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One way to determine how successfully a patient’s cancer treatment has eradicated the disease is to check the bloodstream for free-floating DNA originating from tumor cells, also known as circulating tumor DNA (ctDNA). The detection of ctDNA can serve as a powerful prognostic tool, allowing clinicians to assess the effectiveness of treatment and predict the likelihood of disease recurrence.
Pancreatic cancer, which will affect an estimated 60,430 Americans this year, is notoriously hard to treat. Chemotherapy and immunotherapy drugs sometimes work at first, but often the tumors develop resistance and continue to grow. This makes it one of the most lethal types of cancer, with the average five-year survival rate after diagnosis hovering around 10%.
A range of genetic disturbances can result in the same type of cancer, the way an off-tasting dish might result from any number of bad ingredients or missteps in the preparation process. Often, variation in clinical features—tumor appearance, location, behavior—is what defines cancer subtypes, while the genetic origins of each subtype remain unclear. But to make sense of this variation, and thus refine diagnosis and develop more precise treatments, researchers must trace these clinical features back to their genetic origins.
Clear cell renal cell carcinoma (ccRCC), which accounts for over 75% of kidney cancer diagnoses, gets its name from how the tumor cells look under a microscope. Their clear appearance, as if the tissue were studded with air bubbles, is due to an accumulation of cholesterol in the cells. Studies have shown that ccRCC cells contain at least twice as much cholesterol as normal kidney cells, and in some cases up to 35 times more. How this accumulation occurs and how it contributes to cancer progression, however, is poorly understood.
Researchers at Stanford University have discovered sugar-bound RNA strands protruding from the cell surface, challenging the long-held assumption that these two types of molecules are kept separate within the cell. These newfound “glycoRNAs,” identified by former Damon Runyon Fellow Ryan Flynn, MD, PhD, may serve an important role in immune signaling. A shock to biologists across disciplines, this finding has particular significance in the world of cancer research, as the development of effective immunotherapies hinges on our understanding of how the immune system is activated.
Immune checkpoint blockades are remarkably effective at exposing tumor cells to immune system attack, but only in the minority of patients with highly mutated tumors. While a high number of genetic mutations may seem like a bad thing, more mutations mean tumors produce more antigens, making them more recognizable to immune T-cells, and thus more susceptible to immunotherapy. In a groundbreaking report, Damon Runyon alumni Robert K. Bradley, PhD, and Omar Abdel-Wahab, MD, offer proof of concept that introducing errors in the short-lived RNA—rather than permanent DNA damage—still causes tumors to present antigens on their cell surface, stimulating immune response. The hope is that drugs that induce such RNA errors could be used in combination with checkpoint blockades to shrink therapy-resistant tumors.
Selection bias occurs when those chosen to participate in a study are not representative of the target population, limiting how much we can trust the study results. In order to quantify this selection bias, researchers have come up with a metric known as the diagnosis-to-treatment interval (DTI), which measures treatment urgency among trial participants. DTI, however, is not an ideal metric for selecting trial participants, as non-biological factors like access to medical care also influence the amount of time between diagnosis and treatment. Finding a biological basis for DTI would offer a more objective measure of clinical urgency, and thus be more useful in mitigating selection bias.
After successfully reversing leukemia development in mice and human cell lines, former Damon Runyon-Lilly Clinical Investigator Scott Armstrong, MD, PhD, and his lab at Dana-Farber Cancer Institute are testing a novel therapeutic approach in clinical trials, open to patients as young as one month old. The drug, known as SNDX-5613, is currently being evaluated as a treatment for acute myeloid leukemia (AML), but may one day be used to prevent the cancer from developing in the first place.
The American Society of Clinical Oncologists hosted their annual meeting this past weekend (June 4th-8th, 2021), giving oncology professionals from around the globe the chance to present cutting-edge research on new cancer therapies, ongoing clinical trials, and standards of patient care. Among the studies presented were those of several former and current Damon Runyon Clinical Investigators, whose research unites lab inquiry with clinical application.
One of the many ways tumor cells evade capture by the immune system is by presenting proteins on their surface that signal “don’t touch me” to immune T-cells. These proteins are called immune checkpoints. Therapies that block them—known as immune checkpoint blockades (ICB)—are remarkably effective, but they only work for a minority of cancer patients. In search of more widely beneficial immunotherapies, Damon Runyon Physician-Scientist Gabriel Griffin, MD, and colleagues at the Broad Institute of MIT and Harvard are investigating other mechanisms of immune system evasion to target in combination with ICB. Specifically, they have set out to find epigenetic regulators—proteins that turn genes “on” and “off”—that play a role in helping cancer cells avoid detection.
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