By Guillermo Velasco
Associate Professor of the Department of Biochemistry and Molecular Biology I, University Complutense of Madrid and member of the board of directors of Observatorio Español de Cannabis Medicinal.
The second International Symposium on Translational Oncology of the Hospital Clínico San Carlos took place on May 18th, 19th, and 20th. It should be noted that the symposium was made possible by the support of various sponsors, especially the CANNA Foundation. On this occasion, due to the special circumstances in which we find ourselves, the event took place in a virtual format. Notwithstanding this, the congress had remarkable levels of attendance, with more than 150 registered participants. As in the first edition, this second meeting was aimed at strengthening translational research in oncology and especially facilitating the connection between clinical research and basic research.
If the COVID-19 pandemic has shown anything, it is the importance of strengthening basic research, but also of transferring the scientific findings obtained as a result of that research so that they can lead to the development of clinical trials and - ideally - to the approval of new methods for the diagnosis or treatment of diseases. Unfortunately, cancer, or to be more precise, the numerous types and subtypes of cancer, are themselves a real pandemic that affects millions of people in the world.
Therefore thousands of basic researchers focus their efforts on trying to understand why sometimes one or very few cells in a human being escape the surveillance and control processes of the organism and transform into tumour cells, acquiring the characteristics that allow them to form malignant lesions and invade other tissues. Likewise, many of the studies developed by these researchers analyse the possible weak points of these cancer cells or their environment so that more specific and effective therapies can be designed to combat them. On the other hand, a legion of health professionals — oncologists, but also doctors from other specialities and other health personnel — participate in a plethora of clinical studies that analyse the efficacy of new treatments and/or new biomarkers, many of them derived from the basic studies I referred to above. These two worlds have a common goal, but very different methodologies and approaches, and sometimes even very different languages. Strengthening the connection between them is critical to ensure that new ideas and potential improvements in diagnosis and treatment are delivered to patients sooner and more effectively.
In this context, this second edition of the translational oncology congress has served as an excellent platform to further knowledge exchange between basic and clinical researchers.
One of the examples of translational research in oncology that has been specifically discussed at the symposium is the use of cannabinoids in the management and treatment of cancer. There are numerous basic, preclinical, and clinical studies that have shown the potential of marijuana derivatives to alleviate the symptomatology associated with cancer and aid its treatment. Likewise, although at a less advanced stage of their development, numerous preclinical studies - some of them developed by our research group at the Department of Biochemistry and Molecular Biology of the Faculty of Biology of the Complutense University of Madrid - have shown the anti-tumour potential of THC, CBD, and some other cannabinoids.
In this congress I had the opportunity to present an overview of the studies developed by our group and other researchers over the last 20 years, which have allowed us to understand the molecular mechanisms by which cannabinoids act on tumour cells. Starting with the video on the Endocannabinoid System, (which you can see here), I was also able to summarise another series of studies of a more translational character: these laid the foundations for the development of clinical studies in which the activity of THC and CBD in cancer patients, in combination with other anti-tumour agents, is being analysed. At the moment, said clinical studies derived from basic and translational research are focused on patients with glioblastoma (the most common type of brain tumour and one of the most aggressive forms of cancer). Although these are currently clinical studies with a small number of patients and need to be confirmed by larger studies, the initial results are promising and support the idea that THC and CBD could help to improve the effectiveness of the treatment currently used for the management of patients with this type of tumour. During the talk I also addressed the question of the existence of possible markers of response to cannabinoid treatment that could contribute to the development of individualised therapies aimed at those patients or types of tumours in which a positive response to cannabinoid treatment is more likely. The congress gave the opportunity to discuss these findings with other basic researchers as well as with clinical researchers of great prestige in the field of oncology. In my opinion, the dissemination of these results in a forum with this format contributes to give visibility to cannabinoids within the medical and scientific community, and may, therefore, increase interest in the development of more clinical trials and lay the foundations for the use of these compounds for therapeutic purposes, and specifically for the management of the oncology patient.
The congress was structured in several sessions, each of which focused on analysing advances in the diagnosis and treatment of a group of tumours. At the end of each session there was a very interesting panel discussion. Despite having to develop the debates in online format, in all sessions there were very enriching discussions that allowed the incorporation of the point of view of the basic researcher in the context of the latest advances in the treatment and diagnosis of cancer patients. In addition to the potential use of cannabinoids as anti-tumour agents, it is worth mentioning the discussions that took place regarding the usefulness of treatments based on reactivating the immune system as a very promising therapeutic strategy in the treatment of some types of tumours.
The symposium was attended by many prestigious Spanish and foreign researchers, whose presence contributed to the high scientific standard of all the sessions. In any case, and in order to keep this to a brief summary, I would first like to highlight the awarding of a prize to Dr. Mariano Barbacid for his scientific career in oncology. Dr. Barbacid is one of the Spanish researchers who has contributed most to the development of oncology in our country, and his career is a clear example of how basic knowledge (Dr. Barbacid participated in the discovery of the first "oncogenes", genes whose alteration leads to the development of cancer) can promote translational studies of great relevance.
I would also like to highlight the closing talk given by Sir Philip Cohen. He is a speaker whom I am particularly excited to have participate in our symposium, as I was lucky enough to work in his laboratory at the University of Dundee, Scotland, during my postdoctoral training. Dr. Cohen's career (he is one of the most outstanding European scientists of the last decades, which earned him, among many other awards, the title of Sir in 1998) has focused on the study of the post-translational modification of proteins. His work has laid the foundations for the use of a series of drugs called "kinase inhibitors", which are among the most widely used in advanced cancer treatments. In his lecture, Dr. Cohen reviewed the history of the development of these compounds on the 20th anniversary of the approval of the first of them, imatinib (a chemical tyrosine kinase inhibitor that revolutionized the treatment of chronic myeloid leukemia by selectively inhibiting the aberrant protein Bcr-abl, which is frequently present in these tumours).
In summary, despite having to be held in an online format, this second Hospital Clínico San Carlos Symposium on Translational Research in Oncology has fulfilled its objective of contributing to strengthen communication between basic and clinical researchers and disseminating the latest advances in the treatment of different types of tumours. We hope that the third edition can be held in person and that more advances in oncological research can be presented, including those related to the possible use of cannabinoids in cancer patients.
