Lorne Cancer Conference 2017: It’s Personal

Lorne Cancer Conference 2017: It's Personal

A little over a week ago, while much of the east coast of Australia was sweltering through a major heat wave, a group of scientists gathered in perfect weather at the surf-coast town of Lorne in Victoria. Given the proximity to the beach, it is a testament to the quality of events within the Mantra Lorne conference centre that there was barely a sole to be seen on the sand.

The occasion was the 29th gathering of the Lorne Cancer Conference – Australia’s premier meeting of cancer researchers. I was privileged enough to join the delegates to hear talks from over 50 leading Australian and international speakers, as well as a fantastic group of emerging scientists. The Organising Committee, Secretariat (ASN Events) and Sponsors (CSL, National Breast Cancer Foundation and the Walter and Eliza Hall Institute) should be congratulated for assembling such an impressive line-up.

The latest on the fight against cancer

There is something special about hundreds of great minds converging to tackle a challenge as great and meaningful as cancer, and to share the latest from their work. And there was plenty to share.

An increasing ability to probe the origins and drivers of cancer continues to reveal a host of new therapeutic targets. From the ribosome (Prof Rick Pearson) to metabolic pathways (Dr Kristin Brown, Dr Lev Kats), the tumour microenvironment (Claire Vennin) and the enzyme PRMT5 (A/Prof David Curtis), efforts to understand new biological pathways in cancer are yielding potential avenues to therapy. A session was dedicated to the great work sparked by researchers at the Walter and Eliza Hall Institute on targeting Bcl-2 proteins – work which has led to several potential new drug candidates (A/Prof Guillaume Lessene, Prof Andreas Strasser).

We wrote previously about big data in biotech, and the conference served up data galore. The ‘omics’ (genomics, epigenomics, transcriptomics etc.) are certainly now well embedded within the cancer research toolkit and being used to great effect. Deep profiling of tumours, even at a single-cell level (Prof Zena Werb, Dr Heather Lee), is revealing more about the complexity of cancer and the role that sub-populations of mature or stem cells (Prof Jane Visvader, Dr Frederic de Sauvage) play in cancer progression and metastasis. It is also decoding some of the most difficult and devastating tumours, such as pancreatic cancer (Prof Sean Grimmond) or Asian stomach cancers (Prof Patrick Tan), offering hope that we may be able to finally improve survival for these patients (Figure 2).

Other highlights, just to name a few, included Prof Helen Rizos’ use of circulating tumour DNA analysis in melanoma, novel nanoparticles for delivery of cancer therapeutics (Prof Maria Kavallaris) and Prof Jason Carrol’s work on hormone signalling (using new techniques like RIME) including boldly busting myths about the role of progesterone in breast cancer.

 

Lorne Cancer Conference 2017: It's Personal
Figure 1: Rates of cancer survival over the last 40 years (Source: http://cancerresearchuk.org)

It’s personal

Much of this work re-enforced the immense complexity of cancer – the vast heterogeneity of tumours (even at a cellular level – Figure 3) and their ability to adapt, evolve and become drug resistant. It showed that the more we understand about cancer, the more we see it is hugely personal. No two patients have the same tumour. This creates challenges – and opportunities – in the continued pursuit of ‘personalised medicine’.

Prof Charles Perou highlighted this so clearly. Through genomic analysis of HER2+ breast cancer patients treated with Herceptin (the “poster child” of personalised medicine), he showed that there is a subset of these tumours (HER2+ basal-like) that do not respond to Herceptin at all.

So how personalised is personalised? Can we truly come up with ideal therapies, or combinations of therapies, that will optimally target an individual patient’s tumour and the different cells within it? What does this mean for the design of clinical trials, regulation and reimbursement? These issues were tackled in excellent talks from Prof Louis Staudt (NIH) and Dr Adam Palmer (an Australian expat now at Harvard) and will continue to be a fascinating area of discussion and development.

 

Lorne Cancer Conference 2017: It's Personal
Figure 2: Tumour heterogeneity (Source: Nature – doi:10.1038/nature12625)

Commercialisation: a pathway to the patient

We were particularly interested to see the approaches being taken to get new diagnostics and therapies to the clinic – ultimately, the goal of all this fantastic research is to make a difference in the life of a patient with cancer. There were many stories of successful translation, commercialisation and collaboration that have set new drugs well on the path to approval. Yet there was also a sense that we could continue to improve on this front – particularly in Australia – to ensure that we are building the infrastructure and ecosystem required to get great innovation out of the lab and into the hands of clinicians.

At the end-of-conference dinner, we were treated to a talk from Emeritus Professor Simon Chapman entitled “How to grow rhino hide”. It was an amazing overview of some of the shocking, yet often comical, abuse he has endured through decades of public health advocacy (he was influential in introducing plain packaging for cigarettes) – the man certainly has developed a thick skin. Perhaps it was a fitting encouragement to all gathered to return to the lab with a renewed boldness to continue their fantastic research efforts and – despite the challenges – press on tirelessly towards achieving clinical outcomes in the lives of cancer patients.