Studying Tumors Differently, in Hopes of Outsmarting Them

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Bert Vogelstein, a cancer geneticist at Johns Hopkins University, says he is haunted by three pictures.


The first shows a man’s upper body studded with large melanomas. The second shows what happened when the man took a drug called vemurafenib. Vemurafenib belongs to a relatively new class of drugs, called targeted cancer therapy. Unlike earlier chemotherapy drugs, they attack specific molecules found only in cancer cells. In response to the vemurafenib, the tumors shrank in a matter of weeks, to the point that the man’s skin looked smooth and healthy.

The third picture is a case of déjà vu. After 16 weeks of treatment, the melanoma returned. “All the lesions reappeared — every single one,” said Dr. Vogelstein. “That struck me as nearly as amazing as the fact that they had disappeared.”

The man died several weeks later.

This short-lived reprieve is heartbreakingly common in targeted cancer therapies. To understand why — and how to get around it — Dr. Vogelstein has teamed up with mathematicians to create detailed models of cancer.

Their research demonstrates a little-appreciated but inescapable fact about cancer: It is an evolutionary disease. And their studies are provoking new thinking about ways to use drugs to kill cancerous cells. Some of their findings were published on Tuesday in a paper in the journal eLife.

Written By: Carl Zimmer
continue to source article at nytimes.com

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  1. Now I have an inkling of the fowl horrors of the disease.

    Despite which I found the article cathartic; somehow my gardening aches and pains don’t seem to matter quite as much now.

    Makes note: must remember to get on with my life!

    • In reply to #1 by Stafford Gordon:

      Now I have an inkling of the fowl horrors of the disease.

      No, that’s influenza! ;-)

      (Puts on surgical mask, leaves.)

      Steve

      EDIT: Speaking of cancer as an “evolutionary disease”, I recommend strongly the “biography” of cancer, “The Emperor of all Maladies” by Siddhartha Mukherjee. A very well-written and interesting book.

  2. This is similar to the problem of HIV evolving resistance to drugs. In two weeks I will start up on chemotherapy again, with a cocktail
    of five drugs. By sequencing your personal HIV, you can tell which drugs it will be immune to.

    How might an advanced therapy work? You daily get your cancer/HIV sequenced. A computer then computes a cocktail for the day.

    You would also need to study how drugs fail. What mutation confers immunity to one of your base drugs? You then have to create a drug that goes after that particular mutation and use it in tandem with the base drug from the getgo. I have never heard of any HIV drug that targets such a mutation, so it might be a very difficult thing to do.

    You might be able to try a rotating strategy, where you use a relatively high does of just one of the drugs in a cocktail each day. You might be able to reduce the total drugs administered to reduce side effects.

    • In reply to #3 by Roedy:

      This is similar to the problem of HIV evolving resistance to drugs. In two weeks I will start up on chemotherapy again, with a cocktail
      of five drugs. By sequencing your personal HIV, you can tell which drugs it will be immune to.

      How might an advanced therapy work? You daily get your cancer/HIV…

      Best wishes Roedy. Your comments are always worth reading.

    • In reply to #3 by Roedy:

      This is similar to the problem of HIV evolving resistance to drugs. In two weeks I will start up on chemotherapy again, with a cocktail
      of five drugs. By sequencing your personal HIV, you can tell which drugs it will be immune to.

      How might an advanced therapy work? You daily get your cancer/HIV…

      Hope everything goes well for you during this procedure. I wonder if you’ll be able to keep up with your contributions? Maybe it will be a bit quiet around here for a while.

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