We were delighted to attend the Bone Cancer Research Trust (BCRT) support and information conference. The conference connected patients, family members, scientists and healthcare workers and was a fantastic opportunity to learn from one another. Patient advocates shared their inspiring stories, scientists discussed their research and the BCRT showcased their patient-focused resources.
This is the first of a two-part blog sharing some of the talks from the event. In this blog, we will focus on the osteosarcoma (OS) research talks.
There are many different approaches to researching OS. Whether that’s improving current treatment or discovering new drugs, the ultimate goal is to improve patient outcomes.
Making old drugs new
PhD student Hannah Spencer (University of Bradford) shared her research looking at improving the effectiveness and reducing the side effects of methotrexate (MTX). MTX is a chemotherapy drug often used with other drugs to treat OS. However, MTX does not just kill cancer cells. It moves throughout the whole body, attacking healthy cells, and leading to side effects.
Hannah’s research has involved modifying MTX into a pro-drug. A pro-drug is a medication that enters the body in an inactive form and only starts working at a certain point. Hannah has modified MTX so that it only becomes active when it reaches cancer cells. This means that MTX should focus on killing cancer cells and not the healthy cells resulting in fewer side effects. Additionally, as the MTX pro-drug has a more targeted approach it may be more effective at killing OS cells.
The current work on the MTX pro-drug has been based in a laboratory. There is hope that in the future it will be tested in clinical trials to see how effective it is in humans.
Creating bone in a laboratory
Traditional research methods involve using cell lines (human cancer cells grown in a laboratory) and animal models. Although they provide an idea of how OS acts, they are not a true representation of the cancer environment, which is a lot more complex.
Prof Sibylle Mittnacht and PhD student Luke Farrow (UCL) have been working on a project to create a more realistic model of OS. They are using tissue engineering techniques to grow mini OS tumours from patient samples and implant them into a bone model. This bone model allows OS cells to more accurately reflect how they would act in humans.
This project is ongoing, but the team hope that it will provide valuable information on how OS responds to different drugs. This will help to inform research into new drugs for OS.
Activating the immune system to fight OS
Over the last few years there has been an increased interest in cancer drugs that target the immune system. These drugs, called immunotherapies, help the body’s own immune system attack and kill cancer cells. So far, they have not been effective in OS. This is because OS is very good at evading the immune system.
Dr Olivier Pardo (Imperial College London) has recently started a project looking at how to make OS more sensitive to immunotherapies. He is working on a protein called FGF2. FGF2 promotes OS growth and prevents inflammation at the tumour site. Inflammation helps recruit immune cells so by stopping inflammation FGF2 helps OS to hide from the immune system.
Dr Pardo is trying to block the activity of FGF2. He hopes this will prevent OS growth and increase the number of immune cells at the tumour site. This may make OS more responsive to immunotherapies. If successful, he hopes to move his research from the laboratory towards a clinical trial.
New surgical techniques
Most people with OS have both chemotherapy and surgery to remove the tumour. Mr Kenny Rankin and Dr Corey Chan (Newcastle University) shared some of the new techniques being used in bone cancer surgery.
Firstly, they described how 3D printing is being used in many different aspects of surgery. Bone tumours can sometimes be difficult to visualise. Accurate 3D models of bone tumours can now be made to help surgeons to plan the surgery. Additionally, surgical implants can be 3D printed for patients.
Next, they explained a research project looking at using a fluorescent dye to make tumours glow. Sometimes it can be difficult for surgeons to know whether they have removed all of a tumour. The fluorescent dye aims to overcome this. The dye is taken up by cancer cells and then viewed with a special camera. During an operation, surgeons can use the camera to distinguish between the glowing cancer cells and the non-glowing healthy cells. This has the potential to help surgeons remove all the tumour and reduce the risk of reoccurrence. Currently, the dye and camera are being optimised to ensure that the dye is predominantly taken up by cancer cells.
The value of tumour samples
Vital research can only happen with the input of patients, and there are many ways to get involved. TumourA mass of cells that are growing where they shouldn’t be. Tumours can be benign or malignant. Benign tumours do not spread to other parts of the body whereas malignant tumours are cancerous and have the potential to spread. samples can help to accelerate OS research. For example, they can be used to validate research done in the laboratory. The more samples we have, the more we can learn about OS and the better we can treat it.
One of the biggest barriers to getting patient samples is obtaining consent. Professor Adrienne Flanagan (UCL) explained patients will normally have tumour samples taken to help aid diagnosis. At this point, it is possible to take additional samples that can go toward research. However, consent is needed at what is often a very difficult time, so it is not always brought up with patients. Professor Flannagan has called out to patients to ask them how we can overcome this barrier and ensure that an opportunity to donate tumour samples for research is not missed.
Professor Flanagan and Dr William Cross (UCL) also discussed the PEACE project. This is an initiative where people can donate their body for cancer research after their death. The project has already increased our understanding of the genetics of chondrosarcoma (a type of bone cancer) and hopes to provide information on how to both treat and prevent bone cancers in the future.
The breadth of research discussed during the conferences highlighted just how many researchers are dedicated to improving outcomes for OS patients. It was also lovely to hear how the researchers had been inspired by patients to research OS.
Next week we will share some of the lessons learned from patient stories and the key resources available through the BCRT.
Visit the BCRT website.