How did you get started in your field?
My initial training was in medicine, then medical oncology, and I eventually became a clinician scientist, studying the evolution of melanoma and kidney cancer. When treating cancer patients in the clinic, I was frequently confronted with patients who were developing resistance to existing treatments and saw treatments fail. You can’t encounter that on a regular basis without wanting to do something about it.
I completed my PhD in the lab of Richard Marais at the Institute of Cancer Research, working on the first ever targeted treatment for melanoma. We were trying to find the genetic drivers of melanoma, and hopefully find why some melanomas are aggressive and resist treatment.
Since then, my research has always been driven by my observations in the clinic. I joined Charlie Swanton’s team as a Cancer Research UK-funded visiting clinician scientist, learning how to look at cancer through an evolutionary lens. We were able to build a great team of researchers and clinicians to develop the TRACERx Renal project, a long-term study examining how kidney cancer evolves over time.
The next step is to find the mechanisms behind the observations that we find through TRACERx. We’re starting to be able to identify patterns in the patient data, and we’re now trying to find out how these patterns come about.
What will you be working on at the Crick?
One of our main hypotheses is that the processes of metastasis – tumours moving from their original locations and spreading around the body – is fundamentally linked to the evolution of the primary tumour. If we find the mechanism by which these lethal cancer populations are supported in the primary tumour, we could identify a way to prevent metastasis or even cause tumour death.
One of my main jobs at the moment is setting up my group at the Crick. It’s been exciting to make new appointments, and to find people who are inspired by the questions that my work is trying to answer. There’s an amazing spirit of collaboration at the Crick and we’re planning on collaborating really widely across the building.
Through being at both the Crick and the Royal Marsden, I’m able to combine amazing basic science with clinical colleagues who are the best in their field, along with the wide range of clinical trials that we run on my clinical unit. We need to make sure that we are learning as much as possible from every patient, and by joining forces and working closely together, we’re hopefully minimising the number of things lost in translation – pun not intended!
Who are you looking forward to working with at the Crick?
We’re hoping to develop new kidney cancer organoids – 3D models of cancer in a petri dish that we can use to better understand cancer behaviour. They’re gradually becoming more common for other organs, but there isn’t a usable kidney organoid for cancer research.
Luckily, there’s a lot of organoid expertise at the Crick in groups like Paola Bonfanti’s and Vivian Li’s. We’re planning on making the most of these connections.
We’re also hoping to branch into single cell sequencing, and to be able to build a complete map of a tumours cell by cell. Obviously we’ll be working very closely with the Crick’s Advanced Sequencing facility, but we’ll also be taking tips from group leaders like James Turner, Kathy Niakan and James Briscoe, as well as the Crick’s in-house ‘Single Cell Club’ who regularly get together to discuss new techniques and share advice.
And finally, in an alternate universe, what would you be doing?
Honestly, there was almost an alternate universe where I stayed as a clinician and never got into research. It wasn’t my long-term plan at all.
There was even a point in my undergraduate medical degree when I really thought that medicine wasn’t for me and I was threatening to quit! I spoke to a tutor who told me that I should stick it out until I started treating patients. And he was absolutely right – something clicked the second I started working with patients.
I realised that I was able to help people and do it well. And as I developed as an oncologist, I felt that I would be doing my patients a disservice if I wasn’t doing as much as I possibly could to contribute towards new treatments through original research. We have huge gaps in our knowledge when it comes to cancer and I’m doing my best to address that.