Cancer cure could be 10-15 years away

The Value of Medicines Award that Dr Swee Tan received late last year from Medicines New Zealand is bringing the Gillies McIndoe Research Institute one small step closer in its goal to find a cure for cancer.

“I believe we are on the right path. It’s really a function of having the funding and the resourcing to continue – and desirably accelerate – the work we are doing,” Dr Tan said.

“That’s why the Value of Medicines Award and the $20,000 prize associated with it was so helpful. Every little bit helps us take one step closer to our ultimate goal.”

And Dr Tan estimates that goal could be 10-15 years away.

“Based on the discoveries we have made to date, and the work that is currently underway, I believe this is possible.

“And when you think about how long the world has been searching for a cancer cure, a 10-15 year window is quite a small timeframe.”

The work of Dr Tan and his team at the GMRI has been labelled a paradigm shift by international experts.

Professor Zbylut J Twarddowski of the University of Missouri, USA, is on record as saying “Drug manufacturers and cancer research must take note of this new major paradigm shift [resulting from the work of the GMRI].”

In addition to the ground-breaking and now well-known work on strawberry birthmark, one of Dr Tan’s team members, research student Ranui Baillie, recently made a discovery that could change the way tongue cancers are treated.

Ms Baillie identified a unique population of cancer stem cells in tongue cancer and a patent registration has been filed in the United States covering this work.

Dr Tan says evidence of the existence of cancer stem cells has been accumulating in other cancers but this is the first time a unique population of these cells has been identified and characterised within tongue cancer, the most common and deadly form of oral cancer.

“These cells are thought to be the driving force behind the development and progression of cancer,” he says.

It’s the work of identifying and characterising these cancer stem cells and understanding the systems that control them that drives Dr Tan and colleagues, and which underpins the GMRI’s intensive research programme.

“Our goal is to learn how to manipulate the in-built systems that regulate these cancer stems cells.

“We have already done that in the case of strawberry birthmark, a vascular tumour.

“We know the stem cells that cause strawberry birthmark are regulated by the renin-angiotensin system, and we have learned how to manipulate that system to trigger this tumour to ‘commit suicide’.

“If we can do that for the strawberry birthmark tumours, the logical conclusion is we can do that for other tumours as well.

“What we need to do is to identify the relevant regulatory systems that control the cancer stem cells.”

Scientists have recently found conclusive evidence of the existence of cancer stem cells in cancer. This is regarded by researchers at Oxford University and the Karolinska Institutet in Sweden as “a vitally important step” in understanding how cancer develops and how best to treat it.

The cancer stem cell concept proposes that all cancerous tumours comprise two types of cells:

  • Cancer cells that form the majority of cells within a cancerous tumour. These cancer cells possess little to no self-renewal capacity and will spontaneously die out quickly. They are traditionally treated by surgery, radiotherapy and chemotherapy.
  • A small number of highly malignant cancer stem cells that have unlimited self-renewal capacity as well as the ability to generate cancer cells. These cancer stem cells resist radiotherapy and chemotherapy, which explains why cancers often relapse following conventional treatments. They can enter slow-cycle states where the cancer seems to disappear but subsequently “returns”.

Dr Tan explains this concept with the analogy of a beehive.

“The hive has lots of worker bees, which are the cancer cells. These worker bee cancer cells are made quickly, but they have a limited life-span.

“But the cancer stem cells are the hive’s queen bee. They direct the hive and produce the worker bees, but more importantly they have an unlimited capacity to replicate themselves, producing even more queen bees which, in turn, produce more worker bees. These queen bees can migrate to other sites and start new hives, analogous to cancer spread (metastases).

“And as yet, medical science does not know how to control or manage the equivalent of these queen bees and that’s why the cure for cancer remains beyond our reach.

“But I believe we will find the control mechanisms because our work in strawberry birthmark tumours has provided a lot of insights into how this can be achieved in cancer.

“And once we do, it may lead to the cure for cancer. Given our current resourcing and the research programme it allows us, I’d say a new cancer treatment prototype may be 10-15 years away.”

In a bid to expedite this process, the GMRI has recently partnered with one of this country’s leading investment bankers, Cameron Partners, which hopes to raise as much as $10 million to boost the GMRI’s research efforts.

Rob Cameron, who heads Cameron Partners and who was diagnosed with stage four lung cancer in 2011, is using capital markets techniques to facilitate a philanthropic capital raising for the GMRI.

“I believe Swee and his team are on the road to making discoveries that will lead to a novel treatment for cancer,” Cameron says.

The immediate task facing the GMRI, and which is being supported by the Value of Medicines prize, is a repeat of the hugely successful strawberry birthmark story – to characterise and gain a better understanding of the tongue cancer stem cells that Ranui Baillie discovered, and to identify and unravel the complex bodily systems that regulate and control them.

“We are not certain, but we believe primitive systems such as the renin-angiotensin system will play a role, just as it did in the case of strawberry birthmark stem cells,” Dr Tan says.

Armed with that knowledge, Dr Tan and his team can then seek to design a radically different and far more effective treatment for cancer.

“Much as we did with strawberry birthmark stem cells, we believe it will be possible to manipulate them by simple medications.”

The final step, Dr Tan says, is then to apply this knowledge to other types of cancer.

“It’s a bit like exploring the realms of outer space. The observations that have been made and the evidence you have gathered in your work point you in the direction and give you the confidence that you will find what you are looking for out there. But it is not until you get there that you behold the wonder of what you find. And what you find forms the next step of that complex journey of discovery. But underscoring all these is knowing where to look and plotting the right course to get there in the otherwise unchartered quest.

“At this point, we are at the embryonic stage and there is a lot of exploring – research – to do yet,” Dr Tan says. “Frontier science research is inherently complex and often involves unexpected twists and turns as hypotheses and circumstances evolve. Many baby steps going in the right direction will eventually lead you to what you seek.”