Direct and indirect approaches to fight cancer

Cancer – a group of at least 200 disease forms and many more subtypes – wreaks havoc in the human body through uncontrolled growth of cells. While debates about a suitable 21st-century-definition continue (to avoid over-management of these conditions), it is clear that genetic surveys inform the diagnosis and treatment of many cancers. Catalogs such as The Cancer Genome Atlas, funded by the National Cancer Institute and National Human Genome Research Institute, have informed the understanding of diverse tumor characteristics.

However, the atlas may only have revealed 1/10th of the needed genetic information e.g., researchers estimated that they would need 100,000 samples to find most genes involved in the 50 most common types of cancer. Structural features of each tumor may also hamper the search for effective cancer-fighting therapies. According to Dr. Rakesh K. Jain, director of the Steele Laboratory for Tumor Biology at Massachusetts General Hospital and author of a Scientific American article [1], blood vessels constricted by a tumor constituent or matrix could retard the dispersion of potentially lifesaving medications throughout the neoplasm. Preclinical studies from his laboratory showed that depleting the matrix with a blood pressure medication could improve the perfusion of anticancer drugs in a neoplasm and improve survival rates [1]. Researchers are currently investigating angiotensin inhibitors as matrix-depleting agents combined with chemotherapy in patients with pancreatic ductal adenocarninoma (the fourth leading cause of cancer deaths in the United States) [1, 2]. Should the results bear fruit in the future, Dr. Jain envisions that treatment may consist of targeted cancer cell-killers, vessel-normalizing drugs, and matrix-depleting agents. Patients unable to take anti-hypertensives may potentially also benefit from alternative agents attacking other abundant tumor constituents. Ultimately, laboratory tests could be employed to measure the response of the matrix to different test agents [1].

Cancer researchers are in the midst of exploiting genetic and physical information to understand the etiology of diseases that are increasingly affecting poor- and middle-income countries. Hopefully the global toll of 8.2. million deaths in 2012 could be slowed with these approaches.

References

1.            Jain, R.K., An indirect way to tame cancer. Scientific American, 2014. p. 48-53.

2.            Hezel, A.F., et al., Genetics and biology of pancreatic ductal adenocarcinoma. Genes & Development, 2006. 20(10): p. 1218-1249.