This week I will talk about where lymphoid cancer research is going in the future. I think the greatest promise lies in two areas. But first I need to provide some context.

The treatment of lymphoid cancers has become steadily more successful over the past 30 years. Considering all of the lymphoid cancers, today it is reasonable to expect that more than 50 per cent of patients can be cured, even when their lymphoid cancer is widely metastatic (has spread widely throughout the body). That level of success against metastatic cancer is almost unique across the entire cancer field. It means that we can build on that experience and will learn the most by concentrating on determining how lymphoid cancers become resistant to our best treatments. We will probe into treatment resistance mechanisms employing the newest research tools, which can reveal molecular interactions with unprecedented precision.

For example, Dr Christian Steidl, one of our leading lymphoid cancer scientists here at the BC Cancer Research Center, is now using a single cell genomic sequencer to identify specific changes in the DNA (the molecule our cells use to store their basic operating instructions) of malignant cells that have become resistant to our best treatments. This will allow our research team to isolate the core alterations underlying treatment resistance. Knowledge of these core aberrations is essential to enable us to craft novel therapies that will overcome treatment resistance.

The other area of excitement in the world of lymphoid cancer research is that of immunotherapy. For many years we have seen tantalizing suggestions that our body’s immune system has the potential to be used as a powerful therapeutic tool. What we did not understand is that malignant cells are extremely adept at evading and hiding from the immune system. And, in addition, we did not know how to specifically manipulate immune cells to work for us. However, this has all changed in just the past few years.

For example, building in part on work done by our BC research team, scientists around the world have now discovered that cancer cells produce specific molecules that paralyze immune cells. When we introduce medications into a patient’s body that can neutralize these immune-paralyzing molecules, suddenly the patient’s own immune cells can attack the cancer cells, at times leading to remarkable regressions of otherwise treatment resistant cancers, including lymphoid cancers. More immune-system focused research will allow us to expand the variety and effectiveness of these immune-potentiating treatments.

However, even better, we are now learning how to make immune attacks on cancer cells even more powerful. Using tools developed in just the past few years scientists can now extract immune cells from a patient, enhance these cells with the ability to recognize specific cancer cells and also equip these new crafted cells with surface weapons that can destroy cancer cells.

We can grow and purify large quantities of these specially modified immune cells and then infuse them back into the patient. In a sense we will have taken an already powerful natural defense mechanism and turned it into an even more potent targeted treatment. This work is still just beginning but its remarkable potential is already evident.

Exciting days lie ahead in lymphoid cancer research and treatment. With the continued support of the BC Cancer Foundation and its donors our lymphoid cancer research team will continue to be major contributors to these efforts.

Thanks for reading, Dr. Connors

Medical oncologist and Clinical Director, Centre for Lymphoid Cancers, BC Cancer