Advanced Cancer
Genetic Diversity of Cancer Cells
In advanced cancer and metastasis, malignant cells spread within normal cells, making comprehensive and complete treatment very challenging. In addition, a common characteristic of therapeutic relapse and resistance has emerged in the wake of the widespread adoption of targeted therapies. Genetically heterogeneous populations of cancer cells are likely to evolve and dynamically interact with one another. This underlying intra-tumor genetic heterogeneity provides a substrate for the development of resistance to targeted therapies.
Many early cancers are curable.
Today, due to the development of diagnostic method such as endoscopy and CT scanning, we can find cancers in early stages. Many of them can be surgically removed or completely eliminated by a drug and or radiation therapy. These curable cancers are called early cancers.
What is advanced cancer?
In many cancer patients, cancer cells are hidden among normal cells or lymph nodes, avoid early detection and therapy and later, start growing again. Sometimes, cancer cells spread through blood vessels and start growing in other organs. For example, colon cancer often metastasize to the liver, breast cancer to lung, and prostate cancer to the bone. These 'metastasized" cancers are called advanced cancer.
Why they are advanced cancers resistant to treatment?
Tumors consist from many cancer cells. Recent studies suggest that even early cancers produce several types of cancer cells that can have a variety of gene mutations. Although an anti-cancer drug may be effective against many cancer cells, resistant cancer cells remain and may start to aggressively grow again.
Can we identify these divergent cancer cell types?
Rapid advances in a technology called "single cell analysis" is bringing new information to advanced cancer treatment. Using cancer cells circulating in blood, or from biopsy specimens, we can now precisely identify the cancer cell types and select the most effective combination of therapeutics.
How can we most effectively treat and cure advanced cancer?
Traditionally, oncologists remove wide regions of tissue bordering a tumor or increase cytotoxic drug dosages to fight cancer. In most cases, these treatments exacerbate pain and suffering and decrease the quality of life of the patient. Today we can target unique cell surface markers on a cancer cell and deliver a treatment modality or a combination that could comprehensively cure the advanced cancer.
The Cupid and Psyche system is providing a novel approach to a comprehensive cure for advanced cancers.
References:
• A Review of Precision Medicine
Haendel, M. A., Chute, C. G., & Robinson, P. N. (2018). Classification, Ontology, and Precision Medicine. The New England journal of medicine, 379(15), 1452–1462. doi:10.1056/NEJMra1615014 PMID 30304648.
• Intratumor Heterogeneity
Bedard, P. L., Hansen, A. R., Ratain, M. J., & Siu, L. L. (2013). Tumour
heterogeneity in the clinic. Nature, 501(7467), 355–364. doi:10.1038/nature12627
PMID 24048068.
• Genetic Diversity of Cancer and its Effects
Roerink, S. F., Sasaki, N., Lee-Six, H., Young, M. D., Alexandrov, L. B., Behjati, S., … Clevers, H. (2018). Intra-tumour diversification in colorectal cancer at the single-cell level.
Nature, 556(7702), 457–462. doi:10.1038/s41586-018-0024-3 PMID 29643510.