Two-step treatment cuts off cancer’s backup defences

pharmafile | January 25, 2017 | News story | Research and Development Cancer, sarcoma, washington university 

New research conducted at Washington University’s School of Medicine and published in Cell Reports details a new method for fighting cancer which could present a path forward over established treatments by first starving and then finally killing the tumour in two steps.

Historically, treatments have aimed to ‘starve’ tumours of their nutrients, but cancers utilise a secondary ‘salvage pathway’ to survive. The new method shuts off both pathways for the tumour by exploiting a metabolic defect which means it is unable to manufacture amino acid arginine, a key element in cell division; tumours, particularly sarcomas, must derive it from the cells around them, so when an arginine-inhibiting drug is used, the cancer instead ‘eats’ its own supply, causing it starve while leaving surrounding cells unharmed.

At this point, the cancer begins to rely on different amino acids including glutamine and serine, so researchers have found that by utilising drugs which inhibit these compounds after starving the tumour of arginine, it will begin to die.

“Cancer doesn’t die when you halt its primary fuel supply,” explained senior author Brian Van Tine. “Instead, it turns on all these salvage pathways. In this paper, we identified the salvage pathways. Then we showed that when you drug them too, you kill cells. Our study showed that tumours actually shrink under these conditions. This is the first time tumours have been shown to shrink using just metabolism drugs and no other anti-cancer strategies.”

“We have determined that this metabolic defect is present in 90% of sarcomas. Healthy cells don’t have this weakness. We have been trying to create a therapy that takes advantage of the metabolic defect because, in theory, it should target only the tumour.”

While the metabolic defect is most prevalent in sarcomas, it is believed this research could be extrapolated to tackle variants of breast, lung, brain, bone and colon tumours. The team at Washington University are hoping to begin clinical trials to assess the effectiveness of drug combinations in treating tumours:

“We will start with a baseline trial testing the arginine-depleting drug against sarcomas with this defect, and then we can begin layering additional drugs on top of that therapy,” says Van Tine. “Unlike breast cancer, for example, sarcomas currently have no targeted therapies. If this strategy is effective, it could transform the treatment of 90% of sarcoma tumours.”

Matt Fellows

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