25 examples of research with impact: Breaking barriers in cancer research & treatment

As the FNR marks 25 years since its creation, we highlight 25 examples of FNR-supported research with impact.

In Luxembourg alone, thousands of people are affected by cancer every year. Either by being diagnosed with it, or because a loved one is affected. In Luxembourg, Prof Dr Simone Niclou and Dr Guy Berchem have spent the last two decades advancing knowledge of and treatment for this disease that accounts for a quarter of deaths in the country.

Around 3,000 people in Luxembourg are diagnosed with cancer each year. A recently published study from the Luxembourg Institute of Health, which analysed Luxembourg’s cancer-related deaths over 24 years, found that cancer deaths declined by 2.1% per year – proof that the many research efforts in the areas of earlier detection and better treatments are not in vain. New promising treatments, such as immunotherapy, are offering hope for increased survival in the future on the difficult quest to get this disease under control.

Glioblastoma, the most aggressive and resistant brain tumour

One of the cancers being investigated in Luxembourg is Glioblastoma, a type of brain cancer – the one Simone Niclou focussed on the most during her 18 years working in cancer research in Luxembourg.

Glioblastoma is the most aggressive and resistant of the primary brain tumours and is one of the deadliest cancers. Even with optimal management following diagnosis, the average life expectancy is only 14 months.

Research has found a link between this poor outlook and “pro-tumour” behaviour of the brain’s immune cells, microglia. Evidence is mounting that the tumour has developed complex molecular mechanisms to evade the immune system.

“Glioblastoma is a rare cancer – about 4 in 100,000 people are diagnosed with it every year, but many people I speak to know someone who has been diagnosed with or died of this cancer”, explains Simone Niclou.

Emily Iversen, Digital Communications Manager at the FNR, is one of those people.

“My father died of a Glioblastoma in 2011, in Luxembourg. Even though it was devastating for my family, my father lived for more than 5 years after his diagnosis, which only around 5% of patients do. I am grateful that advances in cancer research gave us more time with him. Guy Berchem was one of my father’s oncologists and the exceptional dedication and presence he showed has never been forgotten in my family. It means a lot to me to know that researchers, such as those in the team Simone Niclou led, have and are putting so much effort into researching this horrible cancer that still has so many unknowns.”

Refuting a widespread belief

Over the two decades, Niclou led various projects that advanced the knowledge around glioblastoma. Her team for example played an important role in refuting a widespread paradigm amongst scientists of so-called ‘cancer stem cells’ in Glioblastoma, by showing that cancer cells are highly flexible and that the majority of these cells can adopt stem cell characteristics.

“Cancer cells basically act in disguise, which helps them survive and adapt to changing conditions in the brain. By the way, refuting a hypothesis is much more challenging than proving one, since you try to publish against the prevailing conviction,” Niclou explains.

Another major contrition from Niclou’s team is the establishment of complex patient-based preclinical models, such as organoids and PDOX mouse models.

“We set up and characterised a large cohort of such complex models which are internationally recognised and have fostered multiple international collaborations,” Niclou explains.

Tremendous development in diagnosis

Niclou explains that there has been tremendous development in the last 10 – 20 years with regard to the diagnosis of brain tumours.

In an FNR CORE funded project from around 2010, which focussed on anti-angiogenic treatment in Glioblastoma and was very topical at the time, the team tested a then novel treatment approach: blocking the formation of blood vessels in Glioblastoma, with the goal of “starving” the tumour.

“This treatment appeared very promising, yet in our complex models we could not see any beneficial effect on survival – a result that was later confirmed by two large multi-center clinical trials,” Niclou explains.

Immunotherapy, the promising emerging cancer treatment

Treatment is a focus of medical oncologist Dr Guy Berchem: cell death mechanisms and the reason why cancer cells do not die – the question: What is the reason for cancer treatment not working on certain patients? Why do the cancer cells survive, or why do they come back? A promising field of research for treatment in recent years has been immunotherapy, which Dr Guy Berchem has also devoted his research efforts to.