Charity launches £14m UK-wide lung cancer research initiativeBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4628 (Published 18 July 2013) Cite this as: BMJ 2013;347:f4628
A £14m UK study to sequence the genomes of people with lung cancer has been launched by the charity Cancer Research UK.
At a press briefing for the launch on 17 July, Charles Swanton, professor of oncology at University College London, and the project’s lead researcher, highlighted three barriers to new lung cancer treatments that the project could overcome: the difficulty in identifying patients who will have a good response to a drug, inevitable drug resistance in advanced metastatic cancer, and high failure rates in the development of new drugs for cancer treatment.
Swanton said, “The problem with lung cancer is that it has more mutations than any other cancer type. There are about 100 mutations per million base pairs [of DNA], which is much higher than something like breast cancer that might have one mutation per million base pairs.”
Adding to the genetic complexity, he said a single tumour could contain cancer cells with very different mutations.
Swanton added, “In contrast to what I was taught at medical school that cancers evolve in a linear fashion, they don’t at all. They evolve in a branched fashion. What that means is that different sites of disease can evolve independently.
“We plan to harness new sequencing technologies to trace the genetic evolution of cancer over the course of the disease. Our research will help explain why lung cancer is difficult to treat, and steer a path towards saving more lives.”
A total of 850 patients with operative non-small cell lung cancer will be recruited into the study over the next nine years. Blood samples and multiple tumour biopsy samples will be taken for genome sequencing, along with clinical follow-up of the patients. Researchers will then investigate genetic mutations in different parts of each tumour, any new mutations arising in response to treatment, and how the mutations correlate with survival.
The project, called Tracking Cancer Evolution through Treatment (TRACERx), will be conducted by more than 60 researchers based in London, Birmingham, Cardiff, Manchester, and Aberdeen. The funder, Cancer Research UK, is the largest independent cancer research organisation in the world and this project is the biggest single investment into lung cancer research by the organisation.
Harpal Kumar, chief executive of Cancer Research UK, said, “It’s one of the biggest projects in lung cancer ever carried out anywhere in the world. Lung cancer kills more people than any other type of cancer. We want to change this. For too long, success against the disease has been slow.”
Swanton added, “Ultimately, I hope that we will develop tools and a clinical path to better target the [cancer gene mutations] early on for clinical trial intervention. We’ve got a number of pharmaceutical companies who are very interested in collaborating with us.”
The study has been launched three months after the London Lung Cancer Alliance was also set up to investigate genetic testing in lung cancers.1 Lung cancer kills 35 000 people each year and the one year survival rate for non-small cell lung cancer in the UK is 30%, lagging behind other rich countries by up to 16%.2
Cite this as: BMJ 2013;347:f4628