In addition to the Sjöberg Prize, where 9/10 of the prize money is reserved for research purposes, the Sjöberg Foundation has in 2020 made decisions on grants totaling approximately SEK 57 millions. This sum includes SEK 4 millions for continuation of the project initiated in 2017 concerning the national network for cancer research and uniform patient reviews for the whole country, see: Grants 2017, National collection of valuable data from cancer care, and one million to a project, MEGALIT, at Uppsala University, which evaluates the effects of existing cancer medicines on patients where conventional treatment has not yielded results. In addition, A non smoking generation has been awarded SEK 1,500,000 in business support.
Individualised treatment for metastatic prostate cancer
Currently, once prostate cancer has metastasised, it is no longer curable. Pernilla Wikström’s research group is characterising metastases from prostate cancer that has spread to the skeleton, with the objective of finding treatments that can eradicate the metastases and allow more people to survive the disease.
Pernilla Wikström, professor at the Department of Medical Biosciences, Umeå University, has discovered that skeletal metastases from prostate cancer can be divided into three main groups: Met A, Met B and Met C. Only Met A responds well to conventional treatment for metastasised prostate cancer, which stops the production of testosterone. This treatment is less effective against both Met B and Met C.
Pernilla Wikström, along with Anders Bergh, professor of pathology at Umeå Universitet, and Andreas Josefsson, specialist physician in urology and researcher at the Wallenberg Centre for Molecular Medicine at Umeå Universitet, will now receive five million kronor from the Sjöberg Foundation for continued studies of metastatic prostate cancer, and to find pharmaceuticals that are effective against more types of metastases. They will also develop a method for characterising skeletal metastases using blood samples.
This method utilises the way that tumour cells are released by skeletal metastases, ending up in the patient’s blood. The research group has isolated these cells and proven that they reflect the cells found in the skeletal metastases. They will now improve this method so it captures more cells from the blood. One long-term aim is to be able to culture the patient’s cancer cells in the laboratory and test different treatments on them. This would allow treatment to be optimised for each patient, hopefully helping more people survive this disease.
Mid Sweden University
Can wilderness activities improve the wellbeing of young cancer survivors?
Childhood cancer survivors often have poorer mental health than their healthy siblings. Miek Jong will now conduct a pilot study on the implementation of a wilderness programme, with the objective of investigating how time spent in nature can affect these young cancer survivors wellbeing and self-esteem.
Cancer is a terrible disease, one which leaves few people unaffected. In addition to a higher risk of recurrence, childhood cancer survivors are more likely to have thoughts of suicide, live more sedentary lives and have a poorer quality of life than their siblings who have not had cancer.
Previous studies have indicated that wilderness therapy can help improve these young cancer survivors’ wellbeing. Time spent in nature appears to reduce anxiety and improve self-esteem. Miek Jong, associate professor at Mid Sweden University in Sundsvall and professor at the Arctic University of Norway in Tromsö, will therefore receive 900,000 kronor for a pilot study in which she will continue to investigate the potential of wilderness programmes.
The project will include 40 cancer survivors aged 16–30, who will be divided into two groups. One group will spend a week in nature and perform wilderness activities such as climbing, hiking and canoeing. The other group will have a holiday week at a hotel with spa facilities. After three months, the groups will meet for follow-ups and to reconnect, and will be followed for another nine months to see how their health is affected. The primary objective of the study is to explore the prerequisites for a larger randomised and controlled study to evaluate the effects of wilderness activities, as well as to learn more about the wellbeing of childhood cancer survivors.
Bespoke treatment will save more children with brain tumours
One in four children who get the brain cancer known as medulloblastoma are affected by a lethal recurrence. Fredrik Swartling is developing methods for the study of cells from children’s tumours in laboratory animals or in minimal cell models of the brain. The objective is to optimise the children’s treatment so that the entire tumour is eradicated.
Every year, around 15–20 Swedish children get a malignant brain tumour called medulloblastoma. Usually, the tumour is surgically removed and the child undergoes radiotherapy and chemotherapy. This cures the majority of the children, but in 25–30 per cent of these cases the disease returns and, when it does, there are no effective treatments.
In order to provide more individualised treatment and eradicate the entire tumour, Fredrik Swartling, associate professor at the Department of Immunology, Genetics and Pathology at Uppsala University, is developing methods for culturing the children’s cells in his laboratory. The objective is to study the effects of different treatments on these cells, and he will now receive three million kronor from the Sjöberg Foundation so he can continue this work.
So far, he has succeeded in getting the tumours to grow in mice, where he discovered a specific cell, SOX9+, which probably drives some recurrences. The long-term aim is to develop minimal artificial models of the brain, organoids, in which the cancer cells can grow. His research group can use these to test the effect of many different pharmaceuticals, investigating which cells survive and can cause the cancer to recur. If they succeed in experimentally developing personalised treatments that eradicate all the tumour cells in the children, the hope is that their lives can be saved.
Can an endogenous protein be beneficial in treating cancer?
Antisecretory factor is an endogenous protein that has numerous health-promoting effects. Peter Nygren will now investigate whether the protein could be useful in treating cancer, both by reducing the increased fluid pressure in tumours and by counteracting the serious diarrhoea that chemotherapy can cause.
Antisecretory factor (AF) is an anti-inflammatory protein, which can regulate how much fluid flows through tissue and counteract diarrhoea. Because this protein has several useful qualities, researchers have developed a special form of rolled oats, SPC-flakes, which increase the endogenous production of AF. They have also succeeded in getting hens to lay eggs that are rich in AF. A powder made from these eggs, Salovum, has proven useful against infant diarrhoea and inflammatory bowel diseases.
Peter Nygren, consultant and professor of oncology at Uppsala University, will now receive 2.7 million kronor from the Sjöberg Foundation for two different studies to investigate whether SPC-flakes and Salovum can be beneficial during cancer treatment. In one study, he will investigate whether Salovum can counteract serious diarrhoea caused by chemotherapy. In the other, he will investigate whether a combination of Salovum and SPC-flakes can prevent diarrhoea in people undergoing chemotherapy for bowel cancer. He will also investigate whether consuming SPC-flakes and Salovum can reduce the high fluid pressure in tumours, which could increase the inflow of pharmaceuticals into the tumour. The hope is that the study’s results will lead to more effective cancer treatments with fewer side effects.
Ersta Sköndal Bräcke University College
Can person-centred care increase quality of life for stem cell recipients?
A stem cell transplant can cure blood cancer, but is a treatment that is physically and mentally challenging. Carin Lundh Hagelin and her colleagues will develop a procedural model to help care staff provide more person-centred support during this treatment, based upon the needs of the patients and their relatives.
In an allogeneic stem cell transplant, the patient receives new stem cells from a donor. The objective is to cure blood cancer, but it is a long process with an uncertain outcome. The patient must stay isolated for several months to avoid infections, and there are often post-treatment complications.
If the patient and their relatives are to remain as well as possible throughout the entire transplantation process, it is important that care and support are provided according to their individual needs. Carina Lundh Hagelin, a registered nurse and associate professor at the Department of Health Care Sciences, Ersta Sköndal Bräcke University College, will now receive four million kronor from the Sjöberg Foundation to develop a procedural model that will help nurses lead this person-centred care.
This procedural model includes systematic questions that the charge nurse can ask, starting a conversation to capture the needs of the patient and their relatives and then, using this as a basis, provide care and support self-care. Knowledge about how to use the procedural model will be disseminated to care staff using web-based education. If the study shows that it improves quality of life for patients and relatives, the hope is for it to be used at Swedish clinics that conduct stem cell transplants.
Can more people survive blood cancer by using an existing pharmaceutical?
In acute myeloid leukaemia (AML), a common form of blood cancer, the cancer cells often become resistant to chemotherapy. This leads to high mortality. Nikolas Herold will investigate whether he can undermine the cancer cells’ defences against chemotherapy by using an existing pharmaceutical: hydroxyurea.
Only one in three people with acute myeloid leukaemia (AML) live longer than five years. This high death rate is partly because the cancer cells are or become resistant to cytarabine, a chemotherapy that is currently one of the best weapons that doctors have against the disease.
By mapping the cancer cells in detail, Nikolas Herold, researcher at the Department of Women’s and Children’s Health at Karolinska Institutet, has discovered that an enzyme that naturally occurs in the cancer cells, SAMHD1, breaks down the chemotherapy. The more SAMHD1 the cancer cells produce, the less impact the cytarabine has on the cancer, which significantly reduces the patient’s chance of survival.
Nikolas Herold will now receive a grant of three million kronor from the Sjöberg Foundation to investigate whether hydroxyurea, a cheap and well-tested pharmaceutical, can inhibit the effect of SAMHD1. In animal trials, he has proven that a single course of hydroxyurea is enough to improve survival among mice with AML that are also treated with cytarabine. This treatment combination will now be tested on patients who have been diagnosed with AML. The project will be conducted as a cooperation between Sweden’s seven university hospitals. The hope is that it will significantly improve survival rates for AML.
How does treatment for stomach ulcers affect the risk of oesophageal cancer?
Adenocarcinoma of the oesophagus is the most rapidly increasing form of cancer in several countries, although doctors do not understand why. As part of a Nordic collaborative project, researchers will now investigate whether antibiotic treatments for Helicobacter pylori, a bacterium that can cause stomach ulcers, could be contributing to this increase.
The stomach ulcer bacterium Helicobacter pylori was discovered in the 1980s. Since then, antibiotic treatments that eradicate these bacteria have become increasingly common. This not only cures stomach ulcers, but also reduces the risk of stomach cancer.
However, the question is whether it could sometimes be important not to treat Helicobacter pylori? Studies have shown that the bacterium not only has negative effects, but also that it provides protection from adenocarcinoma of the oesophagus. This is a serious form of cancer that has significantly increased in recent decades, by as much as 8 percent per year in some countries. Could all the antibiotic treatments of Helicobacter pylori be contributing to this increase?
Jesper Lagergren, professor of surgery at Karolinska Institutet, will now receive four million kronor from the Sjöberg Foundation for a Nordic research project that will answer this question. If the researchers’ suspicions are confirmed, it may lead to recommendations to avoid eradicating Helicobacter pylori in people who have cell changes in the mucosal lining of the oesophagus, a condition called Barrett’s oesophagus. This is a precancerous stage of oesophageal adenocarcinoma. Preserving Helicobacter pylori may reduce the risk of this cancer developing in people with Barrett’s oesophagus.
Can an app support recovery from oesophageal cancer?
Increasing numbers of people now survive oesophageal cancer, but the treatment leaves many of them with lifelong problems. Pernilla Lagergren will develop an app that can help patients manage the potentially negative consequences, with the goal of increasing their quality of life.
Treating oesophageal cancer often entails removing most of the patient’s oesophagus, and chemotherapy and radiotherapy are often also necessary to cure the disease. The extent of this treatment can cause many side effects, such as difficulty eating, reflux, gastrointestinal problems and severe fatigue. Recovery therefore takes a long time for most patients.
To discover how rehabilitation from oesophageal cancer can be improved, Pernilla Lagergren, professor of surgical care science at Karolinska Institutet, has followed 420 people who have had the disease. As part of the project, called OSCAR, these patients have answered hundreds of questions and generated a huge volume of new information.
She will now receive five million kronor from the Sjöberg Foundation. This will be used for an analysis, aided by artificial intelligence, of the vast quantity of data gathered via OSCAR. The objective is to use the results to develop an app that can support patients’ self-care and indicate when they should contact healthcare services. For example, the app can provide advice on lessening reflux by sleeping with a raised head, or that a daily walk counteracts tiredness and low moods. The hope is that the app can help patients enjoy better quality of life and also reduce the need for medical care.
What is the best way to still thirst in seriously ill cancer patients?
Seriously ill cancer patients often feel thirsty, with many experiencing the thirst as severe. Maria Friedrichsen will investigate the best way to still this feeling of thirst for people who find drinking by themselves difficult and who are receiving palliative care.
Thirst is a torturous feeling if it cannot be satisfied. Despite this, it is a disregarded problem in the research into seriously ill and dying cancer patients. For example, there is little knowledge about the ways in which different pharmaceuticals affect the feeling of thirst and how cancer patients experience thirst. Currently, healthcare staff moisten the mouth of a thirsty patient with a flannel dipped in water, but no one knows whether this is an effective treatment.
Maria Friedrichsen, associate professor and nurse at the Centre for Palliative Expertise, Region Östergötland, will now receive three million kronor from the Sjöberg Foundation, allowing her to search for more knowledge about the best ways of managing thirst in palliative cancer care. Which factors affect the feeling of thirst? How do patients experience it? What ethical dilemmas may care staff face when treating thirst?
Maria Friedrichsen will also investigate the best ways of stilling thirst in seriously ill patients. Should the fluid be cold or at room temperature? Is sparkling water better than still? Is an ice lolly better than cold carbonated water? The objective is to be able to provide the best possible quality of life for the patient at the end of their life.
New therapy for difficult to treat skin cancer
Survival rates for malignant melanoma have increased significantly, thanks to immunotherapies. However, not all patients benefit from these, particularly not those with uveal melanoma. Jonas Nilsson is developing a new form of immunotherapy that will hopefully eradicate these hard to treat tumours.
In immunotherapies, doctors activate the body’s immune cells in a variety of ways, so they can attack and eradicate tumours. When these therapies work, they are extremely effective and can even cure metastatic cancer.
However, tumours are frequently resistant to immunotherapies, and uveal melanoma, which develops in the eye, has proven to be very difficult to treat. Jonas Nilsson, professor of experimental cancer surgery at the University of Gothenburg, will now receive a grant of five million kronor from the Sjöberg Foundation for a project in which he combines knowledge from different forms of immunotherapy, including CAR-T cell therapy, to develop a more effective treatment.
The objective is to isolate specific immune cells, tumour-infiltrating lymphocytes (TIL), from patients with difficult to treat malignant melanoma. Using modern tools for genetic engineering, his research group will then insert a protein in immune cells, helping them recognise and attach to the tumour cells. When the immune cells are once again injected in the patient and encounter a tumour cell, they are optimised so that their ‘killer instinct’ wakes to life. The hope is that a clinical trial for this treatment, CAR-TIL, can begin in the autumn of 2022.
Will develop a screening test for gyneacological cancers
Many more people would survive if ovarian cancer could be detected at an earlier stage. Karin Sundfeldt is therefore developing a screening test for gynaecological cancers, which can be used at the regular checks that women already undergo for cervical cancer.
Ovarian cancer is an insidious disease, often only making itself known once it has spread throughout the abdomen, by which time the prognosis for the patient is very poor. Karin Sundfeldt, consultant and professor of obstetrics and gynaecology at the University of Gothenburg, is developing a screening test that will allow earlier detection of both ovarian and uterine cancers.
The test is based upon the way that tumour cells release fragments of their DNA, circulating tumour DNA, when they die. These DNA fragments travel through the fallopian tubes and uterus down to the cervix. Karin Sundfeldt has previously shown that it is possible to extract tumour DNA from fluid biopsies of the cervix and uterus. She can then map the DNA fragments and identify specific mutations that drive the development of cancer.
She will now receive four million kronor from the Sjöberg Foundation to optimise the test, making it more sensitive. She will also search for more cancer-promoting mutations, making it possible to find as many different cancer cells as possible. The objective is to be able to undertake a large-scale trial of the test in 2022-2023, and hopefully it can then be included in the cervical screening to which all women over the age of 23 are called.
Searching for a method to treat a highly lethal cancer
Adenoid cystic carcinoma grows slowly, but often spreads and has a high mortality rate. In order to save more patients, Göran Stenman has spent the last ten years successfully unravelling the molecular mechanisms of this disease. The aim is now to identify drugs that effectively kill the cancer cells.
Adenoid cystic carcinoma (ACC) arises in various glands in the body, in the head and neck, upper respiratory tract, lungs, breast, skin, and prostate. It often spreads and, because there is no effective treatment for metastatic disease, the majority of patients die of their disease.
About a decade ago, Göran Stenman, professor of pathology at the University of Gothenburg, discovered that ACC is driven by a mutation in a specific cancer gene, MYB. Since then, his research group has clarified the molecular mechanisms that drive the growth of this cancer and identified substances that can inhibit the effect of the MYB oncogene. Using one of these substances, they have successfully treated tumours in two different animal models of ACC.
Göran Stenman will now receive three million kronor from the Sjöberg Foundation to further explore the molecular mechanisms responsible for ACC. In partnership with a research group in Münster, Germany, he will continue to search for new substances that can inhibit the effect of MYB and other activated signalling pathways in ACC. Substances that are shown to be effective in animal models of ACC will then be tested on patients in a clinical trial, with the hope that more patients will survive the disease.
Can a common allergy medicine increase cancer survival rates?
Effective, cheap and free of side effects – this is a dream come true for cancer treatments. Håkan Olsson will now investigate whether a common allergy medicine – desloratadine – may be what makes this happen.
When Håkan Olsson, professor of oncology at Lund University, investigated what affects breast cancer mortality, he made a surprising find: people with autoimmune diseases seemed to have more chance of surviving. Why? After investigating the link more closely, he discovered that a medicine taken by the patients – an antihistamine called desloratadine – was probably the explaination.
Desloratadine is a pharmaceutical that is cheap and, in principle, free of side effects. It is also used to treat common allergies. Since his first important discovery, Håkan Olsson has shown that people who take desloratadine (and the related pharmaceutical, loratadine) appear to have an increased chance of surviving many forms of cancer. The studies indicate that the effect is at least as great as that of many existing treatments, but with the advantage that desloratadine also appears to help against cancers with high mortality rates.
Håkan Olsson will know receive four million kronor from the Sjöberg Foundation to take this discovery one stage further. He will use a clinical trial to test the effect of desloratadine on patients with pancreatic cancer and metastatic breast cancer. If this treatment works as well as the preliminary studies suggest, it could revolutionise the treatment of many types of cancer.
Can an anti-inflammatory protein help treat glioblastoma?
Glioblastoma is an aggressive form of brain cancer. Peter Siesjö will now investigate whether an endogenous protein called antisecretory factor can reduce inflammation in the tumour and thus help more people survive.
Only three percent of people with glioblastoma are still alive after five years, because this cancer has proven to be extremely difficult to treat. One reason is that chemotherapy drugs have difficulty entering the tumour’s tissue, which is inflamed and accumulates fluid inside and outside its cells. This causes high pressure inside the tumour and probably pushes away the chemotherapy drugs.
Peter Siesjö, consultant and professor of neurosurgery at Lund University, will now receive four million kronor from the Sjöberg Foundation to investigate whether antisecretory factor can be used to reduce the harmful inflammation in glioblastoma. This is an endogenous anti-inflammatory protein that is already used to treat other inflammatory conditions, including meningitis and inflammatory bowel disease.
Peter Siesjö has shown that antisecretory factor can reduce fluid pressure in glioblastoma tumours in animal trials, making it easier for chemotherapy drugs to enter the tumour. Treatment becomes more effective and over 80 percent of the mice survive the disease. If this treatment works equally well on humans, it will be an enormous breakthrough, saving the lives of many more people with glioblastomat