A relatively new issue of Science (4th of April this year) has an interesting editorial about the value of cancer research.
He claims that some people would like to see the money that is invested in the most fundamental of cancer research directly into the design of treatments and therapies. Something like we know enough about Cancer so let’s stop wasting time and money and let’s start doing things with what we already know. That is for me a rather surprising attitude: since I started working with cancer researchers what I found most surprising is not the amount of things we know, but the opposite, how little do we know after all the time and money invested in research. This is, of course, not the fault of cancer scientists but more the result of the extreme and incredible complexity of cancer as a disease. If there is something we need now is more fundamental research, and if you keep asking me, more theoretical research so we can knit all this knowledge into a cohesive set of laws.
Bruce Alberts, Science’s editor in chief describes examples of how a better understanding of the fundamental mechanisms could go a long way on improving cancer therapies. Specifically he mentions apoptosis and DNA repair which he identifies as two of the most promising areas of research with a potential impact in treating cancer.
The importance of the first one is not difficult to grasp. Cells in multi cellular organisms have a tendency to commit something akin to suicide and only constant reassurances from the environment that they are doing ok prevent them from doing so. Avoiding apoptosis is one of the most important milestones of a tumour cell, otherwise its chance of provoking havoc is somewhat limited.
The second mechanism is less straight forward in my opinion. A flawless DNA repair mechanism should prevent harmful mutations in the first place and will lead to apoptosis if the reparation is not doable. Thus a tumour cell should aim to have a less than perfect DNA repair mechanism in order to accumulate the necessary genetic mutations. For that exact same reason, a therapy that could re establish the functionality of the DNA repair mechanism would go a long way in making sure that abnormal cells die (due to apoptosis) whereas healthy cells stay.
These two are only a sample of things that the author argues we don’t know well and which deserve ample funding even when the hope of getting a therapy out of the money invested is not in the short term. I’d argue that I know a few more areas worth investing on but that might not be entirely unbiased…
David, thanks for pointing out the editorial to me. As someone involved in treating cancer patients, I completely agree with you and Bruce Alberts. But there are many other fundamental mechanisms of cancer that we don’t fully understand. Angiogenesis, the tumor microenvironment and cancer stem cells are just some of examples. I do not think that we need more basic research on tumor immunity.
Thanks for your comment Martin, I agree with particular emphasis on the microenvironment. In any case, any reason why you think we should not spend more investigating the response of the immune system to a growing tumour?
I respectfully disagree with Martin. With so much money been put on applicative therapeutic research, we still need to understand a lot of basic tumor biology, response of immune system & cell’s own apoptotic mechanisms which we don’t yet completely understand for cancer cells. For Instance, Hela cells, (or any cancer cells for that matter), show highly inconsistent chromosome number. This may have something to do with supression of apoptotic regulators (as david has also pointed out in his writeup). Isn’t it significant to know how this selection is made when someone else is asking funding agengies to support his RNAi or gene therapy endeavors?
Tarun, maybe I should have stated this clearer. I do believe that we need more basic research, including research on apoptosis and DNA repair. But realistically, the amount of money that will be put into basic cancer research will be limited. A lot of time and money has already been spent on tumor immunology, and I believe it is time to use these resources in other areas of basic cancer research.
But because a lot of people work on tumor immunology, paper submissions and grant or job applications on tumor immunology have a higher chance of being considered. Which raises an interesting question. Who decides on the research areas that should get attention? Is it up to the individual researcher (and the reviewers of papers and grants)? Or do we need research programmes for areas that are considered important and promising? I have mixed feelings about the efficacy of these research programmes.
Martin raises an interesting point (his question in the second paragraph of his note). When agencies set the priority areas for scientific research, and therefore identify what will be more considered for funding, there is often discontent among scientists, and there is a risk that vested interests may contaminate the entire process.
Too far-fetched, is it?
Tumor microenvironment itself is so intricate that it questions our basic understanding .
I think the point Martin raises is actually very general and very valid. I am still left wondering if it is true the we know enough about the role of the immune system in halting tumour progression (for instance, what would be the proportion of neoplasms that do not progress to a full blown agressive tumour thanks to a vigilant immune system?). Also, given the role of the immune system in apoptosis I guess it might be possible to combine the two areas of research.