What’s next in cancer research?

When your mission is as big as ending cancer, there’s never a shortage of work to do. There is a seemingly unending list of questions that need to be raised and investigated — and a plethora of brilliant minds willing to take them on.

At a place like UT MD Anderson, there is also no shortage of “good science." The challenge is identifying where we can make the greatest impact.

We’re fortunate to have a strong foundation to build upon here at UT MD Anderson. The spirit of collaboration between our labs and clinics is unlike anywhere else. We can leverage this along with our culture of innovation to accelerate high-risk, high-reward cancer research, addressing the most pressing issues and challenges faced by our patients to directly deliver breakthroughs.

The shift away from disease-specific team science

Gradually, we’ve changed how we build our collaborative teams. Previously, everything was organized around specific diseases, like pancreatic cancer or leukemia, for example. But illuminations in biology have revealed that diverse tumors share deep underlying traits. Targeting commonalities like universal cellular mechanisms, including immune evasion and metabolic shifts to name a few, yields a greater impact, rather than studying single organ cancers independently. And focusing on technology and data shifts like the power of multi-omics or artificial intelligence (AI) can provide us with more transformative results.

The problems we’re facing in oncology right now

Given the extraordinary combination of resources, talent and infrastructure built to drive team science , and, above all, the critical unmet needs of patients we serve, we’ve reoriented some of our research at UT MD Anderson to address questions that stretch across multiple cancer types, multiple departments, divisions and labs.

We gave a lot of thought to what are the hard problems that we’re facing at this moment and landed on these seven themes:

• The resistance problem — and how to break it: Why do some cancers not respond to targeted therapies?
• Cancer interrupted: How do we stop early cancer or premalignancy before it starts?
• Beyond the T cell: Looking through the tumor microenvironment – the environment that makes up the tumor – to see what other factors could be targeted to benefit patients. 
• The cancer genome as therapeutic vulnerability: Looking backward at the cancer genome to determine what features could be leveraged against tumor cells.  
• Cooling the toxicity, not the response: How do we limit toxicities and the symptoms and side effects of cancer treatment without limiting the cancer response?
• What is lucky? Leveraging artificial intelligence (AI) to model and predict which patients will respond to treatment.
• Small numbers, big problem: Tackling the challenges of improving strategies for rare cancer patient management. 

Introducing the Breakthroughs Discovery Program

To address these research themes, UT MD Anderson created the Breakthrough Discoveries Program. This program provides funding and resources for ambitious, high-risk, high-reward science requiring multidisciplinary teams and whose work could yield huge impacts for our patients.

The competition for this opportunity was incredibly fierce, and the scientific review, ultimately conducted by an external scientific advisory board, was extremely rigorous. The challenge wasn’t finding outstanding science. It was identifying the ideas with greatest potential to transform cancer care – that is, those where this unique approach to driving high risk/reward science may make the most positive impact for patients.

In mid-August, I had the honor of announcing the first class of recipients of the program.

The following Breakthrough Discoveries Program recipients will receive up to $3million per year for the next three years:

• Humam Kadara, Ph.D., Seyed Moghaddam, M.D., and Jianjun Zhang, M.D., Ph.D.: Triple-I Intercept: Precision Interception of Lung Cancer Evolution Driven by Injury, Inflammation and IL-1 Signaling: Understand the link between injury and inflammation to lung adenocarcinoma, the most common type of non-small cell lung cancer develop biomarkers to guide the management of early lesions, and establish clinical strategies for interrupting the development of this cancer. 
• Simona Colla, Ph.D., and Andrea Viale, Ph.D.: CROSSROADS: CROSS-tissue RegeneratiOn Aberrancy Drives Systemic Precancer Escape: Define the fundamental biology of precancer cell states and what’s known as somatic mosaicism, when mutations cause genetically distinct populations of cells to coexist within the same individual.
• Lauren Byers, M.D., and Carl Gay, M.D., Ph.D.: Dual Specificity CAR T Cells for SCLC and Other Rare Neuroendocrine Carcinomas: Launch a new cell therapy as a potential new treatment for small cell lung cancer and test it as a possibility for other rare cancers.
• Steve Cho, M.D., and Phuoc Tran, M.D., Ph.D.: RADTAC: A Subcellularly Targeted Anti-CD70 Radiotheranostic to Overcome Therapeutic Resistance in Kidney Cancer: Develop a new treatment for patients with renal cell carcinoma, the most common adult kidney cancer, that have already failed with other treatments, using RADiopharmaceutical TArgeted Chimera (RADTAC), a drug discovery and radiotheranostic platform designed to precisely deliver radiotherapy inside the cancer cell’s nucleus invited at UT MD Anderson.
• Kristy Brock, Ph.D., and Bruno Odisio, M.D., Ph.D.​: Replacing Uncertainty with Learning: PREcision DIagnostics & Clinical Trajectory Prediction for Colorectal Liver Metastases (PREDICT-CLM): Create a large, secure database that combines patient information, medical test results and treatment decisions made by physicians, resulting in a digital twin called PREDICT-CLM.

One Breakthrough Discoveries Program Impact Seed Award recipient will receive up to $1 million per year for the next three years:

• Lilie Lin, M.D.,​ and Heiko Enderling, Ph.D.: Decoding “Luck” in Cervical Cancer Radiation Therapy: A Spatially Explicit Digital Twin Program to Personalize Care and Improve Patient-Specific Outcomes: Develop a platform for delivering highly targeted radiation treatment using a digital twin framework to generate patient-specific recurrence risk predictions and risk-adaptive treatment strategies.

The work starts now, but really, it’s been building for years. The approach to team science has been more than a decade in the making, and the questions are some of the most paramount in cancer research presently. At UT MD Anderson, our researchers truly have the opportunity to help patients live longer and better. And now we have the privilege of helping our talented researchers to accelerate progress for our patients.  [Fu2] 

Andy Futreal, Ph.D., is vice president of Strategic Translational Programs.

Learn about research careers at UT MD Anderson.