotech or pharma, forming a spin-out company, licensing IP, or working with CRUK’s in-house drug development team.

Consulting on all aspects of translation, Errico and the commercial partnerships team aid in deciding what needs patent protection and how best to achieve that, and establishing who will make the best partners. She sees her role as removing roadblocks from scientists’ pathways. CRUK takes care of contracts and other commercial aspects of the project– including bringing in funding from the commercial sector – whilst always remaining sensitive to a researcher’s individual needs. “We try to provide researchers with opportunity,” Errico says, “and to make sure that they can do what they do best: science.”

“We always tell researchers that we don't want to stop their ability to publish papers,” she says, “because that's part of what they're judged upon in their academic career.” Being present early in the translational process is a key part of this, she says.

The team, however, remain present throughout the translational journey. The CD25 project, Errico says, demonstrates beautifully that commercial partners rarely buy a finished product. What they typically acquire is a work in progress. “What researchers do with me is continue research and development, because I don’t think the science is ever static,” she says.

“It is a balancing act always,” Errico says. “But our mantra is, it is the lead investigator's decision. It’s their science. We can advise. But once they’ve made the decision, we will do anything we can to support them.”

Explore how we can work with you to help translate your work. 

 

Read more

Liver cancer rates in the UK are highest amongst men in Scotland

4 days 16 hours ago

News report

A paper, published last week in JHEP Reports, has detailed the variation in the number of people being diagnosed with liver cancer across the UK. 

Liver cancer rates have doubled across the UK over the last 2 decades – increasing from 4.4 per 100,000 in 1997 to 9.6 in 2017 – with the highest incidence rates in 2017 seen in men in Scotland, compared to men and women in the other UK nations. 

Dr Tom Bird, an honorary consultant hepatologist at Edinburgh Royal Infirmary and co-author of the paper, said, “Our analysis of this data is showing that liver cancer has become a much more common type of cancer in the UK. Whilst there are signs that liver cancer survival is improving, it still claims far too many lives each year.” 

Bird added that a major factor driving this long-term rise in cancer cases could be fat within the liver related to obesity.  

What did the study find? 

Between 2015-2017 there were around 6,100 new liver cancer cases in the UK every year, the equivalent of 17 new cases every day.  

Over the 1997 to 2017 study period, 82,024 people were diagnosed with primary liver cancer and 58, 348 people died from their confirmed liver cancer across the UK. Age-standardised (AS) incidence and death rates of liver cancer were more than twice as high in men than in women.  

 How are liver cancer rates calculated?  
  • For this paper, the data on liver cancer incidence between 1997 and 2017 were obtained from population-based, nationwide registries in the UK. The team looked at the number of people diagnosed with liver cancer per 100,000 people.  

  • In order to compare the number of people diagnosed each year in different countries and over different time periods, due to the ageing population, other factors like age needed to be accounted for. The team adjusted the data to match the age structure of a standard European population (otherwise known as age-standardised data).  

Although incidence and mortality rates have increased in the last 20 years in the UK, survival has also increased.  The proportion of people surviving their liver cancer for one, 2 and 5-years increased by around 2 times over the study period. 

While the AS incidence rates of different subtypes of liver cancer varied across the nations, Scotland had the highest incidence rate of primary liver cancer between 1997 and 2017, and Northern Ireland had the lowest.  

Although liver cancer only accounted for around 2% of all cancer cases in Scotland in 2017r, rates are increasing more rapidly than almost any other cancer type in the UK. 

The latest study, funded by the British Association for the Study of the Liver and including work by Cancer Research UK funded researchers, revealed that the rate of people dying from confirmed liver cancer in Scotland doubled between 1999 and 2017. Additionally, the rate of people being diagnosed with the disease between also doubled, from 5.83 cases per 100,000 people in 1997 to 11.71 per 100,000 by 2017.  

Professor Linda Bauld, a Cancer Research UK prevention expert based at the University of Edinburgh, said: “It’s shocking that so many people in Scotland are being diagnosed and dying of liver cancer. 

“It should worry us all that liver cancer rates have risen over the last few decades in Scotland. Sadly, it is preventable factors like being overweight or obese, smoking and excessive alcohol consumption that increase the risk.” 

What action is needed? 

Liver cancer  is caused by factors such as overweight and obesity, smoking, and viruses such as chronic viral hepatitis. “It’s important to remember that obesity, and the liver diseases related to it, are both preventable and reversible,” says Bird.  

“It’s clear from this study that action is still urgently needed to help us all lead healthier lives,” says Bauld. “This is why the next Scottish Government must bring forward legislation to ban supermarket price promotions on junk food at the earliest opportunity.” 

Cancer Research UK is calling on the next Scottish Government to introduce bans on junk food advertising and price promotions to tackle the nation’s weight problem, which is a risk factor for 13 types of cancer, including liver cancer.  

In 2019 the Scottish Government announced plans to introduce legislation to restrict price promotion, but was paused in 2020 due to limits on parliamentary time as a result of the coronavirus pandemic. 

Read more

Mutations in overlooked DNA could have profound impact on bowel cancer survival

5 days 9 hours ago

News report

DNA errors in the cell’s energy ‘factories’ increases the chances of survival for people with bowel cancer, also known as colorectal cancer, according to a study published today in Nature Metabolism.

Studying how DNA errors (mutations) can drive cancer development, as well as help it adapt and evolve, has been a key focus of cancer research. But much of that focus has been on DNA found in the cell’s nucleus.

Experts say the errors found in DNA outside the nucleus, in structures called mitochondria, have been “overlooked for decades”, but could have a profound effect on survival.

“Using data hiding in plain sight, we have shown that a critical piece of the cell’s machinery to make energy is quite often broken in cancers.” – Dr Ed Reznik

The researchers hope that in the future, doctors could use this information to identify patients with more aggressive forms of bowel cancer so they can receive the most effective treatments.

Michelle Mitchell, chief executive of Cancer Research UK, said: “This work highlights just how much more there is to discover about the inner workings of cancer, and all those breakthroughs for people with cancer we have yet to unlock.”

Overlooked DNA

Whilst most of our DNA is wrapped up at the centre of our cells in the nucleus, we also have some in our mitochondria, small structures found in our cells that help us turn carbon fuels, such as sugar, into energy. This DNA is also prone to errors (mutations).

Mitochondrial DNA mutations have been found in cancer cells before, but there has been little research into what they do or whether they have any effect on treatment response or how the cancer will progress.

Dr Payam Gammage, co-lead author and group leader at the Cancer Research UK Beatson Institute, said the study shines a light on the impact of mitochondrial DNA mutations in cancer, which have been overlooked for decades.

Transatlantic collaboration

To answer these questions, researchers at the Cancer Research UK Beatson Institute in Glasgow collaborated with the Memorial Sloan Kettering Cancer Center in New York to collate and analyse data from the largest published dataset of tumour samples that include mitochondrial genome data and the corresponding clinical outcomes of the patients.

By analysing data from 344 patients with bowel cancer, the team could match groups of mutations to the likelihood of survival. They found that, after controlling for other variables that affect cancer risk like age, the presence of mitochondrial mutations was associated with 57 to 93% decreased risk of death from bowel cancer, depending on the type of mitochondrial DNA mutation.

“This discovery could have a huge impact on patient care, with potential for changes to suggested treatments and a patient’s outlook based upon the mitochondrial DNA status of their cancer. However, further research will be necessary to move these discoveries from the lab to the clinic,” said Gammage.

“Incredible things can be achieved through research, and the gains are even greater when we collaborate with world class global institutes like Memorial Sloan Kettering Cancer Center,” added Mitchell.

Beyond bowel cancer

The team also wanted to know how common mitochondrial mutations were in cancer more broadly. They used cutting-edge genetic techniques to look at existing data from over 10,000 tumour samples across 23 cancer types to search for mitochondrial mutations that were frequently repeated.

They found that mitochondrial mutations were present in almost 6 in 10 tumour samples, with 25 out of the 30 most commonly mutated genes across cancers being present in the mitochondrial genome.

These results indicate that mitochondrial mutations could play a role in survival beyond bowel cancer. Further research is needed to understand the wider implications of mitochondrial mutations in different cancers, and to delve into the biological underpinnings behind it.

Dr Ed Reznik, co-lead author based at Memorial Sloan Kettering Cancer Center, said: “Using data hiding in plain sight, we have shown that a critical piece of the cell’s machinery to make energy is quite often broken in cancers. It now begs the question of how these mutations within mitochondrial DNA might be exploited as drug targets.”

Read more