Nearly 1 in 2 people will get cancer in their lifetime – yet many at high risk never develop the disease. Understanding why could unlock entirely new ways to prevent cancer – an idea explored in a special new episode of Goalhanger’s The Rest Is Science podcast, a collaboration with Cancer Research UK that looks at the groundbreaking discoveries scientists are using to beat cancer at the game of evolution – shaping the future of medicine.

Until now, scientists have tended to focus less on obstacles to cancer development and more on identifying its causes, such as ageing – which gives genetic mutations time to build up in our cells. But some people consistently defy the odds; these “super-avoiders” somehow dodge cancer despite being at high risk, for example if they smoke or drink alcohol, are very elderly or have genetic variants linked to cancer.

We don’t yet know why certain individuals fit this “super-avoider” profile – so people can’t find out in advance if it applies to them.

Set up to investigate this is Team ATLAS, one of five interdisciplinary groups awarded $25m (£20m) each in early March by Cancer Grand Challenges. The researchers, from France, Denmark, Sweden, Switzerland, the UK and US, believe they can unlock some of the secrets in the immune systems of super-avoiders – potentially leading to new ways to prevent cancer, detect it earlier and improve therapies.

Unlocking the secrets that link Covid-19 and cancer

Team ATLAS is led by French paediatric immunologist Dr Paul Bastard, of the Imagine Institute, University of Paris Cité. He was inspired to investigate super-avoiders after studying the causes of severe Covid-19.

Bastard’s findings about the causes of severe Covid-19 led him to wonder whether autoantibodies might also play important roles in cancer. “We know cancers can be treated with immunotherapies, and that some autoantibodies can weaken the immune system,” he says. “Our hypothesis is that some autoantibodies could be cancer-inducing while others could be protective.”

Team ATLAS is assembling a global map of all the antibodies in the blood of more than 60,000 individuals, alongside their genetic profiles and records of other proteins found in their blood.

This cancer antibody “atlas” comprises data from individuals in various high-risk categories. Their antibody profile will be analysed and compared with people who developed cancer. The research could reshape our understanding of the immune system’s role in cancer, and deliver new ways to detect and treat the disease.