Saturday, June 20, 2020

New Canadian study investigates how cancer adapts its metabolism to overcome therapies

Knowing what cancer will do next could lessen the likelihood of it becoming resistant to treatment. A new Canadian study investigates how cancer adapts its metabolism to potentially overcome therapies still in development.

"Several clinical trials have failed because metabolism is such an adaptive process by which cancer cells gain drug resistance," says Michael Aregger, a co-lead author and Research Associate working with Jason Moffat, Professor of molecular genetics in the Donnelly Centre for Cellular and Biomolecular Research at the University of Toronto, who co-led the work. "If you know how cells are able to adapt to perturbations, maybe we can target them more specifically to avoid resistance from developing."

The research was also led by Brenda Andrews and Charles Boone, University Professor and Professor of molecular genetics at the Donnelly Centre, respectively, and Chad Myers, a Professor of computer science at the University of Minnesota-Twin Cities.

The study, published in the journal Nature Metabolism, is the first to investigate global changes in cancerous cells as they adapt to a shortfall of critical nutrients such as fat molecules, or lipids, which make up the cell's outer envelope.

When cancer cells are unable to make their own lipids, they gobble them up from their environment to ensure a steady supply of these essential building blocks, the study found. Lipids also serve as fuel and chemical signals for communication between cells, among other roles.

The switch in metabolism could be bad news for drugmakers seeking to target cancer by reducing its lipid reserves. In particular, drugs that inhibit an enzyme called FASN, for fatty acid synthase, involved in an early step of lipid synthesis, are being explored in patient trials. Fatty acids are precursors of larger lipid molecules and their production is increased in many cancers thanks to elevated FASN levels, which are also associated with poor patient prognosis.

The U of T study suggests that the effectiveness of FASN inhibitors could be short-lived owing to cancer's ability to find another way to procure lipids.

Because FASN is upregulated in many cancers, fatty acid synthesis is one of the most promising metabolic pathways to target. Given that we know there is a lot of plasticity in metabolic processes, we wanted to identify and predict ways in which cancer cells can potentially overcome the inhibition of lipid synthesis."

Keith Lawson, a co-lead author and Ph.D. student in Moffat's lab enrolled in the Surgeon-Scientist Program at the Faculty of Medicine

To block fatty acid synthesis, the researchers employed a human cell line from which the FASN coding gene was removed. Using the genome editing tool CRISPR, they deleted from these cells all ~18,000 or so human genes, one by one, to find those that can compensate for the halt in lipid production. Such functional relationships are also referred to as 'genetic interactions'.

Data analysis, performed by Maximilian Billmann, a co-lead author and a postdoctoral fellow in Myers' lab at Minnesota-Twin Cities, revealed hundreds of genes that become essential when cells are starved of fat. Their protein products clustered into well-known metabolic pathways through which cells hoover up dietary cholesterol and other lipids from their surroundings.

Cells' intake of cholesterol has become textbook knowledge since it was discovered half a century ago, winning a Nobel Prize and inspiring the blockbuster drug statin and many others. But the new study found that one component of this process remained overlooked all this time.

The gene encoding it was only known as C12orf49, named after its location on chromosome 12. The researchers re-named the gene LUR1, for lipid uptake regulator 1, and showed that it helps switch on a set of genes directly involved in lipid import.

"This was a big surprise to us that we were able to identify a new component of the process we thought we knew everything about," says Aregger. "It really highlights the power of our global genetic interaction approach that allowed us to identify a new player in lipid uptake in a completely unbiased way."

By a remarkable coincidence, two groups working independently in New York and Amsterdam also linked C12orf49 to lipid metabolism, lending further support for the gene's role in this process. The New York team published their findings in the same journal issue as Moffat and colleagues.

Inhibiting LUR1, or other components of lipid import, along with FASN could lead to more effective cancer treatments. Such combination therapies are thought to be less susceptible to emerging drug resistance because the cells would have to simultaneously overcome two obstacles--blocked lipid production and import--which has a lower probability of occurring.

"Therapeutic context that comes out of our work is that you should be targeting lipid uptake in addition to targeting lipid synthesis and our work highlights some specific genes that could be candidates," says Lawson.

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Friday, February 28, 2020

Botanical drug shown to help patients with head and neck cancers in clinical trial

A botanical drug has been shown to help patients with head and neck cancers in a clinical trial. 

In a UCLA-led phase I clinical trial, a new plant-based drug called APG-157 showed signs of helping patients fight oral and oropharyngeal cancers. These cancers are located in the head and the neck. 


Cancers of the head and neck account for 4% of all cancers. About 650,000 new cases are reported each year around the world. People with advanced head and neck cancers have a low survival rate and current treatment options such as surgery, radiation and chemotherapy can have adverse effects. Therefore, more effective and less toxic therapies are needed to help improve the quality of life and outcome for those with these cancers.

APG-157 is a botanical drug developed under the FDA's Botanical Drug Guidance, which includes requirements for the production of plant-based therapies that are marketed as prescription medications. The drug is made up of botanical compounds including curcumin from the Curcuma longa plant, which is commonly referred to as turmeric and is a member of the ginger family. 


Curcumin is one of the medicinally active or therapeutic molecules that has been tested as a possible treatment to help fight multiple cancers because it is an antioxidant that reduces swelling and inflammation. However, there is poor absorption into the bloodstream when curcumin is taken orally. In this study, UCLA researchers found that when APG-157 is taken through oral mucosal absorption, patients have high levels of curcumin circulating in their blood and absorbed by cancer tissues.

APG-157 is made up of multiple compounds produced by plants, including curcumin. UCLA Jonsson Comprehensive Cancer Center researchers found that treatment with this botanical drug resulted in high concentrations of curcumin and its byproducts circulating in the blood and absorbed by tumor tissues within three hours after being taken orally. 


APG-157 reduced the concentration of cytokines -- proteins involved in inflammation -- in the saliva when administered to cancer patients. The therapy also reduced the relative abundance of Bacteroides species, a group of gram-negative bacteria. Gram negative refers to a group of dangerous bacteria that have an outer layer which hides them from the immune system. The relative abundance of gram-negative bacteria compared to the presence of other types of bacteria is correlated with oral cancer.

APG-157 also resulted in the expression of genes that are associated with attracting immune system T cells to the tumor area. This therapy could have a beneficial effect when used in combination with immunotherapy drugs that help immune system T cells recognize and kill tumors. 


The treatment did not have any adverse effects on the study's participants. 


UCLA researchers conducted the study of APG-157 comparing 12 people who had oral and oropharyngeal cancer with a control group of 13 people who did not have cancer. The reason both the people with cancer and without cancer were part of the study was to show that the drug was not toxic to either people with cancer or those without cancer.


 The medication was given each hour for three hours and was delivered as a lozenge that slowly dissolved in the mouth. Blood and saliva samples were collected beforehand -- each of the three hours the medication was administered -- and 24 hours after the last dosage. 


The medication was given to 12 people (some who had cancer and some who did not) and a placebo was given to 13 people. Blood and electrocardiogram tests did not show increased toxicity in the people who took the active medication in comparison with the people who took the placebo, regardless of whether they had cancer or not. 


For the cancer patients who took the medication, there was a decrease in Bacteroides and an increase in T cells in the tumor tissue as compared to cancer patients who took the placebo. Neither the subjects nor the investigators knew whether the drug or a placebo was given when reviewing the blood and saliva test results of the blinded study. 


APG-157 is a botanical drug that has low toxicity. It works effectively to reduce inflammation that contributes to the growth of cancer cells. It also attracts T cells to the tumor micro-environment. 


When used in combination with immunotherapy drugs, APG-157 might have the ability to make the immune system more effective in attacking head and neck cancers. With potential to inhibit the growth of Bacteroides species, APG-157 could also improve cancer therapy through oral microbial changes.

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Thursday, February 20, 2020

New technique to improve melanoma detection, treatment

Combining three assays together, researchers have developed a new way to spot melanoma skin cancer cells circulating in the blood that could provide a new avenue for cancer diagnosis and therapies.

With a new approach to spot melanoma skin cancer cells circulating in the blood, the researchers raised detection rates to 72 per cent which is higher than using one test, said the study published in the British Journal of Cancer. The research has the potential to significantly improve the monitoring of cancer patients and guide future treatment.


“These preliminary findings are a first step towards a new way to stop melanoma from spreading around the body,” said lead researcher Elin Gray, Associate Professor at Edith Cowan University in Australia.

“Cancer spreads around the body when circulating tumour cells (CTCs) shed from the primary tumour and travel through the blood to form secondary tumours (metastases) in other organs.

“If we can find a way to reliably detect these cells, then we have a chance to stop melanoma in its tracks with a powerful diagnostic tool and perhaps opportunities for therapies in the future,” Gray said.


Until now melanoma circulating tumour cells have proved to be incredibly elusive, with detection rates wildly varying from 40 to 87 per cent. “We now understand that CTC detection cannot be resolved with a one-size-fits-all approach,” she said.

“There is a huge amount of variety in the shape and bioactivity of these CTCs and so they all look different and respond differently to assay tests,” Gray said.

The researcher explained that melanoma CTCs are hidden among thousands of other cells and matter in the blood. Armed with a better understanding of the complexity of the task, the researchers tried a multifaceted approach to detecting melanoma CTCs. “By combining three assays together, we raised detection rates to 72 per cent, which was a significantly and consistently higher result than using one test,” Gray said.

“We are confident this approach is a move towards the reliable detection of CTCs, but we now need to tweak the assay to include a better combination to capture the broadest range of CTCs,” she added.


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Monday, February 17, 2020

Scientists develop new technique to spot melanoma skin cancer

While melanoma is less common than some other types of skin cancer, it is most serious as it often spreads. 

Researchers have developed a new way to spot melanoma skin cancer cells circulating in the blood that can raise detection rates to 72 per cent. The research could provide a new avenue for cancer diagnosis and therapies.


The research team is led by Elin Gray, Associate Professor at Edith Cowan University in Australia. They tried a multifaceted approach to detecting melanoma circulating tumour cells (CTCs) by combining three assays together.

Until now melanoma circulating tumour cells have proved to be incredibly elusive, with detection rates wildly varying from 40 to 87 per cent.

The researchers are hopeful that these preliminary findings could lead to the development of a powerful diagnostic tool and a new way to stop melanoma from spreading around the body.


Melanoma skin cancer: Causes and types

While melanoma is less common than some other types of skin cancer, it is most serious as it often spreads. This cancer occurs when pigment producing cells called melanocytes mutate and begin to divide uncontrollably.

Melanomas can develop anywhere on the skin, but they are most likely to affect the chest, back, face and legs. While legs are the most common site in women, this cancer is most likely to affect the chest and back in men. However, melanoma can also occur in the eyes and other parts of the body, including the intestines (though it happens rarely).

There are four types of melanoma: Superficial spreading melanoma, Nodular melanoma, Lentigo maligna melanoma and Acral lentiginous melanoma.

Superficial spreading melanoma is the most common type of melanoma, and it often appears on the trunk or limbs.

Lentigo maligna melanoma are common in older adults, especially in parts of the body that have had excessive sun exposure over several years, like the face.

Risk factors for melanoma include:

    Overexposure to the sun
    Having fair skin
    A family history of melanoma
    a high number of moles
    a previous organ transplant
    the presence of actinic lentigines, also known as liver spots or age spots
    older age

Of these risk factors, only sun exposure is preventable. So, avoid overexposure to the sun and prevent sunburn to lower your risk of skin cancer. If you see any changing or growing moles, get it checked as soon as possible.


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Monday, September 23, 2019

We hope Indian ingenuity will help make cellular therapy for cancer affordable, says Dr Siddhartha Mukherjee

Cancer physician, scientist and author of Pulitzer-winning, The Emperor of All Maladies, Dr. Mukerjee,, is setting up a cellular therapy facility in Bengaluru in the hope of developing drugs. On the sidelines of an event, he tells why personalised medicine and diet are the next frontier for cancer treatment.

At your lab in Columbia University , you and your team of scientists are researching ' living rugs' made from our own cells for cancer treatment. How does this cellular therapy work and what is its potential?
In some forms of leukemia, we could not achieve good results because drugs couldn't distinguish between cancerous and healthy cells. When we attacked the cancer cell, we also attacked the normal one. The idea we patented in my lab is to use gene editing to change the normal cells. For much of the history of cancer, we've focused on cancer cells. Here, we're inverting the logic and saying let's make the normal cells resistant to the therapy with help of gene editing, thereby making the cancer uniquely sensitive to therapy. This uses the human body, the host of cancer, as the element of change. We couldn't change the normal cells earlier because we didn't have the tools, Gene editing provides us with those tools. And all of a sudden, cancer becomes exposed.


How did you think of approaching the problems like this?

The idea occured to me while I was onvacation to Mexico city. I was making drawing with my daughter. One way to make a drawing is to make a black silhouette on white paper. And you can also make a white silhouette in black paper. And I was doing these drawings and began to realise that in cancer we've been using the cancer silhouette against the normal host as the paradign for all treatments. But what if we used the  host as the background and then attack cancer cells? We patented the idea and showed that it can eradicate this untreatable form of leukemia--- acute myeloid leukemia--- in animals and we're rapidly progressing to human studies.


What more can cells tell us about cancer?

A 2nd approach to cancer, we've taken is to ask the question whether other kinds of cells in the body, apart from T-cells, can be used for immunotherapy. One particular type of cell which has never been harnessed before is myeloid, which is a white blood cell and our body's first line of defence against infection. These can penetrate solid tumours, such as ovarian cancer and breast cancer, where Y-cells have not been very successful. A final and 3rd area that we've worked on extensively is personalising cancer medicine. The great irony of cancer is that while it grows so rapidly inside the body, it is difficult to cultivate outside in a lab. But work done by Dutch molecular geneticist, Hans Clevers in the past 10 years whose how to grow cancer cells in a dish. The cells multiply to make a 3-dimensional cluster called an organoid. So, now we take an individual's cancer cells, grow then in a dish and find out what cancer it is and what drugs does it respond to. This allows us to individuate cancer therapy. We're just about to publish a paper to show how you can find completely new cancer drugs and therapies. We're slowly moving away from the protocol-driven therapies which are sort of one-size-fits-all.


The food-is-medicine approach is a grey area in modern science. But your lab is researching the impact of diet on cancers. What have you found so far?

 
We. as a community, have neglected diet for long. Diet is part of the micro-environment of cancer cells, which sustains them. We- and many more labs- have started studying the role of diet in a highly systematic and scientific manner. Certain chemotherapies lead to a rise in blood sugar and hence insulin, which controls sugar. It's a side-effect. And insulin allows cancer cells to become resistant to a particular form of chemotherapy. By reducing the amount of insulin, for instance, through manipulation of the diet ( consuming lots of protein, little fat and no carbs) you can make cancers sensitive to chemotherapy. It's important to note that it's a combination of diet and drugs. The diet on its own won\t help. Human trials for this study are about to start. We\re testing it for lymphoma and endometrial cancers.


You've set up a cellular therapy facility in Bengaluru. Why did you choose India?

 
This is a collaboration with Kiran Majumdar Shaw. We hopefully will be able to deliver T-cell therapy and other cell therapies which have previously been unavailable in India. While the facility has already started we're not producing cells yet because you require incredible infrastructure to make these living drugs. Why India? Because we hope it will bring down the cost of these therapies. In India, the combination of engineering and scientific ingenuity has been able to bring the costs down in IT and tech industries. We are hoping to use the same innovative capacity of local scientists and doctors to be able to reduce the cost five to ten fold and make cellular therapies accessible to more people.



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Friday, August 30, 2019

Researchers develop robotic thread that may slip through brain's blood vessels

Researchers have developed a magnetically steerable, thread-like robot that may actively glide through narrow, winding pathways like the brain's tiny blood vessels. The study, revealed that the magnetically controlled device could one day deliver clot-reducing therapies in response to strokes or other brain blockages.

If acute stroke can be treated within the 1st 90 minutes or so, patients' survival rates could increase significantly, the researcher said.


If we could design a device to reverse blood vessel blockage within this ' golden hour', we could potentially avoid permanent brain damage. That's our hope. To clear blood clots in the brain, surgeons currently need to insert a thin wire through a patient's main artery, usually in the leg or groin, and manually rotate the wire up into the damaged brain vessel, guided  by a fluroscope that images the blood vessels using x-rays.


However, the procedure is physically taxing, requiring surgeons who must be specifically trained in the task, to endure repeated radiation exposure.


The researchers created a robotic thread core made from bendy, springy nickel-titanium alloy, and they coated the wire core in a rubbery paste filled with magnetic particles.


They then bonded the magnetic covering with a kind of hydrogel that gives the thread a slippery, friction-free surface, but does not affect the responsiveness or the magnetic particles, according to the study.


The researchers tested the thread in a life-size silicone replica of the brain's major blood vessels modeled after scanning an actual patient's brain. Those silicone vessels also have clots and abnormal sacs.


They filled the vessels with a liquid simulating the viscosity of blood, then successfully manipulated a large magnet around the model to steer the robot through the vessels' winding, narrow paths.


The team demonstrated that the thread's wire core can also be replaced with an optical fibre that can activate the laser once the robot reached a target region to clear blockages.


They are preparing to test the robotic thread in vivo, according to the researchers.


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