A new approach to cancer treatment identified by a team in Singapore has left its scientists optimistic about tackling treatment-resistant forms of the disease in the future.
In their study, published in the journal Nature Communications last Thursday (Nov 22), scientists from the Agency for Science, Technology and Research’s (A*STAR) Genome Institute of Singapore (GIS) discovered that cancer cells can constantly evolve to overcome drug treatment, the institute said in a press release on Tuesday.
Traditional approaches to cancer treatment focus on the “complete elimination” of cancer cells, according to the institute.
This means that patients are treated with high doses of chemotherapy to target highly proliferative tumour cells.
“However, it is increasingly clear that like any other living being, cancer cells also follow the basic evolutionary principles and will adapt to survive,” said the institute.
The scientists found two types of survival strategies adopted by tumours: “Playing dead” by turning dormant, as well as activating resistant genes or genes that cause the spread of cancer from a primary site.
In addition, the study found that cancer cells could change their epigenetic makeup – in effect, how genes are switched on or off – to become resistant to drugs and other forms of treatment.
In their study, scientists observed that in some patients, cancer cells kept multiplying, even when they were treated with high drug doses. They then theorised that the cells were “switching their stem cell factors upon treatment”, making them drug-resistant.
The new finding could pave the way for greater understanding to target these processes and help delay the spread of disease, said GIS.
“Greater understanding of these mechanisms provides opportunities to target these processes that will help to prevent or delay the spread of cancer,” said the institute.
The scientists said they hoped that by targeting tumour evolution, the disease’s progression could be delayed.
“The cancer cells behave like chameleons, altering their gene expression and cell behaviour to overcome drug treatment,” said Dr Ankur Sharma, first author of the study and research associate at GIS.
“A comprehensive understanding of tumour evolution and our ability to predict cancer’s next evolutionary move can serve as a way forward to manage therapy resistance in the clinic.”
Dr Ramanuj DasGupta, senior author of the study and Group Leader at GIS, added: “Like a game of whack-a-mole, cancer cells have a long history of finding alternative routes to evade treatment.
“By targeting the tumour evolution itself, we aim to prevent or at least delay its progression, and at the same time, avoid the harsh effects of excessive treatment.”
Tackling cancer’s evolution has the potential to convert the disease into something that can be managed in the long term, added GIS executive director Ng Huck Hui.
“We need to adopt new strategies of evolutionary precision medicine to target them with the right drugs,” said Professor Ng. “Targeting the cancer’s evolution itself has the potential to convert this dreaded disease into something that can be chronically managed, and this study is the first step towards that goal.”