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Fran Balkwill

Fran Balkwill is head of cancer and inflammation at the Institute of Cancer at Barts and The London School of Medicine and Dentistry

When Fran Balkwill needed material for her PhD experiments on leukaemia in 1973, she simply went down to the ward to bleed the patients. Though she doubts she鈥檇 be allowed to do that today, it was this early contact with patients that was instrumental in cementing her career choice. 鈥淭he immediacy of actually dealing with patients was very important to me,鈥� she says. 鈥淚t made me want to do something closely related to cancer treatment.鈥�

Today she does just that. Jointly funded by Barts and Cancer Research UK, Balkwill is investigating the link between cancer and inflammation, translating ideas from the lab into clinical trials.

鈥淪ome people think of cancer as just a ball of genetically altered cells growing out of control,鈥� says Balkwill, 鈥渂ut it鈥檚 not 鈥� it鈥檚 a rogue organ.鈥� Alongside the malignant cells, she explains, cancers are more often than not made up of a whole host of other components, including inflammatory cells and mediators.

This micro-environment around cancer cells is a crucial factor in allowing cancer to spread. 鈥淭he inflammatory cells you find in the cancer are more likely to be there to support it, to help it grow, rather than as a host response to beat it,鈥� she says. Through targeting supporting cells along with the malignant ones, novel therapies could emerge and existing treatments greatly improved.

Balkwill鈥檚 career path has taken her through some unusual and sometimes tragic events, most notably the death of her PhD supervisor Gordon Hamilton-Fairley, one of the world鈥檚 leading oncologists, in an IRA bombing. 鈥淚t was a very strange time,鈥� she says, 鈥渁nd I was on my own quite a bit.鈥� But the experience forced her to learn how to work independently 鈥� a skill that has proven useful throughout her career.

Balkwill had originally been set to go to medical school, but felt uncertain about this career choice. Fortuitously, this coincided with the inception of a new course in cellular pathology at the University of Bristol. Established by the distinguished pathologist Tony Epstein, the course focused on practical work and set Balkwill on the path to research.

Epstein鈥檚 ability to tell stories would also be influential. 鈥淗e really conveyed the excitement and the serendipity of science,鈥� Balkwill recalls. Indeed, telling stories about science is something Balkwill does rather well herself. 鈥淚 had two young children and I wanted to explain to them what I did during the day,鈥� she says. 鈥淚 thought there must be fabulous picture books on cells, and I was completely flabbergasted that there weren鈥檛.鈥� Since then she has written over a dozen popular science books for children.

Balkwill鈥檚 talent for communicating science was this year rewarded with an OBE, not just for her books but also for her role as director of Centre of the Cell at Barts. An exciting new interactive science centre for children, it鈥檚 鈥減robably the only one in the world housed right in the centre of a research building鈥�, she says.

Getting to where she is today has not come easily, and it can be all too easy to give up on a career in science when times get tough, says Balkwill. So it鈥檚 a question of being persistent, then reaping the rewards. 鈥淪cience can be extremely frustrating,鈥� she says, 鈥渂ut it鈥檚 never boring鈥�.

Chris Torrance

Chris Torrance is the chairman of Horizon Discovery, a drug discovery company in Cambridge

X-men aren鈥檛 just fictional mutant superheroes. Ask Chris Torrance, head of Horizon Discovery. To him, 鈥淴-MAN鈥� means 鈥淕ene X 鈥� Mutant and Normal鈥�, which is the name of his company鈥檚 product 鈥� a range of mutant cell lines with potentially lifesaving powers.

Horizon Discovery is a young business that provides cancer researchers working in personalised medicine with pairs of cell lines that are genetically identical, or isogenic. The only difference between the two lines, Torrance explains, will be a specified gene 鈥� call it gene X. One line has a normal copy and the other a mutant version, which causes a disease. 鈥淏ecause they are otherwise isogenic, we have a definitive view on how this mutant gene causes the disease, and a tool to find novel drugs that selectively kill it,鈥� he explains. This is important information in the field of personalised medicine, he says, 鈥渨here the idea is to get the right drug in the right patient, based on the genetics of their specific cancer鈥�.

聯The idea is to get the right drug, based on the genetics of the cancer聰

Horizon Discovery is exciting because commercialising these cell lines has never before been possible in human cells. 鈥淚n the past it鈥檚 been very hard to get patient-predictive cancer models in the laboratory,鈥� says Torrance. That鈥檚 because getting the mutations to truly resemble those you see in the body requires a very specific gene-engineering technology.

This is the technology that Torrance鈥檚 company is built around. 鈥淲e are the first and only company that can actually take a human cell line grown in a laboratory and genetically engineer it to create very specific disease models.鈥�

Torrance believes it was a year spent in industry, during his undergraduate degree at what is now Sheffield Hallam University, that whetted his appetite for drug discovery. After he completed a PhD in diabetes, his growing interest in cancer lead him to Johns Hopkins University in Baltimore, Maryland, where he spent six years learning the techniques of human cell engineering and their uses in drug discovery.

To successfully target pharmaceutical companies with his idea, Torrance felt he needed more time in industry. So he went to work for biotech firm Vernalis for five years, gaining insider experience, before following his dream and finally going solo.

鈥淐ancer is not caused by one gene that goes wrong, it鈥檚 generally three or four,鈥� says Torrance, which is why he is now looking towards X-MAN2 鈥� using combinations of targeted drugs for a patient-specific, multi-faceted attack on cancers.

Though it was just over a year ago that Torrance left Vernalis to start Horizon Discovery, his new company already is doing well. Branching out on your own involves an element of risk, but so far his investment has paid off. 鈥淚 love doing science and trying to make a difference doing science,鈥� he says, 鈥渁nd I can do that more than ever by running my own company.鈥�

Ruth Plummer

Ruth Plummer is a clinical professor of experimental cancer medicine at the Northern Institute for Cancer Research (NICR), Newcastle University

In Ruth Plummer鈥檚 line of work, it pays to tread carefully. 鈥淵ou don鈥檛 take anything into the clinic that doesn鈥檛 look as though it鈥檚 got promise,鈥� she says, 鈥渂ut you don鈥檛 know anything for certain, so you can鈥檛 be too optimistic with people.鈥�

At the NICR, Plummer spends much of her time working on early-stage clinical trials. Her caution is justified. Unlike in the well-publicised TeGenero incident, in which six healthy young volunteers in a phase I drugs trial were left fighting for their lives, Plummer鈥檚 patients are already extremely ill. Suffering from incurable cancers, they have tried all available treatments before looking to the clinic for hope. So although these trials seek primarily to establish dose and side effects, 鈥渢he best possible outcome of a phase I trial for a patient is that they get clinical benefit, that the treatment shrinks their disease or stabilises it so that they feel well and can get on with having a good quality of life鈥�, says Plummer.

Having studied at both the universities of Cambridge and Oxford, Plummer returned to her home town to finish her professional qualifications in cancer drug development at Newcastle University. She has now worked at the university for 13 years and knows many of her patients extremely well. Sadly, some don鈥檛 last long in the trials but others visit each week for years 鈥� something Plummer never quite gets used to: 鈥淭here are always patients who catch you out, ones you get more fond of.鈥� The bigger picture, however, is encouraging. 鈥淭he best outcome is that we help move forward the development of a useful anti-cancer drug, helping lots of patients,鈥� she says.

Alongside the trials, Plummer practises as a clinical oncologist, helping patients battle melanoma and sarcoma. She also supervises students and handles the administrative side of her research.

With three degrees and boundless energy, Plummer is certainly inspirational. Yet not all jobs in cancer trials require this level of expertise. Indeed, some don鈥檛 require a degree at all. For the role of data manager, for example, skill in handling data and a good grasp of the clinical trial process is more important than a degree. Then there are research nurses 鈥� oncology nurses who have undergone additional training. They are instrumental in the preparation of trials and the design of studies, says Plummer.

Working with terminally ill patients can be a challenge, Plummer admits, but it isn鈥檛 a bleak one. 鈥淭he patients are absolutely fantastic. These are people who know they are dying and say, 鈥業鈥檇 like to try this, I鈥檇 like you to offer me some hope, and I鈥檇 like to feel I tried to do something to help,鈥� so it鈥檚 a really positive unit to work in.鈥�