Newsweek: Time to Rethink the War on Cancer

Submitted by The Stupid Cancer Blog

We often hear stories of those who triumph over cancer, but that is not the whole picture.

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One Response to “Newsweek: Time to Rethink the War on Cancer”

1. Gregory D. Pawelski Says:
   October 7th, 2008 at 12:52 pm

   To beat down cancer mortality, oncologists need to target all the many cancers that make up a cancer - the dozens of different pathways that cells use to proliferate and spread. That is the leading edge of research today, determining how this patient’s tumor cells work and hitting those pathways with multiple drugs, simultaneously or sequentially, each chosen because it targets one of those growth, replication and angiogenesis pathways. The hope is to match tumor type to drug. We need to make the next leap, getting the right drug to the right patient. I agree!

   Cancer cells often have many mutations in many different pathways, so even if one route is shut down by a targeted treatment, the cancer cell may be able to use other routes. In other words, cancer cells have “backup systems” that allow them to survive. The result is that the drug does not shrink the tumor as expected. One approach to this problem is to target multiple pathways in a cancer cell.

   The key to understanding the genome is understanding how cells work. The “cell” is a system, an integrated, interacting network of genes, proteins and other cellular constituents that produce functions. You need to analyze the systems’ response to drug treatments, not just one target or pathway. Another challenge is to identify for which patients the targeted treatment will be effective. Screening compounds for efficacy and biosafety.

   Tumors can become resistant to a targeted treatment, or the drug no longer works, even if it has previously been effective in shrinking a tumor. Drugs are combined with existing ones to target the tumor more effectively. Most cancers cannot be effectively treated with targeted drugs alone. You need to measure the net effect of all processes within the cancer, acting with and against each other in real time, and test living cells actually exposed to drugs and drug combinations of interest.

   Multi-targeted drugs can be well-predicted by measuring the effect of the drugs on the function (is the cell being killed regardless of the mechansim) of live cells, as opposed to a target (does the cell express a particular target the the drug is supposed to be attacking). While targeted screening tells you whether or not to give one drug, functional screening can find other compounds and combinations and can recommend them from the one analysis.

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