Doctors have launched a major study to understand why a small percentage of cancer patients beat the odds and survive long after being diagnosed with some of the most aggressive forms of the disease.
Eight NHS cancer centers join dozens of hospitals around the world to find patients who have had extraordinary responses to cancer treatment and lived much longer than expected.
Researchers on the study will collect detailed biological information on 1,000 patients and their tumors, analyzing DNA, blood proteins, microbes and molecular biomarkers in hopes of finding out why they did so well.
The insights gained will be used to understand cancer weaknesses and design new therapies for them aggressive cropswith some treatments aiming to mimic the crucial biological features seen in so-called super-survivors to improve the outlook for other patients.
Cancer specialists in more than 40 countries are participating in the study, looking for people who lived unusually long after diagnosis with advanced stage small cell lung cancer, the aggressive brain cancer glioblastoma, or metastatic pancreatic ductal adenocarcinoma. Those in the top 3% in terms of survival time are eligible.
“We don’t expect people with these cancers to live more than two years or three years, but about 3-5% do,” says Dr Thankamma Ajithkumar, a consultant clinical oncologist at Cambridge University Hospitals NHS Trust. “It always surprises us why these people live. Is there anything in the tumor or anything in their genetics that actually makes it easier to fight this cancer?”
The Rosalind study is named after Rosalind Franklin, the British X-ray crystallographer whose Photo 51 famously captured the double helix structure of DNA. The photo was taken in 1952, six years before Franklin died of ovarian cancer.
Ajithkumar said: “Before this study, few had tried to look at the people who did very well with these terrible cancers to see if we could learn anything, and if we could, how we could translate that to the outcome of the make illness better.”
Some patients will owe their survival to genetic quirks in their tumors that make them particularly susceptible to cancer drugs. For others, the answer will lie in their immune system’s ability to destroy cancer cells. The study aims to understand these and other factors that help patients survive.
Data collected from the super-survivors will be kept in a global database managed by Cure51, a French startup that is funding Project Rosalind with investment from Sofinnova, a Paris-based venture capital firm.
“We know that these people survive,” says Nicolas Wolikow, CEO and co-founder of Cure51. “We need to understand why and unlock the mechanism of survival. If we succeed in doing this, there is a good chance that we can contribute to the eradication of cancer.”
However, finding and enrolling super-survivors cannot be easy. In the UK, cancer patients who do well after five years are discharged, making it harder for doctors to track their progress. “Tracing them is going to be a big problem,” Ajithkumar said. Super survivors interested in taking part in the UK arm of the study can contact the Cambridge Cancer Trials Center at info@cancer.cam.ac.uk.
Dr Hattie Brooks, from Cancer Research UK, said: “Understanding why treatments can affect people with the same type of cancer differently is important if we are to develop more effective ways to beat it. This could eventually allow doctors to develop new therapies that are more likely to work for people with these harder-to-treat cancers, who currently have fewer options.
“Studies like this are especially welcome in cancers where fewer people survive for at least 10 years. Although this study is at an early stage, it could be an important step towards new ways to treat aggressive cancers.”
