The award-winning team transforming breast cancer treatment

As the AACR conference gets underway, a group of UK cancer researchers have been named Team Science Award winners for work that has transformed treatment for many patients with breast cancer. We spoke to team leader, Professor Andrew Tutt, about how you build a successful scientific team, the importance of translation and why you always need a touch of humbleness…

Congratulations on the award! What do awards mean to you?
Thank you! I think they validate the work. Especially with this award, it was received on behalf of the many who have been involved in it. And you know, what a wonderful privilege it is to be in that position. I am the representative of many others in receiving an award.

But it’s not just validating that the work was good science. Its that it has had an impact for patients. And so, for us as a team it’s an award for an integrative approach to breast cancer research that has been a collective effort by leaders and their wider teams. That this approach and effort has had an impact for people with breast cancer is just fantastic.

Do you think this important aspect of research – that it is a team effort – is becoming more prominent and recognised in science?
I think it is becoming more prominent than it was. I’m a clinician scientist and when it comes to translating fundamental cancer research to the clinic – no one is going to do that on their own, or even in a team of two or three people. It takes many teams of people. And if you do try it on your own, even if you manage to do something excellent, you’ll be shouting about it in a room on your own. And that’s not going to have the impact in the clinic.

It’s also worth saying that, fundamentally, it’s what the supporters of charities funding cancer research want to happen. And that means we should be expecting to see more initiatives that involve many groups working together. Especially for translational work that’s going to lead right through to impact, it will be increasingly collaborative.

And when it comes to the sort of ‘academic payday’ as it were – the authorships of research papers – then you need to share. Because if you don’t, you’re not giving people what they deserve through merit. Even the more fundamental biology papers are involving larger authorships. That’s a good thing and we just need to become more comfortable with co-authoring and corresponding authoring. Really that reflects the fact that fundamental biology questions are so complicated to answer, and that the methodologies that are needed are often very wide ranging. You need a multiplicity of skill sets and understanding of, not just the biology, but the different ways of approaching it. And if everyone’s putting in that much, then that’s co-authorship. So, I think we see it more and for a good reason.

Do you think there is anything in the idea that large team-based collaborations can be inherently good for research culture and integrity?
I think that’s right. I think it’s healthy to be able to say to postdocs, for example, they should openly collaborate with other labs, because that means that we can all kick the tires of ideas and approaches together. And that means we can be comfortable that our findings are real. For these large projects you are essentially cross-validating work with different methodologies to get to the answer, which means you can be more confident in the robustness of the findings.

I also think it’s important that people are comfortable to discuss these things up front and say, ‘Okay, we’re going to get into this together’. To be able to discuss the idea that we we’re all equal partners in this piece of science one way or another. Trying to work that out in advance is helpful. Many senior researchers can probably all remember from our earlier careers, our supervisors effectively facing off against each other. It was standalone and succeed or fail. I don’t think that’s the way it works anymore, not if you’re going to have impact.

So, the benefits are clearly manifold, but what would you say is important to think about for a modern approach to team science?
For a start, it’s important to imbue your passion for a particular research problem in the people you want to work with. Secondly, I think you need to understand what they’re interested in, and where the overlaps are. So, you need to listen as well as communicate passionately about what it is you think the team should do.

You also need work out the areas in a project where people can’t go in a collaboration – figure out what’s going to be hard for them to achieve, so that you’re not forcing the team early on into areas that are just too difficult. Part of that is to build trust and allow the team to do something together with a reasonably quick deliverable so the team can celebrate some sort of goal in the back of the net – so there’s a bit of success to build on.

The thing I have found most satisfying about pulling scientific teams together is the gathering of different disciplines. The trick is to really communicate to people who are more lab-based the problem you’re trying to solve in the clinic. If you are building a team, never make the mistake of thinking the researchers in the lab won’t be interested in that… they will, and they really want to see an impact on those clinical problems. The key is to translate between the two – clinical and lab-based researchers – and mix people up.

The other vital component is to build trust. Once you’ve found people that share a common interest and you’ve worked on something that’s going to deliver – where you’ve got the trust – keep working with those people. Don’t always try and find the next best team to work with, because you won’t necessarily have built the trust, you’ll have to go through the whole process all over again.

You are a clinician scientist, what more can be done to entice, and keep, researchers with a medical background into cancer research
The first thing to say is that I don’t want to sound like we’re the only important group of people for cancer research to focus on because that isn’t the case! But I do think there is something special about a clinician scientist’s ability to catalyse research and translate it.

But of course, young clinical fellows may have spent very little time in a lab previously, so I think one of the most important things I tell young clinician scientists going into labs with non-clinical scientists is, for God’s sake, be humble. Remember what you don’t know. You’ve got to a point in your career where you probably have a degree of confidence, but don’t come in looking confident about something that you have zero understanding of.

There are things we as a community can do, however, to encourage more clinical fellows. I think we need to accept that just because someone’s been a medic, and they’ve done a PhD, that doesn’t mean they are ready to run a lab on their own. Because why would that be true? We need to allow clinician scientists longer development time so they can translate meaningfully. In a similar way, I think it would help if we didn’t expect people to be capable of producing Nature papers immediately after their PhD. What we fundamentally need is translators, so we should invest in the people who can do that.

The other factor is that the NHS needs oncologists. Medics have got a choice to go back to that even after they have embarked on a research route. Research careers can be very tough indeed – people lose their jobs, the funding goes, and non-clinical scientists sometimes have nowhere to go. Clinicians have the option of often going back to the clinic. And that means that if we make research almost impossible, because they’ve got to publish in prestigious journals, and they’ve got to do this, that and the other, they’re going to take that option.

So, I think if we want these translators, we need to give them some time to develop otherwise we risk losing them.

What was it that tempted you over to research?
I actually hadn’t done any lab work at all before I started as an oncology trainee at the Marsden. And then I decided that I wanted to do some research. I’m a clinical oncologist, trained in radiation, but I was really interested in biology. One day I met Professor Alan Ashworth and asked if I could come and work in his group. He said, ‘If you can win the money, mate.’ So, I wrote an MRC grant application, managed to get to the lab and I just thought, ‘oh wow, these guys are so clever’.

We were doing cutting edge work on BRCA2 – trying to figure out its function. I could see how that could be applied – that the knowledge of what the gene did wasn’t just going to be interesting to work out, but it was going to be useful. That, I think, what was so hugely inspiring – that you could connect biological understanding with the clinic.

It’s by being that translating interface and enjoying having a foot in both camps that allows you to have a real impact on translation. That’s the job of a clinician scientist, and I find it intoxicatingly exciting to be part of that.

The American Association for Cancer Research (AACR) recognised the team’s “seminal translational discoveries in breast cancer research that have led to significant improvements in diagnosis and treatment”. They noted that the team “has led the discovery of new therapeutic approaches and the biomarkers that identify the populations of patients that gain most benefit from them”.

The team was recognised for achievements that include:

  • The discovery of new therapeutic approaches, such as PARP inhibitors, that have changed how patients with BRCA1 and BRCA2 mutant breast cancers are tested and treated.
  • Discoveries that have led to improvements in how oestrogen receptor positive (ER+) breast cancers are treated.
  • Discoveries of ways to test, using predictive biomarkers, that have informed which treatments are selected, how they can be de-escalated or adapted according to evidence of response or resistance.
  • Leading work that has fundamentally changed international guidelines for the number of radiotherapy doses used that reduces the length of the course of treatment.
  • The discovery of molecular changes in breast cancer that cause metastatic colonisation, resistance to cell death but also vulnerability to targeted therapy.

The team is made up of researchers and clinicians from the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research (ICR), the Breast Unit at The Royal Marsden, The Ralph Lauren Centre for Breast Cancer Research at The Royal Marsden, and the Cancer Research UK-funded Clinical Trials and Statistics Unit at the ICR.

Andrew Tutt is Head of the Division of Breast Cancer Research and Director of the Breast Cancer Now Toby Robins Research Centre at the ICR and Guy’s Hospital King’s College London. He is a Clinician Scientist with the Laboratory and Clinical Trials programme, and a Consultant Clinical Oncologist looking after women with breast cancer.

More on this topic

Tags

There are no tags

Source