Seven Questions We Must Answer to Beat Cancer

Seven months ago Cancer Research UK set about finding the biggest challenges in cancer research. Here's the result.

Seven months ago Cancer Research UK set about finding the biggest challenges in cancer research. Here's the result.

1. Can we develop vaccines to prevent cancers not caused by viruses?

We know that some cancers are caused by viruses, triggering research into vaccines to treat and prevent these diseases.

But what if we could develop vaccines to prevent cancers that aren't caused by viruses?

The vaccine would alert the immune system to rogue cancer cells at their earliest stages of development.

We'll need to learn more about how the immune system spots cancer cells, and understand exactly how cancer can dodge detection.

The first Grand Challenge is to: develop vaccines to prevent non-viral cancers.

2. Can we eradicate cancers caused by the Epstein Barr Virus?

Infection with the Epstein Barr virus is linked to an estimated 200,000 new cases of cancer worldwide each year, and more than 140,000 deaths.

So what if we could eliminate these cancers?

To do this we'll need vaccines that can prevent the infection, and ways to target infected cells or kill early cancerous cells.

The second Grand Challenge is to: eradicate EBV-induced cancers from the world.

3. Can we prevent cancers by studying genetic 'scars' in our DNA?

Carcinogens leave 'scars' in a cell's DNA called a signature. Each one is different, marking our DNA in diverse ways. But there are lots of signatures we don't yet know.

For example, we know very little about the genetic damage caused by obesity and varying levels of physical activity.

So can we study a tumour's genetic code and find signatures linked with different causes of cancer? And could this help prevent cancers by knowing the signatures to look out for?

The third Grand Challenge is to: discover how unusual patterns of mutation are induced by different cancer-causing events.

4. Can we spot the potentially lethal cancers that need treating, and non-lethal ones that don't?

Some changes in the body we call 'cancer' don't actually need any treatment, while others are aggressive tumours that do. But we can't always tell which these are.

So what if we could tell the difference between potentially lethal and non-lethal cancers to help diagnosis?

We'll need a precise understanding of the biological differences between lethal and non-lethal tumours.

And then we'll need to turn this into new ways of spotting these cancers.

The fourth Grand Challenge is to: distinguish between lethal cancers that need treating, and non-lethal cancers that don't.

5. Can we make a 'Google Street View' for cancer?

Tumours are part of a 'city' of cells, structural molecules and support proteins. There are blood vessels that act like roads into the tumour, supplying nourishment to keep the cells growing. And these roads serve as escape routes for cancer cells as they spread.

But we don't understand how all these components interact. It's a bit like trying to follow the plot of a film by only looking at a handful of photographs.

So can we develop an interactive 3D map of the city and how it works?

This will mean studying the city as a whole, not breaking it down into individual components as we have done before.

The fifth Grand Challenge is to: find a way of mapping tumours at the molecular and cellular level.

6. Can we target the cancer 'super-controller' MYC?

The MYC gene produces signals telling cells to multiply, and is faulty in almost seven out of 10 cancers.

But research has shown that the protein produced by the MYC gene is a tough molecule to target with drugs.

So what if we could finally crack the challenge of MYC?

Researchers will need to understand its shape and how it sticks to other proteins. Interfering with these sticky interactions is notoriously difficult, but research suggests now is the time to try.

The sixth Grand Challenge is to: develop innovative approaches to target the cancer super-controller MYC.

7. Can we kill cancer cells in patients using new 'smart drugs'?

We can engineer 'smarter' cancer drugs that precisely kill tumour cells in the lab. But this isn't good enough.

The real challenge is getting these experimental treatments to kill tumour cells in patients.

So can we find new ways of helping these drugs reach all cells in the body, but only killing the cancer cells?

We'll need to look at how traditional drugs reach lots of cells, and find ways to apply this to new experimental treatments.

The seventh Grand Challenge is to: deliver biologically active macromolecules to any and all cells in the body.

Those are the seven challenges.

Dr Nick Peel is a senior science information officer at Cancer Research UK