cancer we all know someone has been
affected by it
someone who has it or maybe even
unfortunately we’ve had it ourselves we
see in every day in the media we see
cures announced for cancer our Facebook
feeds posts of new berries found in
jungles new drugs discovered by large
research institutes but every story of a
cure for cancer has always been a
balance of hubris and hope many a cancer
researcher has thought that they would
cure cancer but that would change the
landscape of this disease only to be met
with disappointment
so let me instead tell you a story of
hope but before I do I want you to keep
in mind two things the first cancer is
not a homogeneous disease by this I mean
that cancers are very different from one
another for what causes them to the
physical appearance of how they look the
mutations in their DNA and this respect
all cancers are different like all of
you are different some of you might like
rugby some of you might like hockey some
of you might collect Harry Potter
paraphernalia to each their own and this
is why finding a universal cure a magic
bullet that cures all cancers has been
so difficult but you all have some
things in common some of you have the
same eye color the same hair color and
that brings me the second thing that I’d
like you to keep in mind and that is a
quote from the father of pathology
rudolf victor off and the 1800s which
was ominous cellular acellular which
means all cells from cells it seems
obvious to us now that every cell
originated from another after all each
of us were once a single cell and now we
are made of trillions of them and this
holds true inside of tumors tumor cells
do come from existing other tumor cells
however if you go back from division to
division to division you start with a
healthy cell one of your own
it eventually changes becomes cancerous
and is ultimate betrayal of your own
body what can cause a healthy cell
become a cancer 1 this was something I
worked on while I was at the University
of Queensland studying the tumor genesis
of breast cancer that is how do these
tumors form we were looking at a pathway
involved in how cells grow into hollow
long structures these structures are
critical in the kidney for filtering
your blood they’re important in mammary
glands and breasts we found that if this
pathway was disrupted instead of growing
out long and nice they grew into the
empty space outward in every direction
forming tumors but as I’ve kind of
hinted at tumors aren’t created equally
some are more aggressive some of sorts
you can think of these sorts as being
changes that make them more resilient
grow faster and be more aggressive so
what can make a normal low-grade tumor
become a high-grade one this was
something I was working on well as at
the Hospital for Sick Children in
Toronto Canada I was looking at the
epigenetics of cancer
not so much which genes get mutated but
the difference in how these genes are
expressed for example if you take a cell
for your pancreas and a cell from your
eye they both have the same DNA but your
eye doesn’t express insulin it’s not
secreting insulin everywhere your
pancreas is it’s not that the eye
doesn’t have the gene for insulin it’s
just not turned on this is true in
cancer by studying which genes are
turned on which are turned off and by
how much
we can look at new targets for therapy
and treating high-grade sort carrying
cancers a great example of this is for a
leukemia called CML and 2001 our best
chemotherapy agents gave CML a 5-year
survival rate of only about 30% with our
advancements and knowledge and
understanding of the genetics and
epigenetics of these diseases targeted
gene therapies have increased the 5-year
survival for CMO to 90%
another type of cancer that has
dramatically improved our treatment
based on our understanding it’s breast
cancer breast cancer is the most common
cause of cancer and women in the Western
world with a higher incidence with age
the first approach to a disease like
this is all a tumor is to cut it out
surgery the goal being to cut out as
much of the tumor as you can as we learn
more about how this cancer grows how it
invades the surrounding tissues we
learned what was important to cut out
we also learned what was safe to leave
behind radiotherapy was eventually added
as a treatment for this disease
killing off cells that were left behind
by surgery our understanding of genes
understanding of receptors you may have
heard of her positive breast cancer a
surgeon positive breast cancer has led
to new drugs such as Gleevec and
Herceptin when you add back in all three
of these modalities our new five-year
survival rate for breast cancer is 90%
chemotherapy radiotherapy and surgery
have become the gods of the cancer
panthan Auto treatment our go-to weapons
for tackling these diseases but even
they can be powerless against some of
them the childhood brain tumor diffused
in ponds ik pontine glioma or DIPG is
notorious one of these chemotherapy
agents have a hard time crossing the
blood-brain barrier and the handful that
do have been ineffective against this
treatment surgery is often difficult to
the location in the brain making them
inoperable radiotherapy can actually
slow the way it grows but not stop the
growth and can not cure it the
combination of this resilience to our
main treatment modalities and the way it
grows so aggressively has made DIPG the
most lethal form of childhood cancer the
adult cancer mesothelioma which is a
cancer of the pleura lining of the lung
marks commonly associated with asbestos
exposure
a unique set of challenges itself in
this case radiotherapy can actually kill
a tumor
however the lungs themselves are so
sensitive to radiotherapy that they’ll
die before the cancer does the critical
structures in which this disease grows
around the heart and lungs makes
operations impossible the chemotherapy
agents we’ve been working with 20 years
of our best science and clinical trials
have only extended life by two months
leading an average life median survival
rate of 12 to 20 months traditional
approaches to this diseases do not work
we need to think if there could be an
unconventional approach inside of all of
you is a tiny microscopic autonomous
army your immune system your immune
system has unique ability to identify
recognize and launch an assault against
foreign pathogens like bacteria and
viruses a question we’ve asked ourselves
is could the immune system be used to
fight cancer well let’s take a look at
that healthy cell one more time this guy
you don’t want your immune system to
attack him if you do you get things like
diabetes arthritis lupus I’m sure you’ve
heard of many autoimmune diseases from
house to prevent yourself from being
attacked one way your cells do this is
by loading up healthy cells with these
ligands and receptors called checkpoint
blockade molecules you can think of them
like stop signs if the immune system
runs into any cell that it might think
is maybe different or misbehaving but
it’s holding one of these stop signs it
knows that ah it’s one of mine
I want to go we cool this is this is a
good guy but if this cell was to pick up
a mutation let’s say in lung cancer from
cigarette smoke and the case of melanoma
perhaps from the Sun it could develop a
deadly sword and become aggressive
cancer but
still has a stop sign this is that all
cells from cells it’s still one of your
own and the immune system sees the stop
sign it sees its disguise and will not
launch an attack to make the situation a
little more complicated the immune
system still needs to find cancer not
just recognize it cancers are very good
at developing their own little micro
environments which stops specific types
of immune cells from infiltrating in and
actually seeing the cancer cells you can
think of this like playing a big game of
like Where’s Wally
inside of a maze you may have heard of a
new type of therapy called immunotherapy
immunotherapy is a blanket term for any
therapy that looks to utilize the immune
system and accomplishing its goal in
2014 cancer immunotherapy was hailed as
the breakthrough of the year by science
one of the the idea that the immune
system could respond to cancer however
not a new one in the late 1890s a
physician had a metastatic patient who
responded to bacteria he went on to then
try to treat all of his cancer patients
with bacteria to mixed results but we
didn’t know much about cancer back then
and we know a lot more about the immune
system today the kind of breakthroughs
that were in this magazine article were
things like taking out immune cells
reprogramming them and putting them back
in and the hopes that they’ll attack the
cancer but I want to talk to you today
about a different kind of immunotherapy
one that I’m working on here as part of
the National Center for asbestos related
diseases called checkpoint blockade
immunotherapy checkpoint blockade
immunotherapy works by basically
graffitiing and blocking these stop
signs just e masking them so the immune
system can recognize them and attack
early clinical trials in melanoma with a
similar approach have been wildly
successful and other cancers such as
lung and kidney have shown a response
rate of twenty to thirty percent
but we still don’t know why some cancers
respond and some don’t
we’re still putting all the pieces of
the puzzle together on how cancer and
the immune system actually interact many
researchers are working on ways to boost
the promising effects of this kind of
immunotherapy and others however I’m
taking a different approach I believe
that one of the issues now that the
immune system has been another that
cancer has been de mast and no longer
has a stop sign that the immune system
can’t find it it’s a hard race and he’s
someone to point it in the right
direction
it needs a map to the metastasis a
spinning globe to the lymph node a GPS
if you get the idea I see I see my goal
is to use a novel approach of
radiotherapy treating tumors at distal
locations to expose the immune system to
the cancer cells in hopes of eliciting a
systemic response in the body this work
is still in its infancy but I’m hopeful
make no mistake that this is a powerful
and form herbal opponent but it’s not a
new one the ancient Egyptians first
documented cases and bone and breast
they described it as being the disease
with no treatment but it wasn’t until
the ancient Greeks where it first got
the name it carries a millennia later in
the last 200 years we’ve really learned
what cancer is I’m reminded of a quote
by Carl Sagan who said cancer no heat is
a cancer he didn’t know any Makassar
he said science here’s a scientist
science is a collaborative enterprise
that spans the generations and this
fight is no different we build on those
that came before us
we developed new technologies and
Diagnostics to detect cancer earlier our
better understanding doesn’t just give
us new therapies but teaches us how to
prevent cancer how to minimize our risk
health care professionals work around
the world tirelessly to fight this
disease but we can’t do it alone
we need our patience we are thankful to
every patient that takes the time to
answer our questions that come in from
more tests rather still fighting this
disease we are thankful to our patients
who donate tumors so we can take them to
the lab and hopefully cover something
new and we can’t do this without people
like you clinical trials Cancer Research
it’s very expensive when people like you
support through charities such as Cancer
Council Australia the Canadian Cancer
Society or Cancer Research UK you help
fund the important work we do in this
battle and we need your continued
support so that together we can
understand more about these diseases
develop new treatments and find a cure
and who knows maybe one day our secret
weapon will be the army inside us all
thank you
[Applause]
you
affected by it
someone who has it or maybe even
unfortunately we’ve had it ourselves we
see in every day in the media we see
cures announced for cancer our Facebook
feeds posts of new berries found in
jungles new drugs discovered by large
research institutes but every story of a
cure for cancer has always been a
balance of hubris and hope many a cancer
researcher has thought that they would
cure cancer but that would change the
landscape of this disease only to be met
with disappointment
so let me instead tell you a story of
hope but before I do I want you to keep
in mind two things the first cancer is
not a homogeneous disease by this I mean
that cancers are very different from one
another for what causes them to the
physical appearance of how they look the
mutations in their DNA and this respect
all cancers are different like all of
you are different some of you might like
rugby some of you might like hockey some
of you might collect Harry Potter
paraphernalia to each their own and this
is why finding a universal cure a magic
bullet that cures all cancers has been
so difficult but you all have some
things in common some of you have the
same eye color the same hair color and
that brings me the second thing that I’d
like you to keep in mind and that is a
quote from the father of pathology
rudolf victor off and the 1800s which
was ominous cellular acellular which
means all cells from cells it seems
obvious to us now that every cell
originated from another after all each
of us were once a single cell and now we
are made of trillions of them and this
holds true inside of tumors tumor cells
do come from existing other tumor cells
however if you go back from division to
division to division you start with a
healthy cell one of your own
it eventually changes becomes cancerous
and is ultimate betrayal of your own
body what can cause a healthy cell
become a cancer 1 this was something I
worked on while I was at the University
of Queensland studying the tumor genesis
of breast cancer that is how do these
tumors form we were looking at a pathway
involved in how cells grow into hollow
long structures these structures are
critical in the kidney for filtering
your blood they’re important in mammary
glands and breasts we found that if this
pathway was disrupted instead of growing
out long and nice they grew into the
empty space outward in every direction
forming tumors but as I’ve kind of
hinted at tumors aren’t created equally
some are more aggressive some of sorts
you can think of these sorts as being
changes that make them more resilient
grow faster and be more aggressive so
what can make a normal low-grade tumor
become a high-grade one this was
something I was working on well as at
the Hospital for Sick Children in
Toronto Canada I was looking at the
epigenetics of cancer
not so much which genes get mutated but
the difference in how these genes are
expressed for example if you take a cell
for your pancreas and a cell from your
eye they both have the same DNA but your
eye doesn’t express insulin it’s not
secreting insulin everywhere your
pancreas is it’s not that the eye
doesn’t have the gene for insulin it’s
just not turned on this is true in
cancer by studying which genes are
turned on which are turned off and by
how much
we can look at new targets for therapy
and treating high-grade sort carrying
cancers a great example of this is for a
leukemia called CML and 2001 our best
chemotherapy agents gave CML a 5-year
survival rate of only about 30% with our
advancements and knowledge and
understanding of the genetics and
epigenetics of these diseases targeted
gene therapies have increased the 5-year
survival for CMO to 90%
another type of cancer that has
dramatically improved our treatment
based on our understanding it’s breast
cancer breast cancer is the most common
cause of cancer and women in the Western
world with a higher incidence with age
the first approach to a disease like
this is all a tumor is to cut it out
surgery the goal being to cut out as
much of the tumor as you can as we learn
more about how this cancer grows how it
invades the surrounding tissues we
learned what was important to cut out
we also learned what was safe to leave
behind radiotherapy was eventually added
as a treatment for this disease
killing off cells that were left behind
by surgery our understanding of genes
understanding of receptors you may have
heard of her positive breast cancer a
surgeon positive breast cancer has led
to new drugs such as Gleevec and
Herceptin when you add back in all three
of these modalities our new five-year
survival rate for breast cancer is 90%
chemotherapy radiotherapy and surgery
have become the gods of the cancer
panthan Auto treatment our go-to weapons
for tackling these diseases but even
they can be powerless against some of
them the childhood brain tumor diffused
in ponds ik pontine glioma or DIPG is
notorious one of these chemotherapy
agents have a hard time crossing the
blood-brain barrier and the handful that
do have been ineffective against this
treatment surgery is often difficult to
the location in the brain making them
inoperable radiotherapy can actually
slow the way it grows but not stop the
growth and can not cure it the
combination of this resilience to our
main treatment modalities and the way it
grows so aggressively has made DIPG the
most lethal form of childhood cancer the
adult cancer mesothelioma which is a
cancer of the pleura lining of the lung
marks commonly associated with asbestos
exposure
a unique set of challenges itself in
this case radiotherapy can actually kill
a tumor
however the lungs themselves are so
sensitive to radiotherapy that they’ll
die before the cancer does the critical
structures in which this disease grows
around the heart and lungs makes
operations impossible the chemotherapy
agents we’ve been working with 20 years
of our best science and clinical trials
have only extended life by two months
leading an average life median survival
rate of 12 to 20 months traditional
approaches to this diseases do not work
we need to think if there could be an
unconventional approach inside of all of
you is a tiny microscopic autonomous
army your immune system your immune
system has unique ability to identify
recognize and launch an assault against
foreign pathogens like bacteria and
viruses a question we’ve asked ourselves
is could the immune system be used to
fight cancer well let’s take a look at
that healthy cell one more time this guy
you don’t want your immune system to
attack him if you do you get things like
diabetes arthritis lupus I’m sure you’ve
heard of many autoimmune diseases from
house to prevent yourself from being
attacked one way your cells do this is
by loading up healthy cells with these
ligands and receptors called checkpoint
blockade molecules you can think of them
like stop signs if the immune system
runs into any cell that it might think
is maybe different or misbehaving but
it’s holding one of these stop signs it
knows that ah it’s one of mine
I want to go we cool this is this is a
good guy but if this cell was to pick up
a mutation let’s say in lung cancer from
cigarette smoke and the case of melanoma
perhaps from the Sun it could develop a
deadly sword and become aggressive
cancer but
still has a stop sign this is that all
cells from cells it’s still one of your
own and the immune system sees the stop
sign it sees its disguise and will not
launch an attack to make the situation a
little more complicated the immune
system still needs to find cancer not
just recognize it cancers are very good
at developing their own little micro
environments which stops specific types
of immune cells from infiltrating in and
actually seeing the cancer cells you can
think of this like playing a big game of
like Where’s Wally
inside of a maze you may have heard of a
new type of therapy called immunotherapy
immunotherapy is a blanket term for any
therapy that looks to utilize the immune
system and accomplishing its goal in
2014 cancer immunotherapy was hailed as
the breakthrough of the year by science
one of the the idea that the immune
system could respond to cancer however
not a new one in the late 1890s a
physician had a metastatic patient who
responded to bacteria he went on to then
try to treat all of his cancer patients
with bacteria to mixed results but we
didn’t know much about cancer back then
and we know a lot more about the immune
system today the kind of breakthroughs
that were in this magazine article were
things like taking out immune cells
reprogramming them and putting them back
in and the hopes that they’ll attack the
cancer but I want to talk to you today
about a different kind of immunotherapy
one that I’m working on here as part of
the National Center for asbestos related
diseases called checkpoint blockade
immunotherapy checkpoint blockade
immunotherapy works by basically
graffitiing and blocking these stop
signs just e masking them so the immune
system can recognize them and attack
early clinical trials in melanoma with a
similar approach have been wildly
successful and other cancers such as
lung and kidney have shown a response
rate of twenty to thirty percent
but we still don’t know why some cancers
respond and some don’t
we’re still putting all the pieces of
the puzzle together on how cancer and
the immune system actually interact many
researchers are working on ways to boost
the promising effects of this kind of
immunotherapy and others however I’m
taking a different approach I believe
that one of the issues now that the
immune system has been another that
cancer has been de mast and no longer
has a stop sign that the immune system
can’t find it it’s a hard race and he’s
someone to point it in the right
direction
it needs a map to the metastasis a
spinning globe to the lymph node a GPS
if you get the idea I see I see my goal
is to use a novel approach of
radiotherapy treating tumors at distal
locations to expose the immune system to
the cancer cells in hopes of eliciting a
systemic response in the body this work
is still in its infancy but I’m hopeful
make no mistake that this is a powerful
and form herbal opponent but it’s not a
new one the ancient Egyptians first
documented cases and bone and breast
they described it as being the disease
with no treatment but it wasn’t until
the ancient Greeks where it first got
the name it carries a millennia later in
the last 200 years we’ve really learned
what cancer is I’m reminded of a quote
by Carl Sagan who said cancer no heat is
a cancer he didn’t know any Makassar
he said science here’s a scientist
science is a collaborative enterprise
that spans the generations and this
fight is no different we build on those
that came before us
we developed new technologies and
Diagnostics to detect cancer earlier our
better understanding doesn’t just give
us new therapies but teaches us how to
prevent cancer how to minimize our risk
health care professionals work around
the world tirelessly to fight this
disease but we can’t do it alone
we need our patience we are thankful to
every patient that takes the time to
answer our questions that come in from
more tests rather still fighting this
disease we are thankful to our patients
who donate tumors so we can take them to
the lab and hopefully cover something
new and we can’t do this without people
like you clinical trials Cancer Research
it’s very expensive when people like you
support through charities such as Cancer
Council Australia the Canadian Cancer
Society or Cancer Research UK you help
fund the important work we do in this
battle and we need your continued
support so that together we can
understand more about these diseases
develop new treatments and find a cure
and who knows maybe one day our secret
weapon will be the army inside us all
thank you
[Applause]
you
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