Professor Kirill Alexandrov
Can you tell us what your name is and what research grant you have from NBCF?
My name is Kirill Alexandrov and I am a recipient of the innovator award of the National Breast Cancer Foundation.
What made you decide to focus your research on breast cancer? Do you have any connection with the cause?
Yes, I do have a personal connection to the cause, because several years ago my wife found a lump in her breast and it was a very difficult time for us until all the tests were done and the results came in, and I started thinking back then that there must be an easier way from the diagnostics and there must be a way where the patient has greater control and greater access to her information.
Can you tell us broadly, what are some of the problems women with metastatic cancer experience face, and what are some of the limitations of the current treatments?
Well there are always two sides of the treatment, there’s the diagnosis and there’s actual treatment, and there’s no second without the first, and what we found out several years ago, and we’re saying broadly – scientists in the cancer field – is that cancer is very diverse so a lot of individual diversities. So it is important for patients and for their treating doctors to understand what cancer they have, how it is progressing, what is changing, how it responds to treatment, the more information, the more real-time information we can get, the more control you have over the situation.
So how is your research aiming to address this problem?
So we are a lab with molecular engineering, so we’re essentially applying engineering principles to biology, so what we’re trying to do is create molecular switches which recognise tumour markers in patients’ blood and rapidly convey this information through the electronic devices, so we really want to make diagnosis of many diseases, particularly breast cancer as simple as it is now for diabetes. Twelve/thirteen years ago, if you wanted to measure your blood sugar, you actually had to go to a hospital and be hooked up on a large machine the size of a fridge. Now you can do it just by pricking your finger and putting a little blood on your mobile phone, and that’s where we see diagnostic going, that’s the technology we’re developing, and we believe that will be of great benefit to the patients and their treating doctors.
The aim of our project, and this is particularly in application to the patients who have already been treated and they’re in remission, and there are significant periods of time where there is uncertainty, whether their remission is complete or there can be a recurrence of cancer, so what we’re trying to develop is a blood test which is sufficiently simple for individuals to use at home, so you can prick your fingers for a bit of blood on the chip, and then you will see the result of this data, it will be sent to your clinician and hopefully that can be done within five to ten minutes. So that will allow patients to have certainty that they have been sufficiently, frequently monitored and will give much better control and resolution to the clinicians and similar technology applies also to the case of a patient who’s undergoing treatment to see whether the cancer markers are receding or whether the treatment is actually working.
So what’s the impact on the quality of life for someone with breast cancer if this research is successful?
There are two impacts, one is patients’ much greater control over their condition, and of course being a patient and not being able to access and understand what is going on is very traumatising. Secondly, we will have the ability to have much more time, particularly patients who are not living next to the hospital, in a remote location and don’t have the possibility of travelling, or it’s difficult for you to travel to the hospital, you can basically do this test at home and you just transmit the data by their mobile phone. So there is a significant benefit for remote locations, for remote communities.
So what do you think is the biggest challenge facing you as a breast cancer researcher?
So for us, it’s the ability to put together a truly interdisciplinary team because we need biochemists, protein engineers, electronic engineers, and computer scientists to work with the data that we generate, and we need to be really good at several different things, and we always need to maintain that within a team, the work provided us with an unusual finding to show that those principles can work, and converting those concepts into devices, clinical trials and finally the product.
How important is NBCF funding to achieving your research goals?
The innovator award from NBCF was critical for us, because without that, we couldn’t have started this project, and it was a very innovative idea and we probably wouldn’t have been able to do this research going through standard funding routes of academic research funding because that requires a significant amount of preliminary data, it never funds just ideas. That is where the innovator award has a big advantage for funding ideas, rather than expand and build on the results of our predecessors.
To what extent could more funding accelerate your research goals?
As I mentioned the key for us is to have multi-disciplinary teams, we’re putting a lot more effort into early prototyping and testing. I think now we’re really at the stage of product principle and design and basic sensory components, but creating much earlier prototypes and testing them on clinical samples.
What are the next steps?
Well the next steps are demonstrating that the technology that we developed has the sensitivity, and can perform within the time windows that are relevant for the point of character diagnostics, and that’s what we’ll be spending the next fourteen months on, basically benchmarking the performance of this technology against other technologies and seeing how small and how faster and how cheap this application can be.
If you’re talking about lifespans of projects, for this one, which is developing a diagnostic tool, what are the sort of stages, going from a concept like that hypothesis that you’ve got now, to actually seeing a product in market, what’s the sort of timeframe?
So in the development of the test, there’s obviously several phases. There’s the lab phase, where you just demonstrate that the concept/principle can work. In our case, that the biosensors that we develop can detect the cancer’s DNA in a solution. The next step is sensitivity, the robustness of the sensors can work in the patient’s blood or other bodily fluids, and then there’s a whole range of testing against the existing technology. How does this technology compare to others? Is it more sensitive? Is it faster? Is it cheaper? Then finally there’s the stage of prototyping where you create a prototype which looks similar to the device that may be used later in the clinic or in the field, and then there’s clinical trials where you test the number of patients with known conditions, and we monitor them using the new methods and the existing methods. So typically, the diagnostic development is actually faster than the drug development, so something from as fast as two years, realistically probably something between two and four years, depending on our parameters in trying to achieve, and how difficult it is.
What do you think has been the biggest breakthrough in breast cancer research today?
Well I think the biggest breakthrough in breast cancer was the realisation that the breast cancer’s not one disease, that it’s a collection of diseases, there are dozens of types and they develop differently and they have to be treated differently and they have to be diagnosed to make informed decisions. That was a revelation in the last ten years that will transform the way we see cancer, the way we treat cancer and the way we associate an individual and his or her disease, and that will lead us to our personalised medicine and personalised way of treating breast cancer.
Do you believe we’re on our way to seeing zero deaths from breast cancer by 2030? That’s our aspirational goal.
Yeah. I think having zero deaths by 2030 is a great goal, and in a world of technology changing so rapidly and accelerating so much, that we will see a transformation in the way we diagnose and treat cancer. We probably will come to the stage where cancer will be a condition, not a death sentence, so in the sense, you know, I think if not perfectly there, but very close in the next two decades, it will become a manageable condition.
Do you have anything you’d like to say to our supporters or fundraisers or donors?
Yes, I think the National Breast Cancer Foundation is doing a great job promoting its cause and supporting cancer research, and I would like to thank everybody who contributed and participated and who made an effort to support breast cancer research, and as we see, that translates in the real world.