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Investigating The Emperor Of All Maladies

Cover Story February 2019

Investigating The Emperor Of All Maladies

The escalating cancer cases in the country mandates research on India-specific cancers, their risk-factors and the efficacy of different treatment modalities. Leading cancer research centres across the country are tirelessly working on translating research discoveries into efficient clinical care, and effective state and central disease management programmes.

Aatika H Jain

Cancer remains the second major cause of death worldwide, right after cardiovascular diseases. According to the Globocan 2018 report, there were more than 1.15 million new cancer cases in India, which translates to a 15.7 per cent increase from 2012. The number of cancer deaths was recorded at 784,821, a 12.1 per cent increase since 2012. The mounting number of cancer cases underscores the growing significance of cancer research in the country. Several Indian medical colleges, universities, pharmaceutical colleges and research centres are doing preclinical cancer research, discovery and development of drug, etiopathology assessment and its molecular characterisation. But the clinical translation of the preclinical discoveries is comparatively less. This could be improved with increased collaboration between the various preclinical and clinical research institutes or departments.

In January this year, National Cancer Institute (NCI), allegedly the largest cancer hospital in India, opened its doors to the public. The state-of-the-art 710-bed centre located in Jhajjar district of Haryana is a division of AIIMS-II campus. Its objective is to add impetus to cancer research in the country and also share the patient burden of AIIMS cancer centre. It has been designed after the National Cancer Institute in the US. NCI will head the network of State Cancer Institutes and Tertiary Care Cancer Centres and shall manage all cancer-related initiatives. Its main objective would be translational research in cancers specific to India. This definitely heralds brighter prospects for cancer research in India and in turn, more efficient, comprehensive cancer care for Indian patients.

Hub of innovative therapies (ACTREC)

A team of researchers from the Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Mumbai, recently discovered the biological mechanism behind the protective nature of progesterone injections administered before breast cancer surgery. This single injection of progesterone decreases the likelihood of relapse in patients. ACTREC is the research and development division of the Tata Memorial Centre (TMC), Mumbai. TMC also boasts of Tata Memorial Hospital (TMH), the largest cancer hospital in Asia. The lush 60-acre ACTREC campus in Navi Mumbai houses two subdivisions: Clinical Research Centre (CRC) and Clinical Research Institute (CRI). Its directive is to serve as the national centre of cancer treatment, research and education.

The Clinical Research Centre, along with the research hospital, aims to treat cancer patients and perform clinical and translational research. The Cancer Research Institute is engaged in basic and applied cancer research. Basic, applied, clinical and translational researches carried out at the centre are all geared towards gaining more knowledge about cancer. This would help with timely cancer diagnosis and improved outcome for the patients. Investigators are presently working on identifying molecular mechanisms which cause common cancers in India. “Our efforts focus on fostering innovative basic and clinical research with the aim of translating laboratory discoveries into useful diagnostic and therapeutic tools for effective patient management,” says Dr S V Chiplunkar, former director of ACTREC, who recently made way for Dr Sudeep Gupta.

The clinicians and scientists work in association with their colleagues within the TMC and with national and international academicians and industry partners; 188 projects were underway in 2016 at ACTREC. In the same year, 125 studies performed by the Centre’s researches were published on PubMed, a free resource developed and maintained by the National Centre for Biotechnology Information and US National Library of Medicine. Of these, 66 were basic or applied researches and 59 were clinical or translational research. CRC and the 120-bed hospital is the hub of new developments at ACTREC. Two drugs developed by scientists at BARC— Withaferin A and diseleno-dipropionic acid (DSePA) — are undergoing preclinical testing at ACTREC for prophylaxis against graft versus host disease and radiation-induced pneumonitis in appropriate animal models, says Dr Chiplunkar.

OUR EFFORTS FOCUS ON FOSTERING INNOVATIVE BASIC AND CLINICAL RESEARCH WITH THE AIM OF TRANSLATING LABORATORY DISCOVERIES INTO USEFUL DIAGNOSTIC AND THERAPEUTIC TOOLS FOR EFFECTIVE PATIENT MANAGEMENT.”

Dr S V Chiplunkar Former Director, ACTREC

“We need to create a team of clinician-scientists who are expected to play a vital role in translating research findings to clinical settings,” she adds. Her lab primarily works on identification of the impaired immune function in the cancer patients. They have discovered an immune cell type which augments tumour growth in gall bladder cancer patients. “We are investigating the ‘immune landscapes’ of oral cancer, breast cancer, and cervical cancer, to understand which immune cell types infiltrate these tumours and how we can activate these cells to kill the cancer cells. We are also working on gall bladder and pancreatic cancers, which have emerged as cancers associated with infection and inflammation,” she says. “We want to develop immune cell-based therapies for cancer patients. But we still do not have adequate infrastructure and regulatory policies developed to promote cancer research. We need to develop a strong network between research organisations engaged in cancer research and this has been initiated by the Tata Memorial Centre through National Cancer Grid (NCG).” ACTREC aspires to play a pivotal role in future in innovative drug development and therapies for cancer prevention and cure in the country.

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