Breast Cancer ESMO 2025 Highlights: MonarchE, NATALEE, VIKTORIA1, evERA, DESTINY, ASCENT, TROPION

7-0-2 Weekend Breakfast Healthy Living Living Time to get the show on the road and we start with our healthy living conversations. I'm really encouraging, really exciting news coming out of South Africa. I'm always in awe of the kind of work our researchers and scientists do. It's cutting edge, it's world leading. And the latest bit of work that's now being done here is we've been able to see or scientists in this country have been able to try and understand how it is that cancer evades the immune system. And a person that can tell us about it is the professor of scientific computing and physical chemistry at UCT who led on the study. Kevin Nidu joins us on the line this morning. Kevin, a very good morning to you. Thank you so much for your time. Very good morning to you and good morning to your listeners. Yeah, before we get into what sounds like really, really exciting research, I'd like you to please explain to us until this research that we now have this information, what did we understand about cancer? What were I guess the knowledge that we had, but also the knowledge we just didn't have about cancer? Yeah, so I think that firstly if you just dial back, I'm just going to take you through a short little journey for the last 20 or 30 years, is that cancer is generally thought of and known to be a disease in which your genes mutate that causes this, if you like, malfunction in the way that your cells form in certain organs. And so there's been a lot of focus on genomic studies and we've in fact done a lot of work on that as well in had some critical trials to attempt to see where we can figure out what was going on and what the deep cause of these problems were. But a big part of what was missing was the focus on the molecular changes that happened on cell surfaces that make them different, that make tumor cells different from normal cells. And a lot of people around the world have started working on this, it becomes an open area of study and study in the area called glycobiology. And it's called glyco because the big changes that happened on the cell surfaces are changes in carbohydrates or glycans and biology is called protein. And these glycans play a very important role. They play a very important role because they figure a whole lot of mechanisms that make our cells and these tumor cells evade immune systems and build an infrastructure, if you like, that eventually overwhelms whatever organ they've started on. And so we have a lot of expertise in carbohydrate chemistry and the way that it's all built. And so we decided to focus on the cell, I'll stop there for the minute and just see if you follow where we are going with this. I'm following. So in the instance of these, you said they called glyco, glyco, what did you call it? Glycans, yeah. Glycans, these sort of carbohydrates. How do they behave in a, and I'm putting this in quotation marks in a normal cell. So a cell that hasn't had any mutations, it isn't about to develop cancer or tumor. How do those glyco cells perform normally under normal, I guess, optimal conditions? Yeah. So in the healthy cell or normal cell, these glycans are, if you like, draped around a particular protein and the protein is called musin. And it acts as a defense mechanism in a lot of, as I said, if you think of organs like for example, you're in test time, there's a lot of material that moves down your test time or if it's breast, there's breast milk, for example, that moves down the tubes in the breast and all kinds of organs have these functional tools. So channels, they were things happen. The coating around that channel is called a epithelium. And on those epithelial cells, such these musins, that if you like, act as a warning signal, if there's some foreign body coming in to those tubes, it will cause harm to the organ. And so those foreign bodies could be, for example, back here, they could be viruses, they could be a toxin. And when that happens, it activates your immune system. And you know what happens if you expose to a bacterial virus, you'll get, let's say, a temperature or you feel pathogenic or whatever the case may be. Now, in the case of tumors, these happen, these are our own cells that start, if you like, the SBAV. These tumors don't do that. They don't activate your immune system as we normally expect some sort of, at an end kind of behavior to do. And the way that one of the big things that happens is with these musins or these glycans, and they instead of having their normal sort of very lengthy shape, they have a shortened shape. In some cases, they, instead of activating the immune system, they overwhelm the immune system, getting it to a sort of state of high-plane inflammatory sort of status. And that thing, if you like, allows them to hide from the immune system, and these tumors just grow and they grow rapidly and lots of other kinds of things that they do are very different to normal cells. And often, the problem with cancer, they call it the silent killer, is that it's there for a very long time, you're not aware of it that it's there, unlike other things that happen to your body that you're aware of. And you often find it been a bit too late because the tumor, for example, is going to such an extent that it bumps up against something else and you see, feel a pain, but it's not, the pain that you feel will be because it's going to such an extent that it's like interfering with a neighboring organ, or actually, you know, touches your nerve cells or something like that. Yeah. And so, Kevin, if I'm understanding correctly, Professor, so these cells, right, the Mews and One, these glycans, were so in the case of cancer, it sounds as though normally they would work almost like a panic button or like an electric rinse, that if something is foreign, something is perceived to be a threat, that soon, you know, the glycans will trigger the alarm system. So your body will know something's happening in your chest, something's happening in your stomach, something's happening in your throat. In the case of cancer, that alarm system just doesn't work. It doesn't trigger, it, your electric rinse doesn't ring, the alarm doesn't ring. And only when, like you just said, maybe something else gets impacted. So say you have a tumor, but now it's affecting your liver or your, you know, your stomach. Only then do you kind of get a warning that something has happened, but the cancer is there, it's just hiding and the defense system is basically immobilized, it's unable to work. Yes, yes. And so in fact, effectively what has happened is that it, you know, the difference between normal cells and human cells is that normal cells have a lot of biochemical constraints that allows them to behave in a normal way. But also for example, they won't grow beyond a certain known number. So for example, your liver cells don't keep on growing and growing and your liver just expands, right? It'll stop at some point. Whereas tumor cells don't have this trigger. So that's why they just, for example, they proliferate, they just keep on growing and they keep on building very complicated systems, even a sort of a little network of their own that they invade your blood vessels because they need an excessive amount of all kinds of forms of glucose and oxygen and to help them grow. And so they just, if you like, building a whole sort of colony on their own alongside your body, but the problem is that because it's part of your body and it's found a way to hide from the rest of your normal triggers, it's. you know, it just grows uncontrollably and then it starts spreading to other parts of your body, which is the test and overwhelms you eventually and shuts the shutdowns of your diet. Yes. But they are, I mean, we are working, we're not the only ones, I mean, we're working on this internationally, there are lots of other people working on it as well. What we have done though is just drawn a lot of attention to these particular kinds of cells, which if you like, starts a lot of the processes. And the reason why that's important is that, you know, if you're one with to develop any you know, any form of therapy or any kind of system to diagnose whether somebody's got cancer or not very early on. And the way that we normally do it is that, you know, if something happens to you, then you'll have let's say a bunch of scans like a cat scan or somebody will ever, you know, try and look at you with X-rays or whatever to see, there's some kind of abnormal growth in your your body. But that's a visual scan, right? And when it gets to the point where you can actually see it, it's often too big. Because if a tumor gets to the point of being, let's say around five centimeters or something like that, then it's quite a big system already, because you can see it. And so there are a lot of attempts now to see whether we can develop ways to look at the molecular changes rather than the large cellular changes. And the molecular changes is something like for example, the new sun one that we're looking at yet. So if you can pick up those molecular changes early on, you can develop biomarkers, for example. You can also use those same changes to build sort of muted forms of muson that is effectively a vaccine. So you can build a vaccine sort of so that the big push is to find ways to build cancer vaccines. So that your body sort of becomes in a way and it's very much aware of even this change that's been hiding it at nose exactly what it looks like. And then it pulls antibodies and it can start attacking the tumor by itself. And then you can also build drugs. So that's finding the difference between what is healthy and what is disease is very important in the whole sort of ecosystem of not only therapeutic development, but diagnostics and all of those kinds of things. So what we've done here is sort of find that the mechanism that differentiates normal or healthy versus disease will cancer tumor states. Yeah, because that was going to be my next question, Professor, that this discovery of the work that you've done really does feel as if it moves cancer treatment, cancer treatment development and care a little bit further because we have a better understanding of how the disease works. And if we know a little bit better how it is working, then we can respond to it better. It feels like the kind of thing that's not just great for obviously the works being done in South Africa, but it feels like the kind of research that can be of huge use to research your scientists experts all over the world. Absolutely, we would like to we'd like to believe that it's the Earth's Earth's Earth's Earth's and hopefully you know, this draws attention to where we should place our focus. In South Africa, unfortunately, this whole area of glycovalidies is not very well focused on, but it is a burgeoning field internationally. And you know, there's large centers and organizations being set up to study this particular kind of molecular biology for life. And in South Africa, we hope that more people will sort of place a focus on this. You know, internationally, we part of the international, if you like, movement to get greater attention being placed on molecular changes rather than just very large cellular or organism changes. And you know, molecular changes are important because they give you a lead to, as I said, developing drugs or vaccines or any one of those things. And so yes, I mean, I'm not a medical scientist. I'm a fund more, if you like, fundamental scientists, but we've got a nice thing about fundamental science is that we we've got a lot of tools that we can use to analyze a complex problems like this. And that's in fact what we've seen yet. And Professor, so now that you've identified these musin and these altered sugars that, you know, allowed tumors to evade detection, they triggered the process of turning a normal silent cancerous one. What would be the next step in terms of the research? Is there something else that what we know now, what you've discovered through your work that you're going to apply it to kind of move it, I guess move it forward. Yeah, so this is, if you like, a series of projects that I started working on 10, 15 years ago. And it's in fact the very first one that's out the gate. Before that, what we were doing is building lots of tools to help us do what we just did now. And the next step now is one of the other projects, the other projects that we're working on is to build a combined, a computational model so that we can understand the complex network of all, if you like, you can take everybody as a bunch of billions and billions and billions of chemical reactions that even exorbit as I'm speaking now, this is what's happening, lots of reactions, working to make me do what I want to do. But in the case of tumors is to understand what those complex thousands of reactions are doing at the same time to achieve a greater goal of the progression of tumors. So for that, you need a lot of data and you need to build a lot of data to build those complex models and that's one of the things we're working on. The other part that we're working on is to fine tune and to understand exactly where these changes have occurred and we've done a better network in this project because when we understand exactly the location of the, if you like, linchpin change, then we can then develop what is called precision metal, medicine tools. So precision medicine is a change in the medical sciences thinking that not all of us have, if for example, you get breast cancer, there's various kinds of breast cancer, right? Or colon cancer, the same would be the case, or long times of cancer. So what we try to do is look at the differences in the subtypes, if you like, of in this case, we mostly looked at breast cancer because it's one of the big good killers who in South Africa. And so we will we understand the molecular constructs of the different subtypes we can then start to work on specific pathways towards vaccines or therapeutic. So that's in fact what we're doing. So we're branching out in a couple of areas. A question before we wrap up our conversation professor, Dee and the Easter eggs says good morning, Gorgs and good doctor. I want to ask, can cancer hide in such a way that even a doctor can miss it? How rife are the possibilities? I'm asking because we lost a family family member from cancer recently and they had no idea, even with the constant medical checks. It was a rough three months before they death, even confirming that it was all clear, meaning nothing cancerous was found in their body, though they had mentioned some suspicions of cancer a year also before then. That's a question from Dee in Easter and about, is it possible to miss cancer altogether until it's too late for the patient? Yeah, there are certain kinds of cancers that are very difficult to detect. In fact, my late life passed away from a cancer that that started my entire interest in this area. That went undetected for a very long time. All the signals were there, but the medical profession didn't have the tools to detect it at the time. So when I say, when your caller asks, can it go undetected years or can, but there are many cancers that we can detect. There are lots of tools available to a medical profession where they can see those changes. So for example, if you go over blood tests, they might look for certain markers in your blood that is an indication that there's a molecular change. And once again, what I was saying earlier is that molecular changes are there and that's a very, you should indication early on that something is going wrong. And so then you can monitor their changes and look for other associated changes that will tell you that there's a possibility of a particular kind of cancer on a particular organ. So we only as effective as the tools that we have to combat diseases. And the trend and the urgency now is to discover what is called liquid biopsies. And liquid biopsies are taking a blood sample where you see these molecular changes in people's blood systems and then you can catch them early on. But some cancers like, for example, pancreatic cancer, like for example, some forms of cancer can go undetected because they sort of hide internally. And obviously at once they can't take it. And that's what's very important to go for the liver checks would be sort of breast cancers, prostate cancers, colon cancers. These are the big ones that keep South Africans. And not only South Africans, but worldwide. Many women in slightly different ways. But if you go through these kinds of checks for those kinds of cancers, it's quite easy. It's relatively easy once again if you have access to, you know, top-class medical care, which many South Africans don't simply have. But then that can, you can detect it in this way. But other cancers like as I said, pancreatic cancer, which is very, lots of famous African cells, have passed on because of things like that. Can be very difficult to detect. Thank you so much for giving us your time this morning. And thank you for sharing your incredible research with us. Thank you very much. Thank you, Prof. that is Professor Kevin Nguyenu, Professor of Scientific Computing and Physical Chemistry at the University of Cape Town, doing some groundbreaking research in cancer research. Coming up, we talk naturediary and we are going to the Othosha National Park, that's in Namibia, we'll speak to Willy Olafir, who is a seasoned traveler in Southern Africa and in author. We'll be joined as always by our resident CSI and nature conservationist Tim Neri, but first it's 25 minutes before 7 o'clock. Let's check in with your latest eyewitness news support, without any shader.