Forty years after cancer research was made a priority focus, we must soberly reassess the overconfidence of that era’s expectations. Genuine progress has been made in prevention, early detection, surgical intervention and palliative management of advanced disease. However, we must acknowledge that metastatic cancer is still largely incurable and the toll of cancer around the world remains enormous.
Within that sober assessment, however, the lymphoid cancers stand out. Almost all Hodgkin lymphoma patients and the majority of those with large cell non-Hodgkin lymphoma are cured. For the indolent non-Hodgkin lymphomas, lymphocytic leukemia and myeloma, survival in decades is achievable with many patients able to be off treatment much of the time during a long survival. However, we have mostly exhausted what the empiric trial and error methodology of the past can achieve. Future progress will require much deeper understanding of the fundamental biology of cancer.
What is the BC Cancer Agency’s Centre for Lymphoid Cancer (CLC) doing to improve this understanding?
Recently a CLC investigator, Dr. Ryan Morin, led a team that identified a whole family of previously unknown mutations commonly seen in lymphomas, mutations which alter the way in which cells regulate gene expression at the DNA level, blocking or over-expressing genes through a process called histone modification.
In another team effort, Dr. Christian Steidl found the first consistent genetic alteration ever associated with primary mediastinal large cell lymphoma, a lymphoma that predominantly strikes young patients.
Dr. David Scott employed a powerful new technology to profile the gene expression patterns that identify patients likely to do very well or very poorly with treatment for Hodgkin lymphoma.
Drs. John Spinelli and Angela Brooks-Wilson have shown that organochlorine exposure and specific genes interact to double the risk of developing lymphoma.
These are the types of observations that will move cancer treatment from its blunt empiric trial and error approach of the past, to a future where fundamental understanding of molecular biology and genetics guides development of newer, more effective and less toxic treatments.
The CLC will be in the centre of that action, thanks to the hard work of our investigators and the continued support of our donors and the BC Cancer Foundation.
Joseph M. Connors, MD