Tuesday, September 17, 2013

Cancer's Super Responders

Really cool article from Yahoo! News a couple of days ago on Cancer "Super Responders." These are patients who respond to treatment when no one else does. Researchers can now learn from these Super Responders to help further refine what we know about particular cancers, and how we can treat them.

 Up until a few years ago, the closest we could look at a tumor was through a microscope. Two cells for, say, Follicular Lymphoma, looked pretty much the same under the microscope, something like this:

And then a few years ago, we mapped the human genome. Now we can look even deeper, and see that, upon closer examination, not all Follicular Lymphomas (or other cancers) are necessarily the same.

This very helpfully answered the question, "Why do some patients respond to a treatment but other patients don't?" Well, it's because those patients actually have variations of the same cancer that aren't exactly the same. There are small genetic differences that make a treatment work for one person but not for another.

Which is where the so-called "Super Responders" come in. Oncologists used to speculate that there was something about that patient that made them respond. Now they know what that something special might be.

So now, a bunch of major research hospitals are going back and looking at old biopsies of Super Responders and doing some genetic testing to see just what made them so different. Eventually, we can catalog the differences in genetic makeup, and begin to tailor treatments to sub-classes on particular cancers.

Right now, it costs about $5000 to do a full mapping of a patient's genome, finding all of the differences between a "normal" set of 20,000 genes and the ones that have mutated.  In a few years, the process will cost less than $1000 -- not much more than a 10 mL vile of Rituxan from Walmart (with coupon).

(Yeah, I'm a little freaked out that you can buy Rituxan at Walmart -- with a coupon. Just doesn't seem right that something so amazing is so easily available....)

Anyway, in a few short years, it will be really inexpensive to get ourselves mapped, and this will 1) help researchers figure out which mutations matter for which cancers, and 2) help oncologists figure out which treatments are most likely to work.

It's pretty exciting. I'm not sure we're in for a CURE anytime soon -- still a lot of work to be done once mutations are identified -- but it's very promising stuff.

No comments: