GRANTS 2021 | sjobergstiftelsen.se

Established by Bengt Sjöberg 2016

Grants 2021

In addition to the Sjöberg Prize, where 9/10 of the prize money is reserved for research purposes, the Sjöberg Foundation has in 2021 made decisions on grants totaling approximately SEK 63 million. This sum includes SEK 6 million to CancerRehabFonden for rehabilitation of cancer patients and 1.2 million to Nätverket mot cancer for mapping out the needs for cancer rehabilitation and the available resources.

Umeå University

Will map the role of gut bacteria in colorectal cancer

Researchers have discovered that a disordered gut flora appears to increase the risk of developing colorectal cancer. But why? Richard Palmqvist and his research group are studying the gut bacteria of cancer patients, to better understand how they affect tumor progression and the effect of various treatments.

Even though gut bacteria have recently received a great deal of attention, their role in the development of colorectal cancer is still relatively unresearched. A few years ago, Richard Palmqvist, professor at Umeå University, began comparing the gut flora of people with and without colorectal cancer, with the aim of reducing the blank spots on the knowledge map. His results showed that some bacteria were more likely to be found in cancer patients, particularly Fusobacterium nucleatum, Parvimonas micra and a toxin-producing variant of the common E. coli gut bacteria.

When his research group then mapped the tumors, they discovered that tumor tissue of contained both Fusobacterium nucleatum and Parvimonas micra. The latter was particularly common in tumors that were also full of activated immune cells.

The research group has also contributed to the discovery of a link between having antibodies to toxin-producing gut bacteria in the blood and the later development of colorectal cancer. Richard Palmqvist will now receive 4,500,000 Swedish kronor from the Sjöberg Foundation, so he can continue to explore the role of gut bacteria in colorectal cancer. One hope for the future is that improving a disordered gut flora will prevent the disease or influence its treatment.

Uppsala University

Which contraceptives can prevent ovarian and uterine cancer?

Research shows that hormonal contraception may prevent ovarian and uterine cancer, but different contraceptives contain different hormones. Åsa Johansson will now investigate which contraceptives best counteract these forms of cancer.

Ovarian cancer is one of the deadliest forms of cancer. Fewer than half of all those affected survive longer than five years. This is where contraceptives may be helpful; studies show that hormonal contraceptives reduce the risk of ovarian cancer by 21 per cent. For people who have a high risk of getting the disease – for genetic or lifestyle factors – it is important to be able to prevent it.

However, contraceptives are designed in a variety of ways. Some contain both estrogen and progestin, others just progestin. There are also different types of progestin, and the hormone dosage varies. For example, contraceptive pills that are taken once a day contain more hormones than implants, coils and patches.

Åsa Johansson, associate professor at Uppsala University, will now systematically study which contraceptives best prevent ovarian and uterine cancer and how genetic risk factors and lifestyle affect the reduction in risk. In her study, she will utilize the Swedish Prescribed Drug Register and the Cancer Register, as well as a biobank in the UK. The aim is that the results of the project will lead to evidence-based recommendations, which are individualized for women who have a high risk of being affected by these forms of cancer. The Sjöberg Foundation is contributing 3,000,000 Swedish kronor to the project.

A cooler to protect the mouth from chemotherapy

A common and painful side effect of chemotherapy and radiotherapy is inflammation in the mouth, oral mucositis, which affects children and adults. To prevent these problems, Gustaf Ljungman’s research group is developing a special cooler that may protect the mouth during cancer treatments.

In addition to being painful, oral mucositis can lead to patients experiencing problems eating, as well as being at increased risk of infections. In turn, this can make it more difficult to complete a cancer treatment according to plan.

For short treatments, it is known that oral mucositis can be reduced or prevented if the mouth is cooled. People who receive chemotherapy suck chips of ice or rinse their mouths with iced water for the 30–60 minutes the treatment takes. The cold contracts the blood vessels so blood flow to the mouth is reduced. Researchers believe this protects the sensitive tissue from being exposed to chemotherapy drugs, which reduces the risk of oral mucositis.

However, many children, particularly young children, find sucking on ice for a long period uncomfortable. Their teeth can hurt, they can get headaches or feel nauseous. The research group around Gustaf Ljungman, senior consultant and professor at Uppsala University, have therefore invented a special device that cools the air in the mouth, an intra-oral air-cooling device, which children find easier to use. The research group will now receive 3,000,000 Swedish kronor from the Sjöberg Foundation for the continued development and testing of the device, so it will work even better.

Karolinska Institutet

They will undermine the defenses of lung cancer tumors

New pharmaceuticals against lung cancer have proven to extend the life of patients, but tumors often become resistant to the treatment. A group of researchers will now investigate whether they can undermine the tumor’s defenses using a new type of method: microRNA-inhibiting treatment.

Lung cancer is the deadliest form of cancer, but in the last few years new targeted pharmaceuticals have been developed, tyrosine kinase inhibitors, which have brought new hope. They are effective against tumors that have genetic changes in growth-promoting proteins, especially ALK and EGFR, and often substantially extend the lives of patients. Unfortunately, tumors eventually become resistant to the pharmaceuticals, which leads to the cancer progressing.

When Simon Ekman, senior consultant and associate professor at Karolinska Institutet, investigated the cause of the tumor cells’ resistance, he discovered that they had begun to produce specific microRNAs. These are special molecules that govern how active various genes are in the cells. Once his research group had disabled these microRNAs in cancer cells, the tyrosine kinase inhibitors regained their effect.

Simon Ekman’s research group, together with researchers from several Swedish hospitals, will now receive 3,000,000 Swedish kronor from the Sjöberg Foundation for continued studies of the microRNA–inhibiting treatments. They will transplant tumor cells from people with lung cancer into avatar mice, which will develop tumors very similar to those of the patients. Then they will investigate how the microRNA-inhibiting treatments affect these tumors. The aim is to obtain all the necessary knowledge for the treatment to be tested in clinical trials in patients.

Will test new methods for tracing metastatic stomach cancer

Cancer in the stomach and oesophagus is often discovered late, once the cancer has already spread. Rimma Axelsson will investigate two new types of tracer for the diagnosis of stomach and oesophageal cancer. The aim is to find tumors and discover whether they have metastases, to determine which treatment could be effective.

When a doctor evaluates the best way of treating cancer in the stomach or esophagus, it is vital to know whether the tumor has spread. Often, if the cancer is localized, surgery is adequate but, if the cancer is metastatic, chemotherapy or other drugs are necessary.

However, there are currently few reliable methods for identifying and diagnosing metastases from stomach or esophageal cancer. To improve diagnostics, Rimma Axelsson, senior consultant and professor at Karolinska Institutet, will now receive 3,000,000 Swedish kronor in funding from the Sjöberg Foundation.

In one part of the project, she will utilize a substance called fibroblast-activating-protein-inhibitor (FAPI) to find metastases from diffuse gastric cancer. FAPI binds to this type of cancer. If the FAPI is marked with a radioactive isotope, positron emission tomography (PET) can be used to find metastases of just 3–5 millimeters in size.

In another part of the project, Rimma Axelsson will use a new and unique tracer that binds to HER2 positive tumors. HER2 is a protein that drives the growth of cancer and occurs in esophageal cancer.

Using this unique tracer, she aims to determine which patients with esophageal cancer will benefit from treatment that targets HER2.

Can extreme doses of chemotherapy remove metastases in the liver?

Ocular melanoma is an unusual form of malignant melanoma that is difficult to treat. The disease often spreads to the liver, after which the majority of patients die within a year. Roger Olofsson Bagge will test a new form of treatment, only conducted at Sahlgrenska University Hospital, in which the liver is exposed to extremely high doses of chemotherapy.

Recently, the treatment of normal skin melanomas has undergone a revolution, thanks to immunotherapies. Unfortunately, these have functioned more poorly on ocular melanomas. Roger Olofsson Bagge, senior consultant and associate professor at Sahlgrenska Academy, will now receive funding of 4,500,000 Swedish kronor from the Sjöberg Foundation for the exploration of a new form of treatment for liver metastases from ocular melanoma, in which immunotherapy will be combined with a technique called isolated hepatic perfusion, IHP.

In IHP, the liver’s blood circulation is isolated from the rest of the body. The liver is then connected to a heart-lung machine and extremely high doses of chemotherapy are pumped through the liver for 60 minutes. The rest of the body is spared because the liver is isolated. However, the metastases in the liver will be weakened, and the hope is that the immunotherapies will then be more effective.

The treatment will be tested on 18 patients in a phase 1 clinical trial. All the patients will receive both immunotherapy and IHP, and will be randomly assigned to first receiving either immunotherapy or IHP. The hope is that the combination will further activate the immune system and help more patients survive.

How can poorer health be prevented among people who have had thyroid cancer?

People diagnosed with differentiated thyroid cancer frequently experience poor health-related quality of life. In a current study, led by Christel Hedman, researchers are tracking people who have had this disease to understand why they experience reduced health. The aim is to develop treatment that may improve their quality of life.

Half of all people who get differentiated thyroid cancer are below the age of 50. The disease has a good prognosis, but there is a lifelong risk of recurrence. Most people also require treatment with a thyroid hormone, levothyroxine, for the rest of their lives. Initially, the hormone is given in high doses, which can lead to lethargy and extreme fatigue.

The risk of relapse and the hormone treatment may explain why people who have had differentiated thyroid cancer often experience a reduced quality of life, with many of them having depression, anxiety and a fear of relapse. Despite this, there are no treatments that are known to increase the patients’ mental wellbeing.

To learn more about how people who have had differentiated thyroid cancer feel, a research team, led by Christel Hedman, senior consultant and researcher at Karolinska Institutet, are following a group of people who received the diagnosis between 2012 and 2018. Their long-term aim is to use the knowledge this generates to develop a digital psychological treatment for health-related anxiety, which may increase the group’s wellbeing. They will also examine how the intensive lecothyroxine treatment affects quality of life. The Sjöberg Foundation is supporting the project with 1,500,000 Swedish kronor.

Could selenium be an effective chemotherapy drug?

Laboratory studies have shown that a mineral, selenium, can eradicate cancer cells that have become resistant to all other treatments. These results are very positive, so researchers are now trialling selenium on people with uncurable cancer. The first aim is to see what dosage the human body can cope with.

Selenium is vital; it is a component in various enzymes in the body that are important to our immune system and protect cells from oxidation. However, in large doses it becomes toxic, so physicians are now hoping to utilise this with hard-to-treat cancers.

One reason why cancer cells become resistant to chemotherapy is that they begin to manufacture proteins that can pump the chemotherapy drugs out of the cell, which protects the cancer cells against toxins. However, Mikael Björnstedt, senior consultant and professor at Karolinska Institutet (KI), has discovered that selenium appears to enter the cells using precisely these pumps. The cancer cells therefore absorb much more selenium than healthy cells, and in-vitro studies show that selenium is toxic to cancer cells.

Mikael Björnstedt and Ola Brodin, senior consultant and associate professor at KI, are now investigating whether they can use selenium to treat cancer patients for whom this is their last hope. First, they will evaluate how the treatment should be given and the dosage the body can withstand. Then they will investigate whether this dosage is effective enough to start using selenium to treat patients who have uncurable cancer. The Sjöberg Foundation is granting the project 6,000,000 Swedish kronor.

Combining diagnostic methods to reveal lung cancer

Lung cancer is often discovered too late, once the disease is no longer curable. However, researchers at Karolinska Institutet are developing a new method to diagnose this cancer earlier, by combining a detailed description of symptoms with blood analysis. They will now refine their method using artificial intelligence, AI.

People who develop lung cancer often feel that something is wrong long before they receive their diagnosis. The first signs of the disease – coughing, fatigue, reduced appetite and breathing difficulties – can be vague and difficult to interpret.

Lars E. Eriksson, professor at Karolinska Institutet, and his colleagues, conducted detailed interviews with patients with lung cancer about their first symptoms, and then developed an e-questionnaire that can be used to identify patterns of symptoms that sound an alarm for lung cancer. Working with Janne Lehtiö, who is also a professor at Karolinska Institutet, he combined the results of the e-questionnaire with detailed analyses of the protein composition of the patients’ blood plasma. This produced data that may allow lung cancer to be diagnosed with greater precision.

The researchers at Karolinska Institutet will receive 5 100 000 Swedish kronor from the Sjöberg Foundation to streamline this new diagnostic method using AI. They will also investigate whether the method can be used to improve lung cancer screening for smokers. Currently, lungs are often imaged using various types of computed tomography, but this gives too many false positive results. The researchers hope that by combining the images with symptom descriptions and blood analyses, they will be able to uncover whether a tumor really is developing in the lung.

Gothenburg University

Can new pharamceuticals help treat breast cancer metastases in the brain?

Some cancer cells are dependent on a specific repair system that fixes damage to their DNA. Pharmaceuticals that disable this system became available in 2019 and have proven effective against hereditary breast cancer. Barbro Linderholm and her colleagues will now investigate whether these pharmaceuticals can work against brain metastases from breast cancer.

Some people are born with a genetic risk of developing breast cancer. They have a fault in a special cellular machinery that normally repairs damage to DNA. This results in genetic changes in the cells occurring more easily and more frequently, which may eventually cause cancer.

In 2019, two new pharmaceuticals were approved for use on hereditary breast cancer. They utilise the cells' difficulty with repairing their DNA, making cancer cells even less able to repair genetic damage. This leads to a situation where damage to the genome becomes so extensive that the cells die. This leads to a situation where the damage to the genome becomes so extensive that the cells die.

However, the hereditary form of breast cancer is just 3–5 percent of all breast cancers. Barbro Linderholm, associate professor and senior consultant at Sahlgrenska University Hospital, along with colleagues in Lund and Örebro, will investigate whether these new pharmaceuticals can be used on a considerably larger group of patients. Mapping brain metastases from non-hereditary breast cancer has shown that they fairly often also have defects in their DNA-repair machinery. Therefore, the hope is that these new pharamceuticals, which have relatively few side-effects, will lead to these cancer cells also overmutating and dying. The Sjöberg Foundation is providing funding of SEK 3,000,000 for the project.

Will prevent difficulties opening the mouth and swallowing for people with head and neck cancer

Head and neck cancers are among those that are increasing the most. As a side effect of the disease, many people develop difficulties with opening their mouths and swallowing. Lisa Tuomi will investigate whether a training program can prevent these problems, making jaw-opening and swallowing easier.

Every year, around 1600 people in Sweden develop a head or neck cancer; many of them are treated using radiotherapy. One side-effect is that almost half of these patients have problems opening their mouths, swallowing and eating. In turn, the lack of nutrition leads to patients not coping so well with the treatment and also gives them an increased risk of infections.

To counteract the side-effects of radiotherapy, researchers have previously tested training programs to improve patients’ ability to open their mouth and swallow. However, completing these has been tough and few patients have succeeded. Therefore, based on previous research, Lisa Tuomi, senior speech-language pathologist and associate professor at the University of Gothenburg, has developed a simpler training program. Preliminary studies have shown that it is possible to undertake the program during oncological treatment. The patients have felt better, experienced less pain and improved quality of life.

Lisa Tuomi and her colleagues will now receive funding of 3,000,000 Swedish kronor from the Sjöberg Foundation, so they can test the program in a larger randomized and controlled study. If the results are positive, the program can be used in the healthcare system. If more patients retain better jaw-opening and swallowing abilities, it is likely to reduce mortality and secondary diseases.

Can extreme doses of chemotherapy remove metastases in the liver?

Traces of tumor DNA in the blood will individualize sarcoma treatments

Sarcoma is a general term for several unusual forms of cancer that relatively often affect children and young people. If the disease spreads, the prognosis is poor. Anders Ståhlberg is investigating a new method for tracking the progression of sarcoma tumors using simple blood tests. The aim is to individualize treatment.

When tumors occur in the body, traces of their genetic material, DNA, can be found in the blood. This DNA is called circulating tumor DNA (ctDNA) and can be used to trace and follow tumors in the body.

The research group around Anders Ståhlberg, associate professor at the University of Gothenburg, has developed an extremely sensitive method, SiMSen-Seq, to better map ctDNA in the blood. He is now receiving funding of 4,500,000 Swedish kronor from the Sjöberg Foundation for a project that began in 2017, in which he explores how this method can be used to individualize the treatment of sarcoma.

In the project, regular blood samples are used to map the patients’ ctDNA and their immune system. The aim is to be able to see how different treatments affect the tumor and to discover recurrences. This allows ineffective treatments to be stopped early and new treatment to start rapidly if the cancer is coming back. More individualized treatments increase the chance of therapy being successful and reduces the risk that ineffective measures cause unnecessary suffering.

Lund University

Can toxic substances early in life contribute to childhood cancer?

Why children get cancer is currently partially unknown. Karin Broberg will lead a project in which researchers aim to compare the prenatal environment for children who have developed cancer with those who have not. The aim is to investigate whether there are foreign substances, such as chemicals or metals, which can explain why children get cancer.

Every year, around 370 Swedish children are diagnosed with cancer. When older people get cancer, it is often caused by genetic changes that accumulate in their cells over a lifetime, but just 8.5 per cent of all childhood cancer can be linked to any form of congenital genetic change. So what causes childhood cancer in the other cases?

Karin Broberg, professor at Lund University, will now receive 3,000,000 Swedish kronor from the Sjöberg Foundation to lead a project in which researchers will investigate whether toxic substances during prenatal development may contribute to cancer. They will analyze samples from a biobank where blood serum from pregnant women is stored, and search for traces of chemicals and metals. They will also measure oxidative stress and inflammation in the women’s blood, because that may harm the fetus.

Using various Swedish registers, they will also investigate whether the children’s parents have been exposed to carcinogenic substances in their professions or living environments, whether there is a family history of cancer, whether the mother has smoked or taken a particular medicine, and so on.

If they find a new risk factor for cancer, the knowledge will be used to prevent childhood cancer in the future

Detailed mapping of lung cancer will provide keys to increased survival

Maria Planck and Mikael Johansson will meticulously examine samples from lung cancer patients using large-scale methods from molecular biology. Their aim is to find biomarkers that can be used to diagnose the disease, individualize treatment, and indicate at an early stage whether someone is heading for a relapse.

Recent rapid developments in molecular biology have given researchers the opportunity to map blood samples at an entirely new level of detail. In a joint project, Maria Planck, senior consultant and associate professor at Lund University, and Mikael Johansson, senior consultant and associate professor at Umeå University, will use these methods to obtain knowledge that can increase survival rates in lung cancer.

It is vitally important to diagnose the disease as early as possible, so the researchers will compare blood samples from recently diagnosed lung cancer patients to ones from healthy people. They hope to discover changes in the blood that indicate whether a tumor is beginning to develop in the lung.

To make lung cancer treatment more effective, they will also examine blood samples and tumor tissue from patients to find biomarkers that may reveal in advance how well a particular treatment will work, or whether a patient is in the risk zone for a relapse.

Based on how a tumor changes during treatment, they will also try to understand why some tumors become resistant to treatment and how this can be prevented. The Sjöberg Foundation is contributing 9,000,000 Swedish kronor to the project.