A look back at notable advances in immunotherapy, precision screening and more
December 18, 2018•By Fred Hutch News Service staff
From basic biology to patients’ pocketbooks, scientists at Fred Hutchinson Cancer Research Center explore virtually every angle of cancer and related diseases. Here are just a few of the strides our teams made in 2018.
Precision cancer screening
40 new mutations linked to colorectal cancer. Earlier this month, Fred Hutch investigators led a global study that identified 40 new inherited mutations that put people at risk for colorectal cancer, or CRC. The findings will help researchers better predict risk of disease and identify drug targets for treatment.
A path toward precision screening. Public health researchers drafted a roadmap for the future of precision screening in detecting CRC, the second-deadliest cancer in the world. The new approach, which is much more nuanced than current screening guidelines, uses individual risk factors and genetic data to determine when someone should start screening for colorectal cancer.
Toward next-generation immunotherapy
Looking under a CAR’s hood. In the first comprehensive study of its kind, scientists mapped out how a critical design choice affects how CARs, or chimeric antigen receptors, signal immune attack and how well cells carrying those CARs can eradicate cancer in mice. The work offers a roadmap to creating better, next-generation versions of this type of immunotherapy, called CAR T-cell therapy.
Exposing how cancer evades immunotherapy. Fred Hutch scientists used an innovative technology to learn how cancer cells hid from a patient’s revved-up immune system. The legacy of that patient, who ultimately died of Merkel cell carcinoma, will hopefully help researchers flush out evasive cancer cells in the future.
Standard myeloma treatment reveals itself as an immunotherapy. Fred Hutch research suggested that doctors may have had an incorrect understanding of how a standard treatment for an incurable blood cancer works to prolong lives. The therapy, based around high doses of chemotherapy or radiation, looks like it may be an immunotherapy — a surprise that opens the door to new strategies to harness and augment this effect and, hopefully, improve treatment outcomes for patients with multiple myeloma.
Basic science insights
Solving an 88-year-old molecular mystery. Fred Hutch scientists have cracked an old riddle: how sex cells avoid having the wrong number of chromosomes. The answer is a certain protein that acts like a traffic cop, shielding a key region of DNA from the wrong molecules while ushering the right ones over. The findings shed light on cellular mishaps that can lead to spontaneous miscarriage or certain developmental disorders.
Tracing brain cancer’s origins. Many cases of a supratentorial ependymoma, one of the more common brain cancers in children, share a specific gene fusion — but is it causing the tumors? A Fred Hutch-led study showed that gene fusion is enough to trigger tumor formation in otherwise normal brain cells. Researchers are now exploring how exactly the gene fusion causes cancer and potential strategies that could block the fusion.
Biology meets big tech
Hacking chemo’s side effects. Research led by Fred Hutch found that more than half of cancer patients undergoing chemotherapy are hospitalized or treated in the emergency room for side effects such as nausea, pain, fever or fatigue. Now our teams are working with Microsoft artificial intelligence and machine-learning experts on a pilot technology project to help cancer patients avoid ER visits by flagging side effects early, before they become emergencies.
Mapping the immune system with the Allen Institute. Our researchers are collaborating with the new Allen Institute for Immunology to chart the human immune system by harnessing big data and emerging technologies. Fred Hutch is one of several organizations collaborating with the new institute, which aims to improve human health by refining disease treatments based on the immune system.
Clues toward victories over viruses
A clue to preventing 200K cancer cases. Epstein-Barr virus, or EBV, was the first virus shown to cause cancer in humans. Fred Hutch researchers discovered the first human antibody against it, opening a new path toward a vaccine to block infection and potentially preventing about 200,000 associated cancer cases a year, including some Burkitt and Hodgkin lymphomas.
Gene editing holds promise for shrinking HIV "reservoir." By transplanting blood stem cells that had been gene-edited to resist HIV infection, Fred Hutch scientists were able to shrink the size of dormant viral “reservoirs” in model organisms. Reducing or eliminating these persistent reservoirs is a key step toward curing HIV.
Untangling the cost of cancer care
Cancer care across borders. In a rare comparison of cancer care in neighboring regions of the U.S. and Canada, a Fred Hutch study found Americans were paying twice as much for similar colorectal cancer treatments, with no advantage in survival rates. Meanwhile, cancer patients in rural areas of the U.S. die of their disease at significantly higher rates than those residing in U.S. cities, and scientists at Fred Hutch are trying to find out why.
An Rx for financial toxicity? After five years of data crunching, the Hutchinson Institute for Cancer Outcomes Research released its Community Cancer Care Report, the first public report linking quality and cost measures for cancer clinics. It’s a hugely transparent, hugely ambitious snapshot of the complicated world of cancer clinic performance across Washington state.
Global research milestones
Partnership with Uganda Cancer Institute turns 10. In 2004, Uganda had a single oncologist for about 30 million people. Today that same oncologist helps train the next generation of specialists as the head of the Uganda Cancer Institute. This year marked the 10th anniversary of the UCI-Fred Hutch collaboration that’s helped a “sustainable cancer program” take root in the country, said UCI Executive Director Dr. Jackson Orem.
Milestone for globe-spanning HIV trial. This year marked the successful complete enrollment of the landmark AMP study, which is testing HIV-blocking super antibodies on three continents. AMP — short for antibody-mediated prevention — launched in 2016 and now involves more than 4,500 participants across Africa, South America and North America. If the experimental antibodies provide protection as hoped, the study could help scientists figure out how to reverse-engineer a vaccine to elicit the antibodies at the concentrations needed.
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