Driven by her curiosity, Eleonora Barone has travelled across Europe studying the mysteries of biology. With a background in Molecular Biology from Rome, she has researched Alzheimer’s disease and the effects of nutraceuticals on the brain, but it was the challenge of cancer that truly captured her interest. Today, as a ”la Caixa” Foundation fellow in Dr. Aznar Benitah’s laboratory at IRB Barcelona, she dedicates her time and effort to studying metastatic cancer and metabolism with her Doctoral INPhINIT fellowship. Motivated by a personal experience within her close circle, she aims to advance the fight against this disease to improve the life of the patients.
The ”la Caixa” Foundation fellowship offers a training programme in transversal skills. After one of the programme's webinars, Eleonora used what she’d learned to write this excellent article, inspired by one of the most frequently asked questions she’s asked. Check out her interesting deliberations!
The reason is that cancer isn’t a single problem to address but rather a group of problems, each with its own specific challenges. All these different challenges make finding a cure very complicated. But if there’s one thing I’ve learned after many years of research it’s that, if you want to defeat something, you need to know exactly what you’re up against. So let’s dive a bit more into this, shall we?
You might already know that cancer is a disease characterised by abnormal cell growth, leading to the formation of tumours. There are many kinds of cancer depending on where it starts, such as lung, brain and colon cancer. Additionally, each tumour can be categorised into different subtypes depending on certain characteristics and behaviour. It will be easier to explain this with an example, namely breast cancer, which I’ve been studying for the last few years.
Like all types of cancer, breast cancer also presents different degrees of aggressiveness that depend, for instance, on its ability to move and invade distant organs. The formation of a new tumour in an organ other than the original one is called metastasis. A tumour can therefore be classified as metastatic or not. The more metastatic a tumour, the more aggressive it is.
Along with the aforementioned characteristics, tumours can also be described as heterogeneous. This means that, within the same tumour, each individual tumour cell can be different from the others around it. A tumour can be thought of as a mosaic in which each piece represents a tumour cell and each one may vary from its surrounding cells. This mosaicism is known as tumour heterogeneity. Taken together, all this information shows us the complexity of cancer and how important it is to understand each tumour very well in order to improve how we combat it.
Going back to our original example, breast cancer is a particularly heterogeneous and aggressive type of tumour. But then why don’t we just study the heterogeneity of cancer and a cure once and for all? This is a very good question and many scientists are already trying to find an answer. However, what we are missing in the picture is that
complexity and heterogeneity are not the only challenges we must face when nding a cure for cancer. What we haven’t mentioned yet is that other factors can inuence patients’response to treatments and can therefore be a further challenge in treating cancer.
Imagine a group of people with a cold, all with the same symptoms: a runny nose, sneezing and tiredness. However, although the symptoms are all the same, the underlying cause could be different: a virus, a bacterial infection or an allergy. So would you give everyone the same treatment? Probably not; you’d use an antihistamine if it's due to an allergy and an antibiotic if it's a bacterial infection.
A similar concept applies to tumours. Patients with the same type of tumour can still be very different from one another and, as mentioned earlier, even a tumour in one specific patient can be highly heterogeneous. This means that, even if a particular treatment works for one part of the tumour or for one patient, it may not work for another part or patient. As a result, treatments may have poor overall effectiveness, sometimes leading to the patient’s death. That’s why it's impossible to find a single cure for cancer and why we’re moving increasingly toward “personalised” therapies and combinations of treatments.
Besides complexity and heterogeneity, other factors can also influence a patient's response to treatment, adding yet another challenge to defeating cancer.
As you might expect, the growth of tumour cells can be very fast and rampant, invading the space of healthy cells and killing them off. But to achieve this growth, tumour cells need a lot of energy or fuel, as well as materials to build all their components. So where do all these energy supplies come from? From the host or the patient’s healthy organs, such as muscle and fat. Let’s now imagine a scenario in which tumour cells can request energy from the other organs in the body. What do you think would happen? The healthy organs might respond by sending energy, with the result that they wouldn’t have enough energy for themselves to function properly. The patient would begin to lose energy, to the point that even simple tasks, such as walking, could become a challenge. Imagine if you stopped eating. You’d become weak and any everyday activity would become impossible. If you add to this the presence of a tumour, which is already compromising the performance of your healthy organs, you certainly wouldn’t be the picture of health. And how do you think such a physically weak person might respond to treatment? Simply: they can’t.
Could this be the key to curing cancer? Let me guide you through the ideas we’re exploring in the Stem Cell and Cancer group at IRB Barcelona. Let’s revisit some key concepts I’ve already mentioned.
As you may recall, breast cancer is highly heterogeneous: like a mosaic of different cell types. This can cause some parts of the tumour to be responsive to treatment while other parts don’t respond at all. Moreover, tumour cells are selfish entities that require energy from healthy organs, leading to weaker patients who respond poorly to treatment.
Let’s focus on this energy exchange. In our lab, we believe the tumour’s “I need energy” message to the body might be consistent across patients. So we’re working to decode the “language” used and, more importantly, to stop the conversation entirely.
How does this communication work? We believe the tumour sends a message to the healthy organs. Once this message has arrived and is properly understood, the healthy organs respond by sending energy. Finally, the tumour receives the energy and keeps on growing. However, what we don’t know yet is: How is this message sent? What's the nature of the message? What kind of energy is received by the tumour? How is this energy delivered? How’s it used?
These are the questions driving our current research. If we can crack this code and block the tumour’s energy request, what might happen? Imagine a scenario in which the tumour can no longer signal its needs, or the body stops responding. Patients won’t waste energy by giving it to the tumour. They’ll feel stronger and “healthier” and will respond better to treatment. Equally, the tumour will be placed “on a diet” as its energy supply will be cut off, and its growth might slow down. Or the tumour could become weaker and easier to fight.
It’s like killing two birds with one stone. We’re putting the tumour on an “energy-restricted diet” and also keeping energy in the healthy tissue to be able to fight the tumour. And, in order to achieve this, we’re trying to find a treatment that can stop this communication between tumours and healthy organs. Isn’t this an amazing scenario? But the most amazing part of this idea is yet to come. Just imagine if this request for energy is the same across tumours from different patients. Can you see the potential of all this? More people could benefit from the same therapy!
Let’s go back now to our first question: will cancer ever be cured? In my humble opinion, there won’t be a single cure. It won't be cured with a single treatment but via a combination of therapies. What we can do is develop a treatment that puts tumours “on a diet” and thereby makes patients stronger. The stronger the patients, the better they respond to other therapies and fight back. In other words, we can develop a good therapy that could help other treatments to work better.
One last thought: we must never lose sight of the human aspect of this story. Patients are people, just like you and me, and they deserve to live healthy, fulfilling lives. This isn’t possible if they stumble as they’re getting out of a car and can’t get back in, or if they can’t climb the stairs to their bedroom without becoming exhausted.
I’ve never had cancer but I’ve lost someone very close to me to this disease and I wouldn’t wish that on my worst enemy; the pain felt by my family and myself, the feeling of being so powerless and yet needing to be strong because you’re not the one with cancer. Maybe you’ve had a similar experience or perhaps a friend of yours has.
Through our work and our small contribution, we hope to help someone avoid going through what we had to endure.
If you, like Eleonora, have a passion for innovation and a drive to make a real impact, consider taking the next step in your career with our Doctoral INPhINIT Fellowships! Join us in pushing the boundaries of science at leading universities and research centres in Spain and Portugal. The call for 2025 is now open: apply by 23 January (Incoming) or 18 February (Retaining) to start your journey to groundbreaking discoveries. Check out all the details here and take the first step towards a future brimming with possibilities.
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