Expert Opinion: Professor Peter Johnson

We’re lucky enough to talk regularly with a range of cancer experts, from scientists who study the very building blocks of life in the lab, to doctors who treat people with cancer every day. We’re interviewing a handful of these experts over the coming weeks to give you personal perspectives on the hot topics in cancer research.

In the first of our Expert Opinion interviews, we talk with our Chief Clinician Professor Peter Johnson. He works on immunotherapy, a type of treatment that harnesses the body’s own immune system to fight cancer.

Peter Johnson, our Chief Clinician, talks about his highlights of the past year

Cancer Research UK: For you, what were the hot topics in cancer research last year?

Professor Johnson: I think the topic that has really been rising to the top over the last couple of years has been the whole area of what’s loosely called ‘stratified medicine’, or molecular diagnosis.

Information that is coming out of things like the human genome project is now helping us understand what it is that has gone wrong at a genetic level in cancer cells, and this is giving us a range of ‘targets’ that we can aim new treatments at in the clinic.

So the very direct translation from molecular understanding of the development of cancer through into new types of treatments and how we can aim drugs at the targets – for me, this is what feels like the cutting edge at the moment.

Cancer Research UK: What single piece of work or advance recently most excited you?

Professor Johnson: Actually the thing that excited me most was something in slightly different field, which was the results of treatment with an antibody called ipilimumab in melanoma. I’m interested in that because my particular field is cancer immunology and how we can stimulate immune responses against cancer cells. This antibody effectively ‘cuts the brakes’ on the immune system and allows the uncontrolled proliferation [production] of T-cells [special white blood cells that help the body fight off disease] by targeting a molecule called CTLA4.

For the first time, a randomised trial has shown that it actually made a difference to the outcomes for patients with melanoma. This is really one of the best bits of evidence we’ve had so far that intervening in the immune system – in what is effectively quite a crude way, with an antibody to ‘dis-inhibit’ the immune system – can actually make a difference to clinical outcomes.

And as somebody who’s been interested in applying immunity to cancer for a very long time, it’s really encouraging to see the first glimmers of hope in this field, which up until now has proven quite difficult. While we’ve been able to show fantastic results in the test tube and lab models, this is really one of the most convincing pieces of clinical evidence that we’ve seen so far.

Cancer Research UK: Which recent advance will have the greatest impact on cancer patients?

Professor Johnson: The next year for me is all about starting to move stratified medicine towards reality. The Cancer Research UK Stratified Medicine Programme is going to start rolling forward with the setting up of our clinical centres and the technology hubs to do the concerted analysis of molecular phenotype in cancers so that we can start to develop a system that can underpin all the important research in the future.

[We’ve previously blogged about the Stratified Medicines Programme.]

Cancer Research UK: What do you think the next few years of cancer research will bring?

Professor Johnson: Firstly, I think that we’re going to see an ever-increasing number of specific targeted treatments aimed at molecular abnormalities in cancer cells. Secondly, we’re also going to see an increasing number of immunological types of treatment for cancer. As I’ve said, the antibody field is expanding very rapidly and we’re learning more and more about how that can affect cancer. The cancer vaccine field is also moving forward quickly.

So I think the combination of those two things is really going to transform the way that we think about treating cancer as the next few years go by.

Cancer Research UK: What do you see as the greatest challenges still to be tackled in cancer?

Professor Johnson: I’m going to change the subject again now, and say that early diagnosis has to be our biggest short term/medium term goal in terms of the way we’re most likely to have an effect on the mortality from cancer in the UK.

We know that people in the UK present on average at a later stage than they do in places like Europe and the United States, and we know that this has a very direct effect on our chances of curing them. So for me one of the really important goals in the next couple of years is to start to make progress on early diagnosis – start to make progress on getting people diagnosed faster than they have been up to now.

Cancer Research UK: Finally, what inspired you to work in the cancer field?

Professor Johnson: Well I could be glib and say it was a short attention span and the continuous craving for novelty, and that has some basis in truth! It’s one of the areas in medicine where you get the most direct feed through from what’s going on in science – what’s going on in our understanding of molecular, cell biology and immunology – through into what you can do in the clinic.

There are not many areas in medicine that do it so effectively and so excitingly as in cancer.

Interview conducted by Olly Childs, Senior Science Communications Officer