Personalizing Cancer Treatment

Test projects which agent will work best against particular tumors.

A 24-hour test can predict which treatment agent is likely to work against tumors, which personalizes cancer treatment, according to research published online in Cell.

Researchers from the Dana Farber Cancer Institute in Boston used Dynamic BH3 Profiling (DBP), which is designed to detect apoptosis, in order to determine which agent can work against particular tumors. The test consistently predicted the “winner” among many drugs tested in various cancer cells, the researchers noted, and the answer was generally produced within 16 hours.

“We demonstrated that [the test] can be exploited to select among many therapies the one that it is best for a single tumor,” the authors wrote. “We also demonstrated that it can select among many patients those that are most likely to respond to a single therapy.”

The DBP process can effectively trigger apoptosis in the tumor cells, which generally takes several days. But with the test, which can be used directly on patient samples, the method is more powerful and can more effectively kill the cancer.

“Regardless of the pathway inhibited, or what kind of cell the cancer started in, early drug induced death signaling predicted later cytotoxicity,” explained study leader Anthony Letai, MD, PhD. “We can take an early peek to see if the cancer cell is being pushed toward death. What makes this especially powerful is that we’re not restricted to using one drug at a time — it can test the effectiveness of combinations.”

The test was demonstrated on various cancers, such as non-small cell lung cancers, breast cancers, colon cancers, leukemia, lymphoma, and multiple myeloma. DBP was used to predict which tumors would respond strongly to carboplatin in 16 ovarian cancer patient samples. Those patients whose cells responded strongly in the laboratory had longer delays before their disease progressed.

DBP testing requires living tumor cells that were removed from the patients during surgery or a biopsy, or were frozen in a way that leaves the cells viable, the researchers pointed out. The test does not work on samples that have been preserved in formalin.

“This new technique represents a completely novel approach to precision medicine because we can test possible treatment directly on patient samples to guide cancer therapy,” concluded Joan Montero, PhD, the first author on the report.

Clinical trials testing DBP have already begun, noted a press release.