Cancer Drugs Losing Out: Pruning the Branches, Not Cutting the Trees

An oncologist puts the cancer patient on a targeted therapy, the cancer goes away, patient goes home. But, 6 months later, the cancer is back (relapsed) and is aggressive stage IV. Biologically, the cancer cells have mutated to bypass/ignore the expensive targeted therapy.

At the molecular level, the cancer cells are constantly mutating, evolving, and generating diversity. This phenomenon of cancer evolution is central to cancer relapse, tumor escape and therapeutic failure.

New research from the Institute of Cancer Research, UK, shows extreme diversity of cancer cell types in leukemia patients: multiple cancers within a cancer. 


Researchers from the Institute of Cancer Research, UK, and Wellcome Trust Sanger Institute, UK, performed single cell genomic profiling where they isolated individual leukemia cells and read the genome of each cell individually.

Of the five patients with leukemia who were tested in this study, all had 2 to 10 subtypes of leukemia.

"Every patient has a completely new tree and doesn't have one cancer, they have multiple cancers," Prof Mel Greaves from the Institute of Cancer Research, UK, the primary investigator on the study, told BBC.

The key to successful cancer control is to catch cancer early when the mutation diversity is minimum and only the "trunk" mutations exist.

Potter NE, Ermini L, Papaemmanuil E, Cazzaniga G, Vijayaraghavan G, Titley I, Ford A, Campbell P, Kearney L, & Greaves M (2013). Single-cell mutational profiling and clonal phylogeny in cancer. Genome research PMID: 24056532 

SOURCE


Cancer diversity has 'huge implications.' By James Gallagher. BBC News. November 15,  2013.