Understanding how lymphatic vessels talk to childhood kidney cancers

Many children and young people with kidney cancers are diagnosed too late. This means that the cancer has already spread, making it harder to treat. Some patients have tumours in both kidneys, meaning they may need dialysis or a kidney transplant after the cancer is removed. New advances in cancer medicine, like drugs which target the immune system, do not tend to work for kidney cancers in children. We therefore need a better understanding of how childhood kidney cancers grow and spread.

Professor David Long’s lab at UCL Great Ormond Street Institute of Child Health has identified a potentially important player - the lymphatic system.

Made up of specialised tubes, the lymphatic vessels transport cells, molecules, and debris out of tumours. However, they can also be a way for cancer cells to spread around the body. Professor Long’s team looked at advanced 3D images of Wilms tumours, the most common type of childhood kidney cancer, and were surprised to see that there were lots of lymphatic vessels within the tumours. Crucially, they saw that more aggressive Wilms tumours seemed to have fewer lymphatic vessels, leading them to believe that the way the lymphatic system communicates with cancer cells is a key research area.

In this project, Professor Long will look at how the lymphatic system is communicating with the tumour cells, and whether these messages are different in higher-risk tumours. To do this, the researchers will map all of the molecular messages between lymphatic vessels and cancer cells in Wilms tumour. They will then add lymphatic vessels into groups of cancer cells in the lab, and modify the messages sent. This will allow them to see which messages are influencing the cancer’s growth and spread.

Finally, by linking these findings to patient information, Professor Long hopes to understand which messages between lymphatic vessels and cancer could be used to predict the outcome of children with Wilms tumour. His experiments could lead to tests for earlier diagnosis, allow doctors to predict outcomes better, and may highlight treatments that can reduce the risk of tumours recurring and spreading.