World-leading NET research continues in new project

Having completed her bachelor’s degree at Alzahra University in Tehran and subsequently completed an internship at the Iranian Research Organization for Science and Technology, she moved to Sweden and Uppsala. Here, Elham Barazeghi obtained her master’s degree at SLU and then transitioned to Uppsala University and the Department of Surgical Sciences, with a focus on endocrine surgery.

“For my master’s, I conducted a project within the research group led by Gunnar Westin, professor emeritus at the Department of Surgical Sciences. That was in 2012,” says Elham Barazeghi, quickly adding, “Oh, that was a long time ago.”

It is, in fact, at the same department and research area – endocrine surgery – that she still works as a researcher.

“From early on, I was interested in cancer research. When I did my master’s project, it was in epigenetics and cancer. NET (Neuroendocrine tumours) then became the main focus, and it has continued. This group has access to one of the world’s largest tumour sample biobanks, which provides fantastic opportunities, and that made me even more interested,” says Elham Barazeghi.

First in Sweden

A while ago, she was awarded a unique grant from the Neuroendocrine Tumor Research Foundation (NETRF). The grant of $100,000 is a so-called mentor grant aimed junior researchers in the field. According to Peter Stålberg, Professor at the Department of Surgical Sciences and a colleague in NET research at Uppsala University, the allocation is not only unique for Uppsala University but for Sweden as well.

“From what I’ve seen, it’s a unique allocation. Elham is the first in Sweden to receive this grant,” he says.

“I didn’t know that,” says Elham, both surprised and amused, before continuing. “It’s the largest grant I’ve received, and it means that I now have the opportunity to start my own project.”

The project is called ‘Epigenetic Regulation of Tumor Metastasis in Small Intestinal Neuroendocrine Tumors’. The aim is to understand the mechanisms behind the development of metastases, or secondary tumours. In fact, 70 per cent of all patients with small intestinal NET have metastases at the time of their cancer diagnoses.

“Therefore, the goal of the project is to identify and understand the mechanisms that initiate metastasis development, so that in the future, we can disrupt it and prevent metastases in patients. My focus lies in the epigenetic changes, that is, to see what changes or modifications occur in the DNA between the primary tumour and metastasis,” explains Elham Barazeghi.

“Patients usually have different primary tumours and even one or a few different metastases. So, the idea is to look at primary tumours and compare them with metastases to find the changes that are unique between them. If we can identify the genes that drive the change, we can hopefully find a solution. Thanks to our unique material in the form of our biobank and access to advanced technology via SciLifeLab, we have the opportunity to conduct such a project.”

NET in the small intestine is a difficult-to-detect and relatively rare form of cancer. Approximately 200 new cases are detected in Sweden each year, and many affected individuals have only vague symptoms such as abdominal pain and perhaps occasional diarrhoea. It is often at the time of diagnosis that patients can reflect and connect their symptoms to cancer, which then indicates that they have had tumours for perhaps five years.

“The main goal of Elham’s project is not primarily to see why this particular type of cancer is difficult to detect. That might be a spin-off later on, but here the aim is rather to find markers in the tumours and then find so-called ‘targets’ for more effective treatment once the cancer is detected,” says Peter Stålberg.

Decades of successful research

Elham Barazeghi’s project is one in a series at Uppsala University in NET. It also builds on the long and proud tradition in the field that Uppsala University and Uppsala University Hospital have together.

“Research at Uppsala University has largely been world-leading in the field, as the research line began in Uppsala in the late 1970s. From the start, the research has been led by visionary individuals who, as early as 1979, began collecting samples in the biobank that we are reaping the benefits of today – even though they didn’t quite know what would become of it then. Thanks to good succession and strong support from both Uppsala University Hospital and Uppsala University, everything has expanded to the point where we now have three research groups focusing on NET and also have a developed lab that we can share,” says Peter Stålberg.

Since 2009, Uppsala University Hospital has also had the Uppsala Centre of Excellence for Endocrine Tumors, which has enabled the hospital to stand strong in competition with others.

“The Centre of Excellence here in Uppsala was one of the first four in Sweden, and today we are one of five. Among other things, it contributed to funding new positions in the field. I myself am here today because I got the opportunity to research during paid working hours as a surgeon. We are also the only hospital in Sweden certified as a European Neuroendocrine Tumor Society (ENETS) Centre of Excellence since 2007. Both Uppsala University Hospital and Uppsala University have been receptive and realised that NET research is worth investing in, which has allowed us to be strong compared to other hospitals.”

For Elham Barazeghi, who undoubtedly represents a continuation of a strong NET tradition at Uppsala University, at least two exciting years of research into the epigenetics behind metastasis development await. If she succeeds in finding the answers sought, it could lead to faster diagnoses and, not least, better treatment.

“The idea of ​​looking at primary tumours and metastases in the same patient has previously been part of a study from Gothenburg. In that one, they saw that only one of the primary tumours had overlapping DNA mutations with the metastases, but not the others. In our new study, the idea is instead to compare the epigenetic mechanisms of primary tumours with each other and see if we can find a unique change in one of them that, in turn, corresponds to the metastases. I believe that we can find that change, and then we are one step closer to being able to disrupt or prevent the onset of metastases,” says Elham Barazeghi.

Robin Widing