While the majority of patients with skin cancer are successfully cured with surgery, approximately 10% will present with more advanced disease where a cure is difficult or not possible. Of these, immunotherapy offers hope in improving the outcome for these patients.
Around 50 per cent of people diagnosed with squamous cell carcinomas (SCC) of the skin will respond to immunotherapy and a team of researchers at the PA Hospital (PAH) are on a mission to find out why.
Immunotherapies trigger the body's immune system to attack cancerous tissue and if successful patients can derive a prolonged benefit over and above chemotherapy.
The fact around half of all patients with SCC of the skin respond to the treatment, is an extremely promising sign for patients and researchers, with other cancer types such as head and neck cancer and lung cancer seeing lower rates of patient response.
Made possible by the PA Research Foundation, the project will see a team of researchers including Dr Rahul Ladwa, Dr Arutha Kulasinghe, Professor Sandro Porceddu, Associate professor Helmut Schaider, Dr Howard Liu, Professor Gabrielle Belz, and Dr James Bowman, exploring why patients with SCC of the skin respond in higher numbers, so that more cancer patients can benefit.
Led by Dr Ladwa, the study entitled: Cutaneous squamous cell carcinoma and tumour MICroenvironment Multiplex Spatial Profiling – cMIC, will use novel technology known as digital spatial profiling to identify what proteins in cells cause tumours to grow as well as what causes them to respond and engage the body's immune system.
Dr Rahul Ladwa receiving his 2021 PARF Research Award from Robert Bowen, Chair of the Board, PA Research Foundation
The benefits of spatial profiling technology include allowing researchers to look at the relationship of individual tumour and immune cells simultaneously and the proteins they express whilst using only a small amount of patient tissue.
"Cancer can release proteins that assist it in growth and spread. There are certain proteins that promote or inhibit cancer growth. Although protein signalling in cancer is useful we know it's the interaction of the cells within its environment that is also very important," Dr Ladwa said.
"The beauty of the spatial technology is actually looking at these tumour cells within its environment and how they are talking to each other. What we're trying to do is identify how these proteins communicate with the cells around them to assist in cancer growth."
The study will recruit patients from several stages of cancer diagnosis, from the initial diagnosis to late stage, which is where Dr Ladwa as a medical oncologist sees most of his patients. This approach will allow the team to identify what proteins are expressed on the tumour and surrounding environment to predict those patients who willhave a better outcome from their cancer treatment .
"In SCC of the skin, the immune system is integral in controlling and eliminating the cancer. Immunotherapies are working well with this type of skin cancer, surpassing some of the responses you see in melanoma," Dr Ladwa said.
"To identify the signals that make the cancer grow and link it to the surrounding immune microenvironment is going to be really interesting information to ascertain. This information could help formulate the management plan of patients in the multidisciplinary team, personalising the treatment offered for individual people."
Dr Ladwa said he hopes the project will give hope to patients with squamous cell carcinoma of the skin, now and into the future.
"Skin cancers are cancers the immune system should really target and eliminate. We are asking why is it that these immunotherapies are not working in half of the people and working in the other half," he said.
Dr Ladwa said the collaboration between researchers and clinicians at the PAH is second to none. He sees PA Research Foundation's supporters as unsung heroes in the quest to beat cancer.
"Everyone collaborates so effectively here at PA and I think this translates into good patient care because patients really feel the scope of cutting edge research performed. They know that we're all listening and communicating to each other to get the best outcome," he said.
"PA Research Foundation and all of its donors, I don't think any of this research would happen without the support of this community.
"I have no doubt we're going to advance the knowledge of skin cancer and help people in the future. If it wasn't for the donors, we wouldn't be able to do that."
To help find a cure for squamous cell skin cancer donate here.