31 Mar 2025

Research Blog: Lessons from Down Under

Blood cancers are a growing global challenge, particularly due to the nature of their progression, challenges in detection, and the lack of staging. One country that sees a particularly high incidence of blood cancer is Australia. A recent study from Australia (i) has highlighted just how serious the situation is: according to this study, by 2035, blood cancers are projected to become the most prevalent and deadly form of cancer in Australia, with incidence rates also projected to double. This is only a projection, of course, but this does not negate certain fundamental issues when it comes to treating this blood cancer.

This alarming trend is also not limited to Australia. In the UK, blood cancers already represent the 3rd leading cause of cancer deaths, with more than 40,000 people diagnosed each year. The UK also seems to be reflecting an increase in incidence of leukaemia, although this is not as severe as the Australian projections: Leukaemia European age standardised (AS) incidence rates for females and males combined increased by 15% in the UK between 1993-1995 and 2017-2019.(ii) However, whether this increase has plateaued or is continuing to rise is presently unknown due to the lack of new data points. Nonetheless, as research from Australia underscores, urgent investment in research and clinical trials is the key to changing the trajectory of this disease worldwide.

Why Are Blood Cancers Increasing?

Some of the biggest challenges with blood cancers—including leukaemia—are that they are typically non-hereditary, cannot be screened for in the general population, and often develop spontaneously. Scientists do not yet fully understand why incidence rates are rising so rapidly particularly in Australia, which makes research into causes, prevention, and treatment even more critical. Although incidence rates are not as shocking in Europe, blood cancers still set a significant challenge in terms of early diagnosis and treatment. The study from Australia highlights three key areas that must be prioritised to fight blood cancer:

1. Investment in research to tackle high-mortality blood cancers.
2. Translation of research into practice through clinical trials and collaboration.
3. Building a strong research workforce to drive innovation in treatment and diagnostics.

These priorities align closely with Leukaemia UK’s mission to support early-career researchers, fund innovative studies, and accelerate the discovery of better treatments for patients. Early career researchers usually focus on fundamental or discovery research which builds the foundational knowledge that underpins applications. Driven by curiosity, rather than pursuing a specific application or commercial outcome, makes this group of researchers an important group to invest in.

Australia’s research strengths in blood cancer biology, applied genetics, and clinical trials have led to world-changing breakthroughs, such as the discovery of G-CSF (used to stimulate blood cell production)(iii) and Venetoclax(iv), a targeted drug that has transformed treatment for chronic lymphocytic leukaemia and acute myeloid leukaemia (AML).

These breakthroughs do not diminish the significant advances made in the UK and around the world; rather, they build upon them. The UK has been at the forefront of blood cancer research, contributing to major developments such as the discovery of rituximab – the first monoclonal antibody treatment for B-cell lymphoma(v), and the pioneering of CAR-T cell therapy(vi, vii), offering life-saving options for patients with aggressive blood cancers.

The global nature of research is evident in the support Leukaemia UK receives from around the world. One of our supporters from Australia recently reached out to fund innovative research into juvenile myelomonocytic leukaemia (JMML), a rare and aggressive childhood leukaemia characterised by the overproduction of monocytes and myelocytes due to mutations in the RAS signalling pathway. This funding underscores the need for international collaboration in tackling rare and complex blood cancers. Jodie’s family, for instance, tragically lost their firstborn son, Eli, to JMML just six weeks after his first birthday on the 16^th of November 2008. In his memory, they have dedicated themselves to funding JMML research wherever it is needed—including here in the UK through Leukaemia UK. Their efforts also extend to creating a space for families navigating childhood cancer diagnoses and supporting vital tissue and cell donations, which are crucial for advancing research and finding a cure.

Addressing Inequalities in Access to Treatment

Wherever Australians live, regardless of their social or cultural background, they have a right to expect access to quality treatment and care. However, existing patterns of care disproportionately disadvantage rural and remote communities. Patients in these areas face geographical isolation, limited access to advanced diagnostics and treatments, and often higher out-of-pocket costs. These disparities increase the risks of delayed diagnosis, fewer treatment options, and limited specialised care. Understanding how patients can best navigate the system and receive psychological and social support is crucial for both routine care and breakthroughs in blood cancer research.

This situation closely resembles the postcode lottery in the UK, where access to cutting-edge treatments like CAR-T cell therapy varies dramatically by location. Despite the NHS’s goal of equitable care, rural and lower-income areas often face longer waits, fewer clinical trials, and reduced specialist treatment centres, creating disparities that impact survival rates. Addressing these inequalities is essential to ensuring every patient, regardless of postcode, has access to the best possible care.

The Importance of Early Detection

Early detection and diagnosis have improved outcomes in solid tumour cancers such as breast and colorectal cancers. However, their impact on blood cancers has been minimal to date. Unlike solid tumours, blood cancers often present with vague, flu-like symptoms, making them harder to diagnose in the early stages. Research into better early detection methods—such as blood biomarkers, genetic screening, and artificial intelligence-driven diagnostic tools—is critical to improving survival rates.

At Leukaemia UK, we are dedicated to funding research that will lead to better treatments and, ultimately, a cure. One of our key goals is to double survival rates for AML by 2035, one of the most aggressive and difficult-to-treat blood cancers. This aligns with Australia’s mission of ‘zero preventable deaths by 2035 from blood cancer,’ and both countries share the vision of making significant strides towards this goal.

Supporting the translation of research into practice—through funding and clinical trials—will make a big difference. This requires continued investment in research from the early stages to clinical trials, and ensuring a skilled workforce so that access to important treatments such as CAR-T is not a postcode lottery or rarity. By tackling these disparities head-on, we can work towards a future where all patients, regardless of location, have equal access to life-saving treatments.

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References:

(i) RESEARCH ROADMAPFOR BLOOD CANCER 10-YEAR RESEARCH ROADMAP TO ACCELERATE BLOOD CANCER RESEARCH IN AUSTRALIA – https://www.leukaemia.org.au/wp-content/uploads/2024/10/5-August-AAS-Research-Roadmap-for-Blood-Cancer.pdf

(ii) https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/leukaemia/incidence#:~:text=incidence%20rates%20for%20females%20and,%2D1995%20and%202017%2D2019.

(iii) https://csiropedia.csiro.au/granulocyte-macrophage-colony-stimulating-factor-discovery/#:~:text=The%20factors%20responsible – Accessed 20/03/2025

(iv) https://biomelbourne.org/australian-protein-discovery-leads-tablet-melts-away-blood-cancer/ – Accessed 20/03/2025

(v) Pierpont TM, Limper CB, Richards KL. Past, Present, and Future of Rituximab-The World’s First Oncology Monoclonal Antibody Therapy. Front Oncol. 2018 Jun 4;8:163. doi: 10.3389/fonc.2018.00163. PMID: 29915719; PMCID: PMC5994406.

(vi) https://www.ucl.ac.uk/cancer/research/ucl-car-t-programme – Accessed 20/03/2025

(vii) https://www.uclh.nhs.uk/news/new-car-t-cell-therapy-gives-hope-patients-aggressive-blood-cancer – Accessed 20/03/2025