In addition to killing tumour cells, conventional cancer therapies such as chemotherapy and radiotherapy kill all dividing cells in the body resulting in a wide range of unwanted side effects. Targeted therapy blocks the growth of cancer cells by interfering with specific targeted molecules present only in tumour cells thus with the ultimate aim of  achieving a much more efficient and  specific treatment which only kills tumour cells and thus reduces the side effects experienced by the patients. The Targeted Cancer Therapy group, based at The University of Surrey and led by Professor Pandha are working on several projects:

Viral Therapy:

Investigating so-called oncolytic viruses (viruses that solely replicate in cancer cells causing them to die) including herpes simplex virus (HSV), coxsackie virus and reovirus in bladder and prostate models. A clinical trial has recently been completed which used Coxsackie A21 virus in conjunction with mitomycin C to target and kill non muscle invasive bladder cancer cells. Read more about the science behind this and a new company developing it further — TollCyto Therapeutics

Tumour slice model:

Pioneering work is being carried out to develop a unique and novel model to test drugs in vitro. The tumour slice model uses a vibrating microtome (rather like a meat slicer) to slice a primary human tumour, taken fresh from the operating theatre, into wafer thin slices which can then be cultured for many days in vitro. This allows drugs and other novel compounds to be tested in an environment in which the architecture and tumour cells are representative of the tumour in a much better way than using tumour cell lines in vitro.

Peptide therapy:

A novel peptide, named HXR9 has been developed and shown to kill a range of tumour cell types in vitro. The peptide has also been shown to be effective in killing tumour cells in animal models. The peptide is now being tested in the tumour slice model using a variety of tumour types and plans are to test the peptide in a clinical trial. A small molecule mimic of HXR9 is also being tested.

Immunotherapy:

It has been shown that T cells found in tumours are often in an exhausted state. In order to reverse the process of T cell exhaustion in tumours we are analysing a range of tumours, in particular kidney tumours, to assess the state of their T cell populations with the ultimate aim of trying to reactivate them so that immunotherapeutic approaches are more effective.

Dr Nicola Annels’s research focuses on understanding the tumour immune microenvironment and using this knowledge to develop new immunotherapy treatments for cancer. Two of her current main research projects focus on renal cell carcinoma and prostate cancer. In renal cell carcinoma she is building on our growing understanding of the interrelated fields of renal cell cancer metabolism and tumour immunology to develop a potentially unique treatment approach to improve the clinical outcome for patients with renal cell carcinoma. In prostate cancer, that has so far been left out of the current immunotherapy revolution using novel immune checkpoint inhibitor drugs for cancer therapy, Dr Annels’s research aims to greatly increase the response to these drugs by invigorating the immune cell population in prostate cancer. This will be achieved by infecting the cancer with a cancer-killing virus (‘oncolytic virus’) which swiftly infects and inflames the tumours and results in a strong immune infiltrate, resulting in responsiveness of the tumour to immune checkpoint inhibitor drugs. Both of these research projects utilize state-of-the-art technologies to understand the complexity and diversity of the immune response within the tumour microenvironment. With this understanding immunotherapeutic strategies that have the greatest impact on tumour response and therapy are being evaluated with the aim of generating long-term tumour control in patients.

Optimising prehabilitation exercise to enhance tumour outcomes in advanced oesophageal cancer. The OPTIMUS Trial.

Regular exercise can significantly improve physical and mental health before, during and after cancer treatment, improve treatment tolerance, and reduce the time needed in the hospital. In our recent pilot study that assessed muscle fitness and quality of life changes in patients receiving chemotherapy before oesophageal cancer surgery, we have data that suggests exercise promotes immune cell movement into tumours. Our exercise programme resulted in significantly better physical fitness and quality of life (Allen et al 2022). Our new exercise programme based on results generated in patients with prostate cancer or leukaemia showed that exercising a little harder resulted in better improvements in physical fitness and quality of life. Further, we observed more immune cells in the tumours that likely promote better outcomes. Critically, we found an association between increased fitness and more immune cells in the tumour. Therefore, we aim to compare our previous exercise programme with a targeted exercise programme designed to increase aerobic fitness and, as such, increase the number of immune cells within the tumour.

Link: https://www.royalsurrey.nhs.uk/news/exercise-during-chemotherapy-may-help-immune-cells-fight-cancer-patients-invited-to-join-new-trial-14230

Biobanking:

Setting up a bio-repository and accompanying 'database' of 300 patients with all stages of prostate cancer to allow longitudinal blood sampling whilst on different treatment programs, and enable banking and analysis of serum and DNA at 6 monthly intervals.

Novel Cancer Trials:

A clinical team of 12 staff are developing a large programme of clinical research directed at improved treatment for cancer, understanding the causes of cancer and developing new methods of detection.

 EDMONd

A very large proportion of women with advanced ovarian cancer may develop a blockage in the bowel, which is often inoperable. Bowel obstruction causes significant issues to women, stopping them from being able to absorb essential food and nutrients. Providing the right nutritional support for women with inoperable bowel obstruction is extremely challenging.

Elemental Diet (ED) provides nutrition in the form of amino acids and easily digestible nutrients that are almost totally absorbed in the upper small intestine and could be of benefit to women. The initial concept is the product of the space race and was originally developed by NASA for astronauts.

The aim of the project is to assess whether Elemental Diet would be tolerated by women with inoperable bowel obstruction. The study will also assess whether this diet can meet some of the women’s nutritional requirements and have a positive impact on their quality of life. If successful, this research would be a big step towards improving the quality of life and would help women live longer.

You can read more about our  research and studies here, link: