Understanding Resistance to Cancer Treatment

11 Sep 2023

Understanding resistance to cancer treatment

Did you know that resistance to cancer treatment is a significant barrier to achieving long-term survival for people with cancer?

Some people with cancer may not respond to treatment from the outset, and others may respond to treatment initially, yet, over time, that treatment can become less effective.

Understanding the reasons for resistance to treatment will help to improve cancer treatments and extend survival.

During Blood Cancer Awareness Month (September), one of Can Too Foundation’s funded early-career researchers, Dr Joshua Tobin, shares his research.

Dr Tobin is an early-career cancer researcher at the Mater Research Institute, University of Queensland, and is interested in understanding why people with a particular type of blood cancer, follicular lymphoma, become resistant to chemotherapy. The following is a brief overview of Dr Tobin’s project – its importance, the research, and anticipated impact.

Importance of the project

Follicular lymphoma is a type of blood cancer that develops in specific white blood cells known as lymphocytes. The normal function of lymphocytes is to fight infection and disease to keep you healthy. Abnormal lymphocytes that form tumours can avoid detection by our immune system, enabling cancer to grow unchecked. Over 1,500 people will be diagnosed with follicular lymphoma each year in Australia1.  

According to Dr Tobin, ‘although many patients with follicular lymphoma initially respond to therapy, the inability of the immune response to remove cancer cells can lead to treatment resistance. Treatment resistance leads to early progression of disease and affects survival, with only half of those with treatment resistance surviving beyond five years of diagnosis.’

Dr Tobin’s research focuses on understanding this resistance so treatments can be developed to redirect the immune system towards the lymphoma cells and extend the time to disease progression.

Research plan

Previous research conducted by Dr Tobin has shown that the immune response within the tumour itself, known as the tumour microenvironment, influences survival. In the study, an increased immune response was associated with an extended time before the cancer progressed. In contrast, lower immune responses were associated with a shorter time until the cancer progressed2.

In the current project, Dr Tobin will build on this knowledge and explore the reasons for these different immune responses within the tumour microenvironment. He is particularly interested in understanding how the tumour cells change the way the immune system processes fuels like fats and sugars. Repairing this may improve the immune system’s ability to recognise cancer cells and help prevent treatment failure in people with follicular lymphoma.  

Anticipated impact of the project

Through this project, Dr Tobin will ‘identify novel metabolic and immune pathways that drive the progression of disease in people with follicular lymphoma’.

‘The knowledge gained from this project will help guide treatment decisions and clinical care, with the identification of biomarkers that can be used to predict patients at high risk of progressive disease.’

‘The findings will also provide insights into how the immune response can be improved, through existing or new therapies, to increase survival for people with follicular lymphoma’. 

For more information on Can Too and lymphoma:


1The incidence of follicular lymphoma in Australia was calculated based on data obtained from the Australian Institute of Health and Welfare, Cancer Data in Australia Web Report, AIHW Website, accessed 7 August 2023. Follicular lymphoma accounts for 25-30% of all non-Hogkin lymphoma cases (with an estimated 6,635 diagnosed in 2022). 

2Tobin JWD et al., (2019) Progression of Disease Within 24 Months in Follicular Lymphoma Is Associated With Reduced Intratumoral Immune Infiltration. J Clin Oncol 37(34):3300-3309. doi: 10.1200/JCO.18.02365.