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Patients with terminal cancer could "effectively be cured" by the discovery of a pair of drugs which can shrink tumours or bring them under control in nearly 60% of people with advanced melanoma.
In an international trial of 945 patients, treatment with the drugs ipilimumab and nivolumab stopped the cancer advancing for nearly a year in 58% of cases. This was compared with 19% of cases for ipilimumab alone, which resulted in tumours stabilising or shrinking for an average of two and a half months.
The treatment, known as immunotherapy, uses the body's immune system to attack cancerous cells. Researchers say it could replace chemotherapy as the standard treatment for cancer within five years.
[Paper]: http://www.nejm.org/doi/full/10.1056/NEJMoa1504030#t=article
Original Submission
(Score: 2) by Joe on Thursday June 04 2015, @11:43PM
Not all cancers use the same mechanism, many are not well understood, and a singular cure is highly improbable.
You are right that there are many types of cancer and they employ many different strategies that are unique to their micro-environment (such as vasculogenic mimicry - arranging themselves into their own "blood vessels") or from their original tissue (Philadelphia chromosome, HER2/neu positive, etc.), but there are also many common mechanisms (hallmarks of cancer). Some of the common mechanisms of cancer include: evasion of the immune system (the immune system will kill them, otherwise), mutation (cancer needs to mutate normal genes into oncogenes and inactivate tumor suppressors), limitless replication (malignant cancer needs to keep growing), and an altered metabolism (that provides the building blocks needed to keep growing - Warburg effect).
https://en.wikipedia.org/wiki/Philadelphia_chromosome [wikipedia.org]
https://en.wikipedia.org/wiki/Vasculogenic_mimicry [wikipedia.org]
https://en.wikipedia.org/wiki/The_Hallmarks_of_Cancer [wikipedia.org]
https://en.wikipedia.org/wiki/Oncogene [wikipedia.org]
https://en.wikipedia.org/wiki/Tumor_suppressor_gene [wikipedia.org]
https://en.wikipedia.org/wiki/Warburg_effect#Oncology [wikipedia.org]
- Joe
(Score: 0) by Anonymous Coward on Thursday June 04 2015, @11:48PM
blockquote>
In contrast to normal cells, aneuploidy--alterations in the number of chromosomes--is consistently observed in virtually all cancers. A growing body of evidence suggests that aneuploidy is often caused by a particular type of genetic instability, called chromosomal instability, which may reflect defects in mitotic segregation in cancer cells. A better understanding of the molecular mechanisms leading to aneuploidy holds promise for the development of cancer drugs that target this process.
http://www.ncbi.nlm.nih.gov/pubmed/15549096 [nih.gov]
It's one disease, they just don't teach about aneuploidy and cancer in med/grad school much (I don't remember a single mention). We need a way of detecting and targeting cells with the wrong number of chromosomes. Simple as that, in concept at least.
(Score: 3, Informative) by Joe on Friday June 05 2015, @12:45AM
It's one disease
I disagree, but it really is just semantics. I would say that it is a class or type of diseases (autoimmunity, neurodegenerative, infectious, metabolic, poisoning, etc.) as it has many commonalities, but different types of cancer are divergent enough to need distinct treatment programs (you can't cut-out a leukemia and you can't cure a glioblastoma with a bone marrow transplant).
Genomic instability is one of the hallmarks of cancer if you follow the link I posted. Targeting aneuploid cancer cells would be difficult because all cells have chromosomes and some cells different numbers of chromosomes, such as germ cells (which are haploid) or multinucleated cells (e.g. some muscle cells). I can imagine that a therapy that tried to take advantage of this concept would probably be a fusion protein (like the linked paper, but for cancer) of some intracellular sensor of genomic stability (some DNA damage protein or something involved in chromosomal sorting) and something that kills/sensitizes the cell to treatment (caspase domain/toxin/sodium-iodide symporter) packaged into a viral vector.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0022572 [plos.org]
- Joe
(Score: 0) by Anonymous Coward on Friday June 05 2015, @01:45AM
If there is a commonality in all cases I would say its a single disease. And right, actually targeting something like aneuploidy is not straight forward. However, I'd think the off target effects on normally 'chromosomally special' cells would be no worse than current treatments.
(Score: 1) by KGIII on Sunday June 07 2015, @09:12AM
I am not right. I am just sharing what was shared with me by an oncologist. Either way, thank you for your reply, I will check the links out and see what I can gather from them. I am, by no means, an expert.
"So long and thanks for all the fish."