With cancer, if we could find out what’s happening in the body where it is developing, would it help us deal with it? Even stop it in its tracks?

Well, researchers at University College London and London’s Francis Crick Institute think it just might. They’ve been examining the immune cells in the environment around a tumour to help predict how a person’s cancer might progress and respond to treatment. The study aims to create a detailed map of lung cancer immunology to speed up new treatments.

Apparently there are four different environments around lung tumours, each generating a different pattern of cancer progression. The most aggressive cancers have low levels of powerful immune T and B cells, but high levels of neutrophils (a white blood cell), and are more likely to spread to other parts of the body.

Surrounding cancer cells are immune cells, proteins and blood vessels. The make-up of this micro-environment can vary, so looking at multiple parts of the tumour and its surroundings is helpful to get a more accurate picture of what’s going on during disease progression. Samples of tumours and normal tissue from 81 patients with lung cancer taking part in the TRACERx study came up with four microenvironments.

Each of them contains varying numbers of immune cells in different areas of the tumour. It turns out that tumours with a low infiltration of T and B cells throughout the tumour, but a large number of neutrophils, can evade the T and B immune cells that are able to attack the cancer. The cancer cells can hide.

The number of neutrophils were higher in tumours that were more likely to spread, suggesting neutrophil numbers could be an effective clinical test. This helped doctors to determine who might need additional treatment to prevent cancer spread. The Crick’s Mihaela Angelova, co-senior author of the study, explained: “We’ve shown that high infiltration of neutrophils could be
a marker for cancer evolution and spread.

“These tumours were genetically altered, separated from the blood supply, and managed to evade the immune system, making them better able to spread.” Professor Charles Swanton, co-senior author at UCL Cancer ­Institute and Cancer Research UK, added: “Lung cancer, particularly if caught at a later stage, is hard to treat, and mapping the environment around the tumour can help us to categorise cancers and work out personalised treatment strategies for patients. “This research highlights the ­importance of pairing the evolutionary history of a tumour with information on how the tumour microenvironment organises in 3D to build the most accurate picture of an individual’s cancer.” World-class stunning research.