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Taking immunotherapy research from bench to bedside in Wales

Immuno-oncology is one of the most exciting areas of modern cancer research. CReSt theme lead Prof. Awen Gallimore explains how Wales-based innovation could help to unlock the next generation of immunotherapies.

For many years, we didn’t appreciate just how powerful the immune system can be in fighting cancer. It was thought that because cancer represents abnormal growth of normal cells in the body, that the immune system didn’t really notice it and so allowed it to grow unchecked.

But in the last couple of decades it’s become apparent through research that, actually, the immune system can see cancer. When cancers grow, they put up barriers and use clever tricks to hide themselves from the attention of the immune system. It’s these barriers and disguises that means the immune system can’t do its job properly.

As immunotherapy-focused researchers, we’re trying to work out what those barriers and disguises are. If we can understand them, we can break them down. 

By understanding this basic science, suddenly there are a whole host of possibilities on offer to exploit the immune system for better cancer treatments. This is an exciting new advance; it’s something that we’ve only really started to understand in the last 20 years. And we’ve realised that we still only understand a small part of the puzzle. 

But even this small bit has enabled us to do a lot. We can only imagine what’s left to understand and what that might unlock in terms of lifesaving new treatments.

In Wales there is a lot of work going into understanding what the immune system ‘sees’ in the context of a successful immunotherapy. What bits of cancer cells is the immune system recognising? How can we break down the barriers and disguises so that cancer can be killed? One exciting avenue is the development of so called ‘smart viruses’ that are being engineered in the lab of Prof Alan Parker. Once disease causing agents, these ‘smart viruses’ are engineered not to make us sick, but instead to hunt out and infect cancerous cells. In doing so, they remove the disguises that these cancer cells adopt to ‘hide’ from our immune system. These viruses, developed in Cardiff, are on course to be tested in patients in clinical trials in 2024.

In a different approach, Prof Andrew Godkin is testing whether a drug, usually used for chemotherapy, can be used at much lower and less toxic doses for the purpose of galvanising the immune system into anti-cancer action. He’ll be starting a 500-patient study in Cardiff soon, funded by Cancer Research Wales. If this works, it’ll open up exciting possibilities for well-tolerated, effective and cheap treatments to prevent recurrence of colorectal cancer. These are just a couple of examples of the innovation and new studies coming from Wales, that can be exploited for the next generation of immunotherapies.

As the Wales Cancer Research Strategy (CReSt) unfolds, we want to build our profile as significant contributors in the immuno-oncology field. Our focus will be building in mechanisms to accelerate the process of taking our research from the laboratory bench into the clinic. Our discovery science is exciting and innovative and cancer patients are treated here in Cardiff, so we hope to achieve an acceleration of research across that pathway in the next few years.

We hope that CReSt will help to build our workforce in cancer immunology, so that we can appoint more early-career clinical and non-clinical researchers, integrate them into this field and help to accelerate that process from the bench to the bedside.