By: Laura Donnelly
Scientists have discovered a way to develop “tailor-made” cancer treatment – by testing drugs on “mini-tumours” grown in the lab.
The study by the Royal Marsden and Institute of Cancer Research found that cells taken from cancer patients could be used grow replica tumours, allowing them to keep testing drugs until they found the most likely cure.
Research on 71 patients found that testing drugs on mini tumours was 100 per cent accurate in identifying drugs which did not work for the individuals – and picked out drugs which shrank the tumours in almost 9 out of 10 cases.
Scientists said the breakthrough was “extremely promising” because major advances in cancer treatment depend on personalising medicine, and targeting specific drugs to the right patients.
They said the change could bring an end to reliance on “trial and error” techniques selecting cancer treatment, ensuring rapid access to drugs for patients facing a “race against time”.
Every patient could have mini tumours grown up and tested for drug sensitivity before starting treatment – allowing doctors to design them a personalised treatment regimen.
The new research was carried out in bowel, stomach and other digestive system cancers, published in the journal Science.
Scientists from the Institute of Cancer Research and The Royal Marsden took biopsy samples from 71 patients with advanced bowel, gastro-oesophageal or bile duct cancers, whose tumours had spread round the body, and who were enrolled in early-stage clinical trials.
They used cells from these biopsy samples to grow a mini tumour in the lab, on which 55 types of drugs were tested.
The results were then compared with how the patient had responded in the clinic.
The study found that using the mini-tumours to test the drugs was more accurate at predicting drug response than analysing the DNA code of the patient’s tumour alone.
Across all the patients, the original tumours and lab-grown mini tumours were found to be 96 per cent identical across 151 cancer-related genes – with very few new mutations since being grown in a dish.
Study leader Dr Nicola Valeri, Team Leader in Gastrointestinal Cancer Biology and Genomics at The Institute of Cancer Research, London, and a Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:
“Once a cancer has spread round the body and stopped responding to standard treatments, we face a race against time to find patients a drug that might slow the cancer’s progression and extend their lives.
“We found that recreating patients’ tumours in the laboratory using this new technique gave us an extremely promising way to predict whether a drug would work for a patient. We were able to look in incredible detail at how tumours responded to drugs – including patterns of gene activity and mutation, and even how the cancer would evolve in response to treatment.”
“We looked at tumours from patients with cancers of the digestive system, but the technique could be applied to a wide variety of cancer types. We need to further evaluate its potential in larger clinical studies, but it has the potential to help deliver truly personalised treatment – and avoid the reliance on trial and error for many patients when clinicians give them a new cancer drug.”
Study co-author Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said: “Cancers are highly complex and constantly adapting and evolving – so it is extremely difficult for doctors to know whether a particular drug will work for the patient on front of them.
“This study has shown that testing drugs on replica tumours before they are given to patients is not only possible, but predicts how a patient will respond more accurately than simply looking at the cancer’s DNA. It could predict whether a cancer will be drug resistant before a person ever receives the treatment – which is especially important for those with advanced cancers where time is so precious.”
The breakthrough could also speed drug discovery and reduce reliance on amimal experiments, he said.
Study co-author Professor David Cunningham, Director of the NIHR Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, said:
“Tackling the unpredictable nature of cancer is one of the major challenges that we hope to overcome in cancer research. The same type of cancer can differ between patients, and can also adapt and evolve within that same patient and then in response to treatment.
“This promising research moves us forward in the field of personalised medicine, and should ultimately lead to smarter, kinder and more effective treatments for patients.”
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.