Improving soft-tissue sarcoma diagnosis with non-invasive procedures
Professor David Gonzalez de Castro
Queen's University Belfast
Fusion genes, when two “normal” genes are re-arranged together to create a “chimeric” gene, can lead to cancer. This project aims to develop a diagnostic method to detect fusion genes in blood samples, as well as tissue, which could improve diagnosis in a substantial number of soft tissue sarcoma patients, crucial considering there are more than 60 types of soft tissue sarcoma.
Circulating tumour cells as predictors of disease progression and overall survival in dogs with naturally-occurring osteosarcoma
Professor Matthew Allen
University of Cambridge
Dogs are 10 times more likely than people to develop osteosarcoma, so focusing on dogs with naturally occurring forms of the cancer could yield vital insight into our understanding of the disease and how it spreads in humans. Dogs develop the same pattern of clinical disease as people, with the tumour developing in bone and spreading to distant organs such as the lung through cells entering the bloodstream (known as circulating tumour cells or CTCs).
Tumour cells are thought to escape from the main tumour and enter the bloodstream, after which they may form metastases at other sites in the body. The cells can be identified as circulating tumour cells which can be isolated and studied. This project is a pilot which will isolate, quantify and characterise these cells in sarcoma patient blood samples, potentially offering a biomarker to identify which patients may be at risk of developing metastatic disease.
Isolated limb perfusion (ILP) is a surgical technique whereby the limb is isolated from the rest of the body and chemotherapy is given. The technique is used in cases where the tumour is large or the limb has had previous surgery. This project is a clinical study to see if the virus T-VEC can be safely combined with ILP and used to treat sarcoma patients. Tissue samples will be collected and examined to see if this combination stimulates the immune system to attack cancer cells. This project will provide knowledge into the role of cancer killing viruses in combination with ILP and a treatment for metastatic sarcoma.
The project looks at the correlation between demographic area and the impact it has on a sarcoma patient's diagnosis and routes into treatment pathways. It will also look at the link between poor diagnostic experiences and poorer treatment, rehab and follow-up, helping to provide evidence to shape future healthcare interventions to support earlier diagnosis of sarcoma.
Soft tissue sarcomas can be removed by surgery, but may return. All cancers are different which affects how they respond to treatment. A test is needed to predict which tumours will return and what treatments will prevent this.
Low oxygen levels in cancer, called hypoxia, make them harder to treat. Research has identified a gene signature to measure hypoxia in sarcomas. The signature needs testing in cells in a laboratory to make sure the signature is definitely measuring hypoxia in soft tissue sarcoma.
Soft tissue sarcomas are rare cancers commonly affecting the limbs. In most patients, treatment involves surgical removal of the cancer. Isolated limb perfusion (ILP) is a surgical technique that may be used when patients have a large tumours or had previous surgery. ILP delivers high-dose anti-cancer drugs to an affected limb whilst avoiding life-threatening side effects throughout the body. Research has found that adding cancer-killing viruses to ILP (OV-ILP) improved how long the treatment kept the tumour from growing, neither ILP or OV-ILP treatment prevent tumour spread.
Osteosarcoma tumours are affected by a variety of factors. One is the internal pressure of tumours, which is generally higher than the surrounding healthy tissue. This increased pressure is known to have an effect on drugs reaching the tumour. The increased pressure is also known to promote tumour growth and increases the risk of the tumour spreading.
This project looks at how this pressure is generated in osteosarcoma, how osteosarcoma cells respond to different pressures and what causes sarcoma cells with high internal pressure to grow and spread.
Pazopanib and regorafenib are drugs which are effective in the treatment of advanced soft tissue sarcoma. However, there are some patients who do not respond to treatment with these drugs and in other patients, the effect of the drugs can wear off as cancer develops resistance.