3 new technologies add to the precision of cancer treatment

Release date: 2015-11-16

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Malignant tumors seriously endanger human health, and their morbidity and mortality are rising. According to the "2014 China Cancer Registration Annual Report", in 2010, there were estimated 3.09 million new cases of malignant tumors and 1.96 million deaths. At present, the main clinical treatment of malignant tumors is surgical chemotherapy and radiotherapy, but it is difficult to achieve satisfactory results, and traditional radiotherapy and chemotherapy has obvious toxic side effects on the human body, such as bone marrow suppression of gastrointestinal reactions, rash and hair loss.

Therefore, in recent years, a new term has attracted the attention of scientists and clinical experts, that is, precise treatment, that is, anti-tumor molecular targeted therapy - targeting over-expressed tumor cell molecules, thereby inhibiting excessive proliferation and infiltration of tumor cells. At the site of metastasis, it has little specific damage to normal cells. Several new technologies have also provided new evidence for this precise treatment:

New three-dimensional cell culture technology

A tragic current state of cancer treatment is that the treatments used are highly toxic and their effectiveness is unpredictable among different patients. Researchers from Harvard Medical School, Bayesian Women's Deacon Hospital Cancer Research Center, used a new three-dimensional cell culture technique to amplify and culture new cancer cell organs from pancreatic cancer patients. This technology allows researchers to directly use patient tissue for targeted research and rapid and economical individualized drug testing.

The most important feature of this technique is the ability to directly use the patient's own tissue rather than the experimental cell line for organ-like organ culture, and these organs can well preserve the pathological morphology and biological mechanism of the patient's tissue. In this study, the researchers also found that tumor-like organs can retain the sensitivity of the patient's tissue itself to new agents in vitro.

From a research perspective, this method of culturing tumor-like organs enables us to effectively establish a living tissue bank of organisms. This library of living tissue can be used to discover and validate new drugs, simulate and study the resistance of targeted drugs. If we use a group of patients' tumor-like organs to study the relationship between drug reactions and genetic mutations, it is possible to understand why some patients respond effectively to the drug while the other patient is unable to respond effectively to treatment. As a result, we are able to avoid unnecessary and ineffective treatments for patients. From a clinical point of view, this approach can help patients and physicians choose treatment options more effectively.

Olaparib targeted drugs

Olaparib is the world's first approved drug-targeted cancer mutation targeting drug. It has been proven to benefit up to one-third of prostate cancer patients, many of whom do not inherit the oncogene, but their tumors have acquired DNA repair. defect.

In this trial, called TOPAP-A, 49 patients with advanced prostate cancer were treated with olaparib, and 16 of them (33%) were defined as having a response to the drug through a set of clinical criteria.

Olaparib prevents prostate cancer growth, leading to a persistent decline in prostate specific antigen (PSA) levels and a decrease in circulating tumor cell counts in the blood. Through genomic testing, this clinical trial found that 30% of advanced prostate cancer male tumor DNA repair systems are defective - these patients responded particularly well to olaparib.

Of the 16 patients with detectable DNA repair mutations, 14 responded well to olaparib – the vast majority of patients benefiting from this drug. Most of these men have advanced prostate cancer, and their treatment options are limited, and their disease control time is much longer than expected in this group of patients.

These results led to the initiation of the second part of the trial, TOPAP-B, which allowed men with prostate cancer carrying detectable DNA repair mutations to receive olaparib. If the results are successful, olaparib may be a standard treatment for advanced prostate cancer and men with DNA repair mutations.

CRISPR/Cas9 Technology

The CRISPR/Cas9 system is popular all over the world, and its application in cancer research and treatment is in full swing.

According to Tyler Jacks of MIT, the CRISPR-based genome project will become an important link between the experimental platform and the sickbed, bringing cancer biology to a new era. Using this technique to comprehensively analyze patient tumors, individualized cell and animal experimental systems can be established. Researchers can quickly find genotype-specific weaknesses and synergistic lethal interactions on such platforms. In addition, using this personalized platform to simulate patient-accepted treatments can also quickly reveal resistance mechanisms and help people find effective responses.

Although it is still too early to use the CRISPR–Cas9 target cancer gene for clinical treatment, the prospects for such gene therapy are very exciting. Studies have shown that this technique can permanently correct pathogenic mutations in the liver of a mouse model and successfully alleviate the symptoms of the disease. Clearly, CRISPR–Cas9 can also be used to permanently correct cancer-related mutations. CRISPR–Cas9 can also be used for immune cell genetic engineering to help people develop better cancer immunotherapy.

Source: cell

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