A new technique that would see cancer drugs tested on ‘mini tumours’ from biopsy samples could revolutionise personalised treatment, British researchers have reported.
Researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust discovered that creating miniature replicas of a patient’s tumour enabled doctors to establish in advance which treatments would work – with a success rate of between 88% and 100%.
The researchers took biopsy samples from 71 patients with advanced bowel, gastro-oesophageal or bile duct cancers, whose tumours had metastasised, and who were enrolled in early-stage clinical trials.
The samples were tested against 55 established or new drugs against the mini tumours and compared the results with how the patient had responded in the clinic.
Writing in Science last night, the research team say that testing mini tumours was 100% accurate at identifying drugs that would not work in an individual patient, and was 88% accurate for selecting drugs that would shrink a patient’s tumour.
They also found that the mini tumours were more effective at predicting drug response than analysing the DNA code of the patient’s tumour alone.
Study leader Dr Nicola Valeri, team leader in gastrointestinal cancer biology and genomics at The Institute of Cancer Research, London, and a consultant medical oncologist at The Royal Marsden NHS Foundation Trust, said: “Once a cancer has spread round the body and stopped responding to standard treatments, we face a race against time to find patients a drug that might slow the cancer’s progression and extend their lives.
“We found that recreating patients’ tumours in the laboratory using this new technique gave us an extremely promising way to predict whether a drug would work for a patient. We were able to look in incredible detail at how tumours responded to drugs – including patterns of gene activity and mutation, and even how the cancer would evolve in response to treatment.
“We looked at tumours from patients with cancers of the digestive system, but the technique could be applied to a wide variety of cancer types. We need to further evaluate its potential in larger clinical studies, but it has the potential to help deliver truly personalised treatment – and avoid the reliance on trial and error for many patients when clinicians give them a new cancer drug.”
Study co-author Professor Paul Workman, chief executive of The Institute of Cancer Research, London, said: “This study has shown that testing drugs on replica tumours before they are given to patients is not only possible, but predicts how a patient will respond more accurately than simply looking at the cancer’s DNA. It could predict whether a cancer will be drug resistant before a person ever receives the treatment – which is especially important for those with advanced cancers where time is so precious.
“The potential of mini tumours doesn’t stop there. Having a better model for how cancers may respond to treatment could help accelerate drug discovery and even reduce reliance on animal experiments.”
The research was supported by the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), and Cancer Research UK.
Science 22 February 2018
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