EACR Travel Fellowships are co-sponsored by Worldwide Cancer Research and provide funds up to €3,000 to early-career cancer researchers. For more information on how to apply for Travel Fellowships, you can visit the EACR website.
Name: Vasilis Stavrinides, PhD student, clinical research fellow
Home Institution: University College London, UK
Host Institution: Johns Hopkins University, Baltimore, USA
Dates of visit: 02 – 31 October 2018
Research: MRI is a new imaging modality that is revolutionising prostate cancer diagnosis. Doctors can, for the very first time, see suspicious lesions in the prostate and confirm or exclude cancer through targeted biopsies. Interestingly, inflammation and a turbulent microenvironment are frequently present in the prostate, drive carcinogenesis and mimic tumours on MRI. The focus of my research is to characterise these entities in the biopsy-naïve prostate and find new ways of differentiating them from tumours on imaging. This research could help men avoid unnecessary biopsies and encourage us to find new ways of preventing prostate cancer.
Why did you decide to apply for an EACR Travel Fellowship?
As I am studying inflammation, stroma and cancer precursors in biopsy samples obtained during the practice-changing PROMIS trial, I wanted to collaborate with a world-leading expert in prostatic inflammation and pre-malignancy. I also needed extra technical expertise, training and support to meet my project objectives. My supervisors, Prof Mark Emberton (Prof of Interventional Oncology, UCL) and Dr Hayley Whitaker (Reader in Cancer Biology, UCL), encouraged me to contact Prof Angelo De Marzo at Johns Hopkins, who was very interested in our work. Therefore, I decided to apply for an EACR travel fellowship in order to visit his lab, have face-to-face discussions on the project and learn some of the techniques that are essential for its success.
Why did you choose the host lab?
Prof Angelo De Marzo’s group focuses on developing new insights into the molecular pathobiology of prostate cancer. The group has developed a very popular model of inflammation in prostate carcinogenesis and has published several scientific papers on the topic. In addition, Johns Hopkins is a leading research institution with state-of-the-art facilities and excellent track record in prostate cancer research. I was certain that the expertise and facilities in the lab were directly relevant to my work and, in retrospect, I believe I made an excellent choice.
Can you summarise the research you did or what you learned on your visit?
Inflammation, reactive stroma and a generally turbulent microenvironment are enablers of malignancy associated with cancer precursors and false positive MRI lesions. Part of the problem with analysing such entities in rare biopsy samples is tissue scarcity. To overcome that, immunohistochemistry (IHC) with multiple antibodies against markers for specific immune cell subsets (including memory and cytotoxic T-cells, B-cells, NK cells and macrophages), stromal components (e.g. collagen or fibroblasts) and cancer precursors (such as prostatic intraepithelial neoplasia) is essential. Relevant antibody panels that are validated for multiplex IHC are uncommon and substantial expertise is needed for producing and interpreting IHC results. The Johns Hopkins team has a very robust process of antibody validation and staining and I was fortunate enough to learn how to stain tissue using their protocols. In addition, I learned how to use a digital pathology platform to recognise epithelial cells, stroma, immune cells and other components in biopsy samples using a random forest classifier. I intend to use this knowledge during my project and hopefully keep enriching it until the end of my PhD.
Describe a ‘typical day’ on your visit
The day very often started with a cup of coffee while attending a meeting or a lecture. The Pathology Department organises regular seminars on cancer pathology that I found very educational. I was in the lab until the afternoon and regularly worked with the uropathology fellows Dr Igor Vidal, Dr Levent Trabzonlu and Dr Busra Ozbek, who took me through several lab techniques and taught me how to use digital histopathology image software. I also attended lab meetings, where research by the group was regularly presented, as well as seminars of general scientific interest. Overall, every day was really enjoyable and my time at Hopkins really helped me grow as a researcher.
Did you take part in any interesting local/cultural activities?
I would go back anytime.
The Maryland Fleet Week and Air Show took place in early October and I was amazed to see aircraft performing really jaw-dropping stunts over the city port. I saw “Charm City” at the Stavros Niarchos Foundation Parkway; this was an interesting documentary on the problems the city of Baltimore currently faces and was followed by interesting discussions between the audience and members of the Baltimore community. I also saw the Baltimore Philharmonic Orchestra performing Vivaldi, which was a great experience. Finally, I explored some beautiful bars and restaurants in the area with friends from Hopkins. Overall, Baltimore was a vibrant city and I found its character unique. I would go back anytime.
What was a personal highlight of your trip?
I was fortunate enough to attend the 6th Molecular and Cellular Characterization of Screen-Detected Lesions (MCL) Consortium Meeting. This huge team of pathologists, molecular biologists, imaging specialists and NASA engineers worked together in a truly inspiring way to deliver a massive, original research project. I attended lectures on the latest molecular and digital histopathology techniques and I met researchers from various US institutions, including MD Anderson and UCSF. It was really inspiring to see this huge effort and to witness how collaborations result in better, cutting-edge science. But also, I had fun and interesting conversations with well-respected pathologists and am very thankful to Prof De Marzo for involving me.
Did you have a personal mentor or anyone who particularly helped you?
Dr Igor Vidal, a talented pathologist and postdoctoral researcher originally from Brazil, very kindly guided me through my first days at Johns Hopkins. He also trained me in cutting-edge multiplex immunohistochemistry and digital pathology, including the application of artificial intelligence to recognise stroma, epithelia and immune cells in H&E-stained prostate biopsies. He was extremely motivating and helpful and I hope to work with him again soon.
Does your lab plan to do any future collaboration with the host lab?
We have now established a collaboration between UCL and Johns Hopkins and will exchange protocols for multiplex immunohistochemistry, as well as expertise on digital histopathology. More importantly, we are considering the possibility of exchanging tissue for analysis and I am already planning a second visit to the De Marzo lab in 2019. I believe that this work will result in very interesting findings and both parties are interested in a joint publication in the near future.
How has this visit been beneficial to your research and/or your career?
our combined expertise will propel my project forward
Obtaining this EACR fellowship was a defining moment for my PhD at UCL and my career in general. I visited a world-leading US institution, gained insight into modern digital and molecular pathology techniques and met brilliant and truly inspiring researchers. We now have an excellent professional relationship with the Johns Hopkins group and I am confident that our combined expertise will propel my project forward. Prof De Marzo also kindly supported my application for an MRC Clinical Research Training Fellowship in the UK. This was awarded to me in November 2018 and I am certain that EACR and my trip to Hopkins contributed to this achievement. I could not be more happy or grateful.