On the 14/15th March our School of Pharmacy attended the Science in Health Live! event at the University Hospital in Cardiff. The event, run by Cardiff University’s School of Medicine, invited teams from the suite of Bioscience operations across South Wales to teach Year 12 pupils about some of the science behind health professions. There were 750 pupils from England and Wales in attendance at the event across the two days.
The School of Pharmacy and Pharmaceutical Sciences stand at the event aimed to tell pupils about some of our exciting research taking place in the battle against breast cancer resistance. While many patients benefit substantially from anti-hormonal treatments, about a third of breast cancers develop resistance to such treatment as patients undertake their often long journey through therapy. When resistance happens, and the drug that was working well is no longer effective, unfortunately the cancer can return and may migrate to other parts of the body, where it could become a threat to life.
To demonstrate the concept of resistance, Drs Julia Gee and Stephen Hiscox invited the pupils to play their Skittles Game. In this game, the player must aim the “anti-hormonal drug” (a medicine bottle tied to some string) at a group of nine “cancer cells” (the skittles). Some of the skittles fall down, representing cancer cells that respond to the treatment. But some of the skittles are magnetised and so more difficult to knock over, representing resistant cells evading treatment. The staff went on to explain to the pupils that their research uses breast cancer cells grown in the laboratory to discover the particular genes and proteins underpinning such resistance.
Following on from the game, one of our research technicians, Pauline Finlay, showed the pupils some slides of various breast cancer cells down the microscope. One of the slides showed brown staining in the breast cancer cells. This staining indicated a protein called HER2 was present in the tumour cells. We have found HER2 can be at high levels when cells grown in the laboratory become resistant to the anti-hormone tamoxifen. The HER2 is good for the cancer cells but potentially bad for the body, because it allows high levels of signalling to take place within the cells, leading to their uncontrolled proliferation despite tamoxifen treatment.
This is just one possible mechanism for resistance, which was shown to the pupils as an example at the School of Pharmacy stand. They were then told the good news that if we understand the mechanism of resistance we can look for ways to better treat it. So we now know that if their tumour has HER2 over-expression, breast cancer patients may potentially be suitable for a drug called Herceptin, an antibody specifically designed to target the HER2 protein. Herceptin binds to the HER2 on the cancer cells and flags them for the immune system to destroy them. As well as this, Herceptin is able to hinder the signalling inside the tumour cells and so help stop them from proliferating.
And this was the crux of the final part of the story at the School of Pharmacy stand – smart drug design and delivery. When you know what is going wrong in cancer cells, it is easier to tailor treatment to properly address the problem. This was demonstrated by Drs Jen Wymant, Edd Sayers, and Professor Andrew Westwell, who all work on drug design at the School of Pharmacy. Their Cell Game involved the pupils throwing different “medicines” at a large cell, with the aim being to hit the nucleus and so kill the cancer cell. The pupils were given various inefficient “drugs” to throw – balloons, flat sheets of plastic, bits of polystyrene, even bubbles.
Of course, these “medicines” were ineffective. But when the pupils were given small rugby balls, they were able to get into the nucleus of the cancer cell easily. The game is an excellent way to show that if drugs can be smartly designed, with various properties taken into account – such as size, shape, weight, charge, toxicity – we can vastly increase the chances of the medicine reaching the intended site for it to better target and kill tumour cells.
The pupils were then told that here at the School of Pharmacy we are doing just that – designing drugs to help cancer patients. Understanding and battling cancer resistance is an incredibly important field of research, because ultimately it may provide treatments that could improve outcomes for patients whose options are currently more limited. The pupils, having been told this, were enthused by our exhibit. Some were already considering a career in pharmacy research and so we hope the day inspired them to pick up the baton and made them aware that here at the School of Pharmacy, behind the excellent MPharm course, there is also a raft of pioneering research.