07-14 The Biology of Cancer

“In the 19th century, living organisms were widely regarded as machines infused by vital forces. Biologists eventually came to realize that cells are not some sort of magic matter, but complex networks of chemical reaction pathways. Then came the genetics revolution which describes life in the informational language of instructions, codes and signalling. Mainstream research today focuses almost exclusively on chemical pathways or genetic sequencing. For example, drugs are designed to block reaction pathways implicated in cancer. The cancer genome atlas is amassing terabytes of data in which people hope to spot some of mutational patter. But while of great scientific interest, such projects have not led to the much-anticipated breakthrough” ( “Whats really going on in those cancer cells?” New Scientist Jan 5 2013, p.24)

  1. May 5, 2013 at 12:26 am

    p.10 Genetic mutation analyses is fashionable, promising targeted therapies that otherwise may go undiscovered [it proved very useful for a patient of mine with a very rare mast cell cancer without options until analysis discovered an ALK mutation and Xalkori (crizotinib) proved (along with a cocktailed regimen of HDAC inhibitor and gammadelta immunotherapy) to control the disease]. Larry Weisenthal (Weisenthal Cancer Group) whom I much respect doesn’t make too much of this approach. Complexity and heterogeneity of cancer biology limits the usefulness of this approach (see p. 10). In 2012, the New England Journal (NEJM 366:883, 2012) reported research by Swanton’s team at Cancer Research UK that demonstrated that two-thirds of genetic mutations in the same tumor differed from one biopsy to the next, thus the treatment and prognosis for each person was good or bad depending which bit of tumor was sampled by the biopsy! This phenomenon explains in part why targeted therapies may not always be successful, and dents the hope that tailoring individual treatments with targeted therapies based on mutations unveiled in any single biopsy.

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