Tackling Poor Prognosis

Fiona Walker was just 19 when she was diagnosed with glioblastoma, a type of cancer that affects the brain and spinal cord.

Her mother Claire explains: “Fiona was 18 and in her last half term at school when she started experiencing numbness in her leg. The symptoms got worse throughout the summer so we eventually took her to a neurology clinic. Nothing showed up on the first few scans but eventually they confirmed she had a tumour at the top of her spine.” The tumour spread quickly and 18 months later, Fiona passed away.

Brain tumours are now the biggest cancer killers of children and adults under 40. Only one in five patients survive beyond a year and fewer than one in 33 patients are alive after three years.

Despite years of research, treatment options are limited. Tumour cells are able to spread widely within the nervous system, which means that brain tumours tend to be diffuse. So it is nearly impossible to target a whole tumour with surgery or radiotherapy. New therapies are urgently needed.

Dr Steve Pollard has been researching brain cancers for more than 10 years. He says that with internationally recognised strengths in cancer research, genetics, stem cell biology and neuroscience – together with a significant new crop of young brain tumour researchers – the University is perfectly poised to make advances in the field.

His own research team focuses on stem cells in the nervous system. These give rise to the many different types of cells found in the brain and spinal cord during normal development and, in some regions, continuing into adulthood. Comparing normal stem cells to brain tumour cells can tell us a lot about how cancers develop and spread.

“Brain tumours include more than 100 very different subcategories of disease, which makes them extremely challenging to understand and treat,” Dr Pollard explains. “They are also difficult to study because of the challenges of obtaining brain tissue at early stages of the disease.

“But we can now capture brain tumour cells in the lab from patient biopsies and keep these growing in the petri dish. We can then compare and contrast tumour cells with normal neural stem cells, to better understand the genetic mechanisms that drive cancer development and growth. This creates an opportunity to test new and existing medicines and drug combinations directly on patient relevant tumour cells.”

Next year, the Royal Hospital for Sick Children and the Department for Clinical Neuroscience will relocate to the Royal Infirmary site at Little France, next to the University’s MRC Centre for Regenerative Medicine where world-leading brain tumour stem cell research takes place.

Combined with state-of-the-art brain imaging facilities and recent investments in the latest gene-sequencing and editing technologies, Dr Pollard says this will create the perfect climate for new collaborations.

He says: “Fostering closer interactions between scientists and clinicians will help maximise the use of precious tumour samples and biopsies. This can have immediate effect in helping provide patients with better diagnoses and prognosis indicators. It also opens up opportunities for additional collaborative research projects to tackle the disease.”

The Walker family have established the Fiona Walker Fund to take advantage of this momentum.

Claire Walker says: “Thanks to a substantial fundraising effort from family and friends, we’ve already supported University research in this area through the sponsorship of PhD students. We’re now raising additional funds in the hope that we can fuel new research ideas and collaborations.”

“Fiona was such a party girl – full of character and always pushing at boundaries. She had good grades and a place at university to study product design. She was ready to fly and become her own person and have some independence. Then suddenly she was struck down. We just want to do whatever we can to try and improve the outlook for other families.”

Dr Pollard says: “The new fund will give researchers an opportunity to be bold and ambitious, to explore riskier projects and develop essential pilot data that will provide confidence to build larger programmes of research and attract further investment.”

Brain tumours include more than 100 very different subcategories of disease, which makes them extremely challenging to understand and treat.

Dr Steve Pollard

The University’s research into ovarian cancer is also benefiting from the generous support of a family affected by the disease. The Nicola Murray Centre for Ovarian Cancer Research at the University has been established in memory of Nicola Murray, who died of ovarian cancer at the age of 34 just four months after being diagnosed. Her family set up a foundation after her death in 2010, which has raised more than £200,000 over the past six years and allowed the University to set up the research centre in her name.

Nicola had a particularly aggressive cancer caused by a rare genetic mutation. At the time, little was known about how the mutation could affect how her disease might be best treated. This lack of understanding spurred the family into action.

Her sister, Caroline Turnbull, explains: “It was only a month or so after her diagnosis that Nicola realised her hopes of successful treatment were narrowed due to the lack of current research. She began planning ways in which we – her family and friends – could raise money to fund research so that no other young women should go through what was happening to her.”

If ovarian cancer is caught early, nine out of 10 women will survive beyond five years. But the symptoms are vague and often overlap with other more common conditions. Most women are not diagnosed until the cancer has already spread. The average survival is just three or four years.

Like brain cancers, experts believe that ovarian cancer is probably a collection of many different subtypes of disease. Each one is likely to be biologically different and therefore response to treatments will vary.

The new centre has been set up to probe these biological differences in the hope of improving diagnosis of ovarian cancer. Researchers believe that more detailed diagnoses will help them to tailor therapies to the individual patient and maximise the chances of a better outcome.

Professor Charlie Gourley leads the new centre. He says: “Our research is focused on sub-dividing types of ovarian cancer according to genetic changes. This information will give us new insights into how the tumours grow and why some respond well to particular medications whilst others do not.

“Eventually we hope to develop new treatments that can tackle even the most resistant forms of ovarian cancer.”

The Centre is located within the Edinburgh Cancer Research UK Centre, which is home to advanced drug discovery facilities and part of the University’s world-leading genetics research hub– the Institute for Genetics and Molecular Medicine. Professor Gourley believes it is an ideal place to make a difference.

Fostering closer interactions between scientists and clinicians will help maximise the use of precious tumour samples and biopsies. This can have immediate effect in helping provide patients with better diagnoses and prognosis indicators.

Dr Steve Pollard

“Edinburgh is home to one of the largest clinical databases of ovarian cancer in the world,” he says. “This means that we can probe the genetic changes that have occurred in tumour samples and link this back to what happened in individual patients.”

“Strong links between scientists and the clinic mean that if we identify a treatment that we think may work well in a particular group of patients, we can readily set up clinical trials to test it. The support of the Nicola Murray Foundation is crucial for this as it gives us the flexibility to move quickly.”

The success of the University’s efforts to improve prognoses for difficult-to-treat cancers depends on the next generation of researchers. For both Professor Pollard and Professor Gourley, training young scientists is a key focus.

Professor Gourley says: “It is crucial that we invest in young researchers so that we can secure a brighter future for cancer research.”

With backing from families such as the Walkers and the Murrays, the University can continue to ensure that researchers are working to help improve the lives of cancer patients both now and in the future.

Eventually we hope to develop new treatments that can tackle even the most resistant forms of ovarian cancer.

Professor Charlie Gourley

Learn more

Find out more by visiting the Cancer Research Centre website.

Cancer Research UK Edinburgh Centre