The Ella Project
Image credit: Image by allinonemovie at Pixabaya
Research led by Prof Tracy Hussell and Dr Robert Metcalf into adenoid cystic carcinoma (ACC) at The University of Manchester continues to build on the important work started by Dr David Morgan.
Today, the programme has grown into a larger collaborative effort within the Hussell Laboratory, working closely with Dr Metcalf and colleagues at The Christie NHS Foundation Trust, with one clear aim: to better understand ACC so that more effective treatments can be developed for patients.
The research team now includes postdoctoral scientist Dr Zi Zhang and two clinical research fellows, Dr Sam Rack and Miss Sian Dobbs, who are undertaking PhDs alongside their clinical training. Together, they are studying tumour samples generously donated by patients with ACC. These include both fresh tumour tissue collected during surgery and archived tumour samples that have been carefully preserved. By comparing cancer tissue with normal salivary gland tissue and blood samples from the same patients, the team hopes to understand not only how ACC develops, but also why some tumours remain slow growing while others become more aggressive through high-grade transformation.
None of this work would be possible without the generosity of patients who choose to donate tissue and blood samples for research. Every sample contributes to a better understanding of ACC and helps answer important questions that may lead to improved treatments for future patients.
One of the biggest challenges in ACC research is that every tumour is different. Even within the same tumour, there can be areas that behave in very different ways. To tackle this, the researchers are studying carefully selected regions of interest within each tumour. This allows them to compare low-grade and high-grade areas side by side and investigate what changes as the disease becomes more aggressive.
The team is even examining these regions at single-cell resolution, looking at individual cancer cells, immune cells and supporting cells one by one. Rather than viewing the tumour as a single mass, this approach reveals the different cell populations that make up ACC and how they communicate with each other. Understanding these conversations between cells may explain why some tumours evade the immune system, continue to grow or become resistant to treatment.
To answer these questions, the researchers combine several advanced technologies. Imaging Mass Cytometry helps map where different cell types are located within the tumour, while RNA sequencing reveals which genes are active in different cells. Multicolour immunofluorescence provides an even closer look at selected regions of interest, allowing the team to validate and explore important findings in greater detail. Together, these complementary approaches create a much more complete picture of how ACC behaves than any one technique could provide on its own.
A major focus of the programme is understanding how the immune system interacts with the tumour and with the extracellular matrix which is the network of proteins and supporting tissue that surrounds cancer cells. By comparing low-grade and high-grade disease, the researchers hope to understand what drives tumour progression and how these changes influence the body's immune response.
Ultimately, the goal of this research is not simply to describe ACC in greater detail, but to identify new weaknesses that can be targeted with medicines. By understanding which cells and signalling pathways drive tumour progression and allow ACC to escape the immune system, the team hopes to identify new drug targets that could lead to more effective treatments. Through close collaboration between scientists, clinicians and patients, this work is helping to build a clearer path towards personalised therapies and better outcomes for people living with ACC.
This research is part of the The Ella Project which was named after adenoid cystic carcinoma patient Ella Pinney, who was diagnosed with ACC aged 32 in March 2017. Ella fundraised for this UK-wide study focused entirely on Adenoid Cystic Carcinoma (ACC) research. It was founded in 2019 and you can learn more about it here.
Last Updated July 2026