Established by Bengt Sjöberg 2016
In addition to the Sjöberg Prize, where 9/10 of the prize money is reserved for research purposes, the Sjöberg Foundation has in 2019 made decisions on grants totaling approximately SEK 49 millions. This sum includes SEK 3 millions for continuation of the project initiated in 2017 concerning the national network for cancer research and uniform patient reviews for the whole country, see: Grants 2017, National collection of valuable data from cancer care. In addition, “A non smoking generation,, has been awarded SEK 200,000 and Lysekils Gymnasium SEK 100,000 in material grants for environmental studies.
Will improve the diagnosis and treatment of brain tumours
Glioma is the most common form of brain tumour in adults, and in many cases it is aggressive. In a joint project, six researchers at Umeå University will now try to find biomarkers in the blood that can lead to early discovery of the disease, improve image diagnostics and optimise treatment.
Doctors who are going to treat brain tumours, gliomas, can find it difficult to decide when to start treatment. Tumours can be detected using MRI, but it is hard to determine how aggressive they are, how well they respond to treatment, or discover any recurrence at an early stage.
The Sjöberg Foundation is now giving SEK 6 million to improve opportunities for diagnosing and treating glioma to six researchers at Umeå University: Beatrice Melin, professor of oncology; Maria Sandström, associate professor and senior consultant; Richard Sjöberg, docent in neurosurgery; Lars Nyberg, professor of neuroscience; Henrik Antti, professor of bioinformatics, and Benny Björkblom, senior research engineer in chemistry.
The project has several primary objectives. One of them is finding biomarkers in the blood that can reveal the development of brain tumours or whether a recurrence is underway. In her previous research, Beatrice Melin has discovered that high levels of vitamin E and provitamin C seem to precede glioma; she will now investigate whether these findings can be confirmed.
Another objective is to improve image diagnostics for brain tumours. Maria Sandström is investigating a method called FET-PET, which makes it easier to differentiate brain tumours from the surrounding tissue and can be used to follow the development of the disease.
A third objective is to investigate whether changes in the brain that are caused by the tumour or treatment can be linked to neuropsychological injuries in patients, and then study whether the brain is able to heal this damage.
Will open up tumours to immunotherapies
In some patients, immunotherapies can cure metastatic cancer, while they have no effect on others. Jonas Nilsson will investigate a method that may puncture the barriers that tumours build against the immune system. When the barriers come down, immune cells can enter the tumour and destroy it.
In 2018, immunotherapies received the Nobel Prize in Physiology or Medicine, because they have revolutionised oncology. However, some tumours are called “cold” tumours, because immunotherapies have no effect on them. One reason for this lack of effectiveness is that the tumours can build a barrier against the immune system, so the body’s own immune cells are prevented from infiltrating the diseased tissue.
To improve the effects of immunotherapies, Jonas Nilsson, research fellow at the Department of Radiation Sciences at Umeå University, will investigate whether it is possible to create gaps in this barrier. He will now receive SEK 3 million from the Sjöberg Foundation to investigate a potential weakness in the tumour: special receptors, beta-adrenergic receptors, in the environment around the tumour that are triggered by the hormones adrenalin and noradrenalin.
The results of his previous research show that when he blocks these receptors, the immune system’s cells, including killer T-cells, can get into the tumour. The aim of the project is now to examine these mechanisms more closely, and to develop small molecules that can work as potential pharmaceuticals. The method will probably open up for immunotherapies for prostate cancer and pancreatic cancer, where this form of treatment has so far had limited success.
Large-scale project for better treatment of pancreatic cancer
Malin Sund will receive SEK 3.6 million from the Sjöberg Foundation for large-scale mapping of biomarkers in the blood that may indicate pancreatic cancer. The aim is to develop blood tests that can lead to earlier diagnosis of the disease and give doctors a clearer idea of how they should treat the tumour.
Pancreatic cancer is one of the most dangerous forms of cancer. Only 3–5 per cent of patients live more than five years. The cancer is operable if it is discovered at an early stage, but the problem is that the disease has vague symptoms and often only becomes apparent after the tumour has spread.
To improve survival rates for pancreatic cancer, Malin Sund, professor at the Department of Surgical and Perioperative Sciences, Umeå University, is searching for biomarkers in blood that can reveal the disease is beginning to develop at an early stage, and which can also help doctors to determine what the stage of the tumour.
In this very large-scale project, she is using blood samples from ongoing health studies, including the Northern Sweden Health and Disease Study and the international European Prospective Investigation into Cancer and Nutrition, which has more than half a million participants. By comparing the samples from healthy people and those who have developed pancreatic cancer, she has already found a unique pattern of microRNAs in the blood that may indicate pancreatic cancer. The aim is now to make these tests more specific, so that doctors are better able to know what treatment to use. She will also look for markers that can reveal that the disease is beginning to develop before it properly appears, because early diagnosis can save lives.
Will design immune cells that can destroy brain tumours
Using genetic engineering, researchers have added proteins to endogenous immune cells so that they attach to cancer cells and kill them. This new form of immunotherapy is called CAR T-cell therapy. Magnus Essand will now develop a CAR T-cell therapy that is effective against aggressive brain tumours.
Once immune cells learn to recognise cancer cells as something foreign to the body, they can destroy a tumour in a few weeks. The problem is that the immune system often doesn’t recognise the tumour cells, allowing the cancer to grow unrestrained.
To help the immune system find cancer cells, researchers have isolated a particular type of immune cell, T-cells, from cancer patients’ blood and used genetic engineering to change them so they can find and attack cancer cells. When these engineered CAR T-cells are transferred back into the patients they can, in some cases, completely eradicate the cancer. This therapy is now successfully used for leukaemia and lymphoma.
Magnus Essand, professor at the Department of Immunology, Genetics and Pathology at Uppsala University, will now receive SEK 6 million from the Sjöberg Foundation to develop a CAR T-cell therapy for glioblastoma, which is the most common and most aggressive form of brain tumour.
The T-cells that he and his colleagues are to develop will have several modes of action. They will be equipped with a “CAR” protein that specifically attaches to IL13Rα2, a molecule on the surface of brain tumour cells, and they will also release a signal molecule called NAP, which attracts other immune cells and encourages them to attack the tumour. Last but not least, the T-cells are given a type of molecular key, which means they can get through the otherwise difficult to penetrate blood-brain barrier.
If he succeeds in making the therapy work, it may lead to an effective treatment for a form of cancer that is now highly lethal.
Developing a blood test for earlier diagnosis of ovarian cancer
Ovarian cancer is often discovered too late, and the disease therefore has a high mortality rate. Ulf Gyllensten has developed a blood test that can differentiate between benign and malignant tumours and can potentially be used to screen for ovarian cancer. He will now validate the test further, so it can be used clinically.
Only 30-40 per cent of those diagnosed with ovarian cancer live longer than five years. To be able to discover the disease at an earlier stage, Ulf Gyllensten, professor at the Department of Immunology, Genetics and Pathology, Uppsala University, has developed a blood test for ovarian cancer. The test is based on the levels of eleven different proteins in the blood, which change when someone develops ovarian cancer.
In his previous research, Ulf Gyllensten has shown that the test can differentiate between healthy and sick women with a high degree of certainty. He will now receive SEK 3 million from the Sjöberg Foundation to investigate how the test can be used in the healthcare system, where it could have three important functions.
The first one is to contribute to more accurate diagnosis. Currently, when an ovarian tumour is discovered using ultrasound, an operation is necessary to determine whether it is benign or malignant. In three of five cases, the tumour is benign, and the operation was conducted unnecessarily. With the new test, many of these unnecessary surgical interventions can be avoided.
Another area of use is to discover more quickly, post-treatment, whether someone is at risk of a recurrence of ovarian cancer. The third is to use the test to screen women for ovarian cancer. Ulf Gyllensten will investigate whether it is possible to conduct the test at the same time as women are screened for cervical cancer. The earlier the disease is discovered, the more lives can be saved.
Will get liver cancer cells to fall for their own trick
In the most common form of liver cancer, hepatocellular carcinoma, the cells produce large amounts of free radicals. Thomas Helleday has discovered that they protect themselves against the free radicals using a special enzyme, OGG1. By knocking out this protection, he will now try to get the cancer cells to kill themselves.
Cancer cells generally produce large amounts of free radicals, which damage the cells’ DNA. To protect themselves against the free radicals, they also produce a special protein, 8-Oxoguanine glycosylase (OGG1), which can repair the damaged DNA. Thomas Helleday, professor of translational medicine and chemical biology at Karolinska Institutet, has discovered that if he knocks out OGG1, cancer cells can be destroyed by the free radicals that they produce themselves.
He will now receive SEK 3 million from the Sjöberg Foundation to investigate the effect an OGG1 blockade can have on liver cancer. Preliminary data shows that if liver cancer cells produce a great deal of OGG1 – and thus have very effective protection from free radicals – this is linked to a poorer prognosis for the patient. Therefore, an OGG1 blockade could provide extra benefits in liver cancer.
In the first stage, Thomas Helleday’s research group will use molecules they have previously developed, and which inhibit OGG1, to see how they affect liver cancer cells. If the trials are positive, the research group will apply for additional funding to develop pharmaceutical candidates for testing in clinical trials. The long-term objective is to develop a beneficial treatment for one of the deadliest forms of cancer.
Will help the immune system to attack liver cancer cells
Immunotherapies – where the body’s immune system is harnessed to attack tumours – are revolutionary cancer treatments, but many patients do not respond to them. Anna Pasetto and Marcus Buggert will now investigate how to improve the way the immune system targets liver cancer cells, so more people survive.
Previously, the most common form of liver cancer, hepatocellular carcinoma, was generally only treatable if it was discovered at an early stage. Thanks to new immunotherapies, one in five patients can now receive treatment that reduces the size of the tumours.
When immunotherapies do not help, it is because the immune system does not discover the diseased cancer cells. Anna Pasetto, assistant professor at the Department of Laboratory Medicine, and Marcus Buggert, assistant professor at the Department of Medicine, both at Karolinska Institutet, will now receive SEK 6 million from the Sjöberg Foundation to develop a method to help the immune system find the cancer cells.
In the first stage, they will identify genetic changes that differentiate the cancer cells from healthy cells. Using a range of techniques in molecular biology, they will then develop a library of special proteins – T-cell receptors – that recognise and attach to these unique changes in the cancer cells. The aim is then to use genetic modification to introduce these special T-cell receptors into immune cells. The specially designed immune cells will then find the cancer cells and signal to the body’s immune system that it should attack and eradicate the tumours.
The hope is that the researchers will be able to conduct a clinical trial with this new treatment strategy on patients with advanced liver cancer within four years.
How do patients experience their care for incurable cancer?
Thera are an increasing number of treatments that can extend the life of patients with incurable cancer. Agneta Wennman-Larsen will investigate how men with prostate cancer experience the information they receive when the disease is no longer curable, their level of involvement in treatment decisions and how they feel during treatment.
A number of new treatments for advanced prostate cancer have recently been developed, each of which can extend life by a few months. Scientific studies have allowed researchers to confirm the treatments’ positive effects and map their side effects, but there is a lack of knowledge about how patients experience the period in which they are offered and receive these treatments.
Agneta Wennman-Larsen, registered nurse and associate professor in caring sciences at Sophiahemmet University, will now receive SEK 3 million from the Sjöberg Foundation for a project which follows men with prostate cancer in the late stages of the disease. Using interviews and questionnaires, she investigates how informed and participatory the men feel they are in the decisions about their treatment and what their expectations are. She also monitors their quality of life, how they feel during and after the treatment and how this changes as the disease progresses.
Thanks to the funding from the Sjöberg Foundation, the project can expand from 150 men receiving life-prolonging treatments at a late stage, to include a further 50 men who are receiving treatment for metastatic disease in an earlier stage and 50 who have declined or cannot receive life-prolonging treatment. The long-term goal is to improve care in incurable cancer, so that patients have the best possible quality of life.
Can dietary fibre protect the gut during a cancer treatment?
Radiotherapy can damage the mucous lining of the gut, and some people who survive cancer have serious intestinal problems. Gunnar Steineck will now receive SEK 6 million from the Sjöberg Foundation to investigate whether a fibre-rich diet can protect the gut and prevent it becoming inflamed.
People who develop intestinal problems after surviving cancer treatment can testify to a stigma that few people talk about. Some need to go to the toilet up to 15 times each day, and many get diarrhoea, faecal incontinence or problems with foul-smelling gases.
In cancer care, patients are often recommended to avoid dietary fibre during radiotherapy, because of the idea that the fibres stress the gut and cause acute side effects. However, a lack of fibre can lead to the mucus that protects the gut wall being broken down, and the cells lining it running out of energy. In turn, this may make the gut less resistant to radiation, and bacteria can enter the wall of the gut and cause inflammation.
To discover whether dietary fibre can protect the gut during radiotherapy, Gunnar Steineck, professor at the Department of Oncology at the University of Gothenburg, will lead a large randomised and controlled study, FIDURA. Five hundred patients will be randomly placed in two groups. With support from a website,
eftercancern.se/fidura/ and dieticians, one group will be advised to eat at least 16 grams of dietary fibre every day from varied foodstuffs, the other group will get the same advice and a supplement of 5 grams of dietary fibre. The researchers will investigate whether the supplement causes more acute side effects during treatment and whether it may provide long-term protection for the gut. The objective is to cure cancer with radiotherapy and restore intestinal health in the cancer survivor.
New strategies for the diagnosis and treatment of malignant brain tumours
The diagnosis and treatment of tumours located deep in the brain is difficult, quite simply because they are relatively inaccessible. Mattias Belting will receive SEK 6 million from the Sjöberg Foundation for a project in which researchers will develop different methods that can facilitate and improve the treatment of the most common and aggressive type of brain tumour, glioma.
Some gliomas grow slowly, while others are aggressive. Currently, a sample from the tumour is necessary for a doctor to be able to determine which form of glioma a patient has and offer individualised treatment – but obtaining these is risky, because healthy areas of the brain can be damaged.
Mattias Belting, professor of clinical oncology at Lund University, and his colleagues Pia Sundgren, professor of radiology, and Johan Bengzon, adjunct professor of neurosurgery, will now develop a simpler method for diagnosing brain tumours. Cells in the brain, particularly cancer cells, continually release small particles (exosomes) into the blood, and their content reflects that of the cancer cells. The researchers have succeeded in isolating these particles out of a blood sample. The aim is now to reveal which type of cells, benign or malignant, are hiding in the brain by mapping the exosomes’ molecular content.
To obtain an even more precise diagnosis, the blood analyses will be combined with a new type of MRI, amide proton transfer weighed imaging, which makes it easier to distinguish tumours from the surrounding tissue.
Another aim in the project is to investigate the glioma’s dependence on fat. The researchers have discovered that stressed glioma cells often collect fat and attract immune cells in a manner similar to that of atherosclerosis. They will now investigate whether pharmaceuticals that counteract atherosclerosis can also be used to treat glioma.
A third aim of the project is to identify targets for immune or antibody therapies. The researchers have developed a unique method for mapping the proteins on the surface of brain tumour cells. They will now look for proteins that are unique to the tumours, and which can be used to create targeted treatments that differentiate between diseased and healthy tissue.
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