Dr Andrea Napolitano
The Royal Marsden
Awarded: £200,000
The challenge
Gastrointestinal stromal tumours (GIST) are the most common type of sarcoma of the digestive system. Many patients with this type of cancer are treated with a drug called imatinib, a targeted drug that works to shrink the tumour. However, not all GIST cancer cells respond to this treatment, and some can lie dormant before starting to grow again, causing the disease to relapse.
Researchers think this happens in two ways: some cancer cells change their DNA, so the drug no longer works on them, while others survive by hiding within parts of the tumour where the drug is less effective.
How will this project tackle this challenge?
Dr Andrea Napolitano and his team at the Royal Marsden will study how and why GIST tumours become resistant to imatinib. They will use special labels like barcodes to track individual cells over time, so they can follow what happens when the cells are treated with imatinib. This will help them find out whether cells that don’t respond to imatinib are present from the start, or whether others develop resistance over time. They will also look at how changes in the DNA might help the cancer cells to survive imatinib treatment.
The team will then map where different types of cancer cells live inside a tumour, looking at whether cells that survive imatinib treatment cluster together, and what other types of cells help them survive. This will give a much fuller picture of how and where resistance develops.
What this means for people affected by sarcoma
The findings could help doctors predict who is most at risk of their cancer coming back, and tailor treatments that target not just the tumour itself, but also the surrounding environment that helps it survive. By making it harder for cancer cells to survive treatment, we can hopefully reduce the risk of GIST returning.
