Scientists, patients and clinicians share learnings to target treatments in cancer
There’s a chute at University Hospital Galway that connects Dr Róisín Dwyer’s lab directly to an operating theatre.
When collaborating surgeons in that theatre remove cancerous tumours and surrounding tissue from consenting patients, theatre staff can immediately send precious samples of those tissues into the chute.
“It takes about 30 seconds for the samples to arrive at our lab, and we can get to work on them,” says Dwyer, who is an Associate Professor in Translational Science at University of Galway and a member of Precision Oncology Ireland. It's apt that the samples travel directly to the lab, without the need for 
being ferried about the hospital. Because Dwyer’s research is developing ways to deliver treatments to tumours that have moved beyond the primary site to other parts of the body.
“One of the things we learned very quickly from the surgeons we work with is that they can remove the primary tumour, and that our research needed to target the tumours that have spread in the body,” explains Dwyer. “So we set about looking at ways to get new treatments to those metastatic tumours that can’t be easily removed by surgery.”
The new treatments in question are ‘microRNAs’, or small, naturally occurring molecules that regulate biochemical processes in cells.
Dwyer collaborates with surgeon and Precision Oncology Ireland investigator Professor Michael Kerin in Galway, which ensures the research stays clinically focused and aims to address the unmet needs of the patients he treats, as Dwyer explains.
“Our research has identified a particular microRNA called miR-379 that can suppress or slow the growth of tumours in the lab,” she says. “Now my lab wants to send this and other important microRNAs into breast cancer tumours that have spread beyond the primary site.”
To make this delivery, she is using tiny bubble-like packages called extracellular vesicles (EVs) that emerge from cells. Dwyer believes that EVs from adult stem cells will be able to find tumour cells hiding in difficult-to-access parts of the body, including the brain.
Her lab is now developing ways to collect and modify EVs from adult stem cells, drawing on the experience and expertise across the Precision Oncology Ireland network.
“It’s just phenomenal to be able to pick up the phone and call experts in the network and access equipment and expertise. It adds new dimensions to our work,” says Dwyer.
She recalls an example where her lab in Galway worked with POI colleagues to profile the proteins impacted by miR-379, to reveal how it can suppress tumour progression.
“I rang the infrastructure manager in UCD's Systems Biology Ireland, Kieran Wynne, who provides critical analytical support to the POI programme. Kieran gave us advice on how to design experiments and prepare samples for protein analysis, then he ran tests on the samples at UCD and met with our team members to help analyse the resulting data,” she says.
“In this and many other ways, Precision Oncology Ireland is invaluable for accessing resources to carry out our experiments, and for learning from people with in-depth knowledge in areas where we need to work.”
Patients, too, bring key insights to Dwyer’s research. Through Professor Kerin and the National Breast Cancer Research Institute (https://breastcancerresearch.ie/), a partner in Precision Oncology Ireland, she has connected with several people living with or after cancer, including Rachel O’Mahony, who has been a key contributor to the research for a number of years.
“As a patient receiving cancer treatment it’s a whole new world you enter into, and it can be very scary. We don’t get to see what happens behind the scenes and the wonderful work of the scientists, the research being carried out and the progress being made. I got to meet Róisín and her team in the lab and witness first-hand what they do, she showed me what happens with the tumour tissue sample, explained the process, it made the science very relatable,” says O’Mahony.
“My patient experience was welcomed and encouraged. Róisín listened and understood the importance of returning to a full life. There can be many side effects from drug treatments, and as Róisín outlines if healthier tissues can be bypassed to reduce these side effects this will improve the outcome for patients. The researchers could see the impact of the treatment on me as a patient, and meeting patients helps them work towards making treatments most effective while still giving the patient a quality of life.”
Meeting with people who know first-hand about living with cancer is both a privilege and necessary for setting the direction of scientific research, agrees Dwyer.
“Even when patients have a positive outcome, we hear from patients that the side effects from therapy can be long lasting and significant, such as lymphoedema,” she says.
“This has really highlighted for us in the lab the need for therapies that bypass healthy tissue and target only the cancer. We want patients to be able to return to live a full life after therapy. As scientists we need to learn from patients about what is important, what matters in their lives. Then we can focus on new and better ways to treat cancer that really make a difference to people who live with the disease.”