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Challenge 2: Eradicate EBV Cancers
Each year 200,000 cancers worldwide are caused by Epstein Barr Virus (EBV). We want to find a way to reduce that figure to zero.
So our Grand Challenge is to:
ERADICATE EBV-INDUCED CANCERS FROM THE WORLD
Read our science blog post all about this challenge.
Around 19 in 20 adults carry the Epstein Barr Virus (EBV), making it one of the most common human viral infections.
In most people, EBV is relatively harmless, although it’s the cause of glandular fever, “kissing disease”. But in some parts of the world it’s a big problem – every year, EBV infection accounts for 200,000 new cases of cancer worldwide, and more than 140,000 deaths.
To eradicate EBV-induced cancers from the world is a grand challenge that would make a significant difference to global health, and is a fully achievable ambition.
Up to 20% of worldwide cancer cases are associated with infectious diseases, and we could prevent these cancers by eliminating the infections that cause them.
The success of the human papilloma virus vaccine, which has shown the potential to protect young girls from developing cervical cancer, shows how powerful this approach can be.
The Epstein Barr Virus (EBV) is present in around 95% of adults and is generally asymptomatic during childhood, but it can cause glandular fever in adults, with often debilitating effects.
The darker side of EBV is that it causes significant deaths from cancer in China and South East Asia, where it is associated with the development of nasopharyngeal carcinoma (NPC).
Worldwide, EBV infection is also linked with up to 15% of stomach cancers, and with Burkitt’s and Hodgkin’s lymphomas.
Certain communities and geographical locations are hotspots for the development of these cancers and EBV has been cited as important target for cancer prevention by the US National Institutes of Health.
If we are to eradicate EBV-induced cancers, we need to develop preventive or therapeutic vaccines, or drug treatments that target infected cells.
Although some promising vaccines are currently in development we could be doing more, particularly in light of recent rapid advances in research into how tumours and other cells are able to hide from the immune system.
We now have a chance to make real progress in understanding the immune recognition of EBV and of EBV-infected and transformed cells.
This challenge is not just about EBV-directed vaccination strategies, although the panel would welcome proposals aimed at developing an effective, robust and cheap vaccine that would prevent initial infection in childhood or adolescence, providing that it is distinctly different from those already being trialled.
At least two other approaches can be imagined. The first is to develop drugs, as has been done for hepatitis, to specifically kill EBV-infected cells and EBV-induced cancers. These might directly target viral oncogenes or uncloak the virus-infected cells from the immune system, for example. A second approach might be to select or engineer patient T cells to recognise viral-encoded peptide antigens presented on the cell surface by the immune system.
Novel approaches falling outside these two categories will be considered favourably. For example, understanding the factors that cause regional and ethnic differences in the incidence of EBV-associated cancers may offer alternative ways of achieving the Grand Challenge goal.
The successful team tackling this challenge is likely to integrate epidemiological studies with immunological and drug discovery approaches and we would welcome applicants with expertise in these areas but with no prior experience in EBV research.
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