08 December 2018
Thanks to a three-year Early Career Cancer Research Fellowship grant from Cancer Council SA’s Beat Cancer Project, Dr Lauren Thurgood is able to continue pursuing new therapies that target energy pathways in the hope of slowing—or ultimately, halting—the growth of chronic lymphocytic leukaemia (CLL) cancer cells.
Currently, CLL is the most commonly diagnosed form of leukaemia in Australia, with approximately 1,400 people diagnosed each year. With a median age at diagnosis of 70, it’s a disease that will become more prevalent with our country’s ageing population, and one that requires highly tailored treatment—including combination immunotherapy—to decrease the risk of comorbidity-related issues.
The more we understand about this disease, the closer we will be to forming better treatments, or even stopping the growth of the cancer entirely.
Why CLL research is urgently needed
1. CLL has a highly unpredictable course of disease
Approximately 30 per cent of people with CLL will never require treatment, and notice very few symptoms. They’ll also have no increased risk of mortality. But for the other 70 per cent, they will develop symptoms such as recurrent infections, fatigue, sweats and weight loss and their B-cells will suddenly spike. For those with the most aggressive forms, it can claim their life in just two or three years.
Aside from a select few patients who have a genetic marker indicative of aggressive CLL, doctors are currently unable to accurately predict who will fall into which category. If we had a better understanding at this early stage, we could offer more tailored treatments that would result in better individual outcomes.
2. There are dangers of early adoption of CLL drugs
To make the situation more complex, it may not be suitable to begin treatment from the point of diagnosis. There’s no evidence to suggest that earlier treatment is more effective, and in fact, it can often make the prognosis worse. Instead, following a diagnosis, doctors will adopt a ‘watch and wait’ approach. At the first sign of symptoms or increased B-cell numbers, they will then begin treatment.
3. CLL cells develop resistance to drugs over time
Then there’s one final hurdle. Once patients have developed symptoms, begun their treatment, and noticed a significant improvement for several years, their drug can suddenly stop working. This happens because the cancer has developed a resistance over time. My research aims to develop alternative drugs so that patients still have options available to them if and when resistance develops.
Further, we’re also investigating this concept of drug synergy, seeing whether certain drugs may combine as a new hybrid drug that could deliver better effects than either of them could individually. This could then be used with current therapies to reduce incidence and improve response.
About chronic lymphocytic leukaemia (CLL)
B-cells are important immune cells that produce antibodies to protect the body from infections. But in patients with CLL, these cells grow uncontrollably, which causes recurrent infections, bruising, lethargy and anaemia.
The aim of treatment is therefore to slow or ideally stop the uncontrollable growth of these cells.
In my preliminary research over the past five years, my team and I made a significant discovery: that CLL cells have a different energy source to most other cancers. If we can better understand how CLL cells make their energy, then maybe we can work out how to starve them.
What my research will achieve
In February 2018, I was awarded $240,000 of Beat Cancer Project funding for my current three-year project, ‘Metabolic reprogramming of B-lymphocytes in chronic lymphocytic leukaemia: a new therapeutic strategy?’.
Based at Flinders Centre for Innovation in Cancer, this project will focus on translating my preliminary findings into patient benefit.
We will seek to answer key questions, like:
- What microscopic changes are driving this cancer growth? This finding will allow us to better predict the course of disease in individuals.
- Are CLL cells producing their own energy source, or are they sourcing energy from elsewhere in the body? With this information, we have a better chance of starving the cancer.
- Are energy sources being transferred between cells? If we know this, then we can target these pathways with alternative treatments.
Crucially, these findings have the potential to inform research into other blood cancers, and even solid cancers. All cancers require energy to stay alive and thrive, and so the theory follows that all cancers can be starved of energy.
This Cancer Council SA funding comes at a crucial point in my research—ultimately helping to progress it to a stage where we fully understand the science, we know that it’s safe, and so we can start laying the groundwork for human trials.
As cancer researchers, we all have one common goal: a cancer free future. Cancer is complex, it evades, it evolves, it spreads, but most of all, it grows. In order to sustain this frenzied growth, the cancer cell requires energy. If we can understand more about where it gets this energy from, we can develop new therapies that interfere with this process. Our ability to investigate questions like this rely on the generosity of donors and funding agencies like Cancer Council.
Dr Lauren Thurgood
Cancer Council SA’s Beat Cancer Project Early Career Cancer Research Fellowship recipient Flinders Centre for Innovation in Cancer Research
You can learn more about the research projects currently funded by Cancer Council SA’s Beat Cancer Project.