What Does Understanding the Genome Mean for Curing Cancer?
I recently went to the American Association for Cancer Research meeting and was blown away by all the exciting research that is currently underway. Key takeaways:
• "Mapping the genome" has unlocked the ability to understand the mechanics of how a cell functions. Research is underway to figure out the molecular-level processes of how and why various cancers start, how they thrive and how it may be possible to kill them.
• These processes can be different for different kinds of cancer and sometimes for the same kind of cancer that has different genetic characteristics. For example, there may be two different prognoses and treatments for "prostate cancer" with a particular gene and "prostate cancer" with that gene silenced.
• Some genetic mutations promote uncontrolled cell growth. And some genetic mutations disable genes which naturally suppress that growth. Both variations cause cancer.
• The instructions that control cell behavior are essentially a relay team of protein messengers, each taking one step in a complicated chain of commands that determine what a cell does. Understanding what each protein does in its step opens the possibility of affecting just the malfunctioning protein with a "targeted drug," rather than using a sledgehammer like traditional chemotherapy that affects all the cells in the body. When this works, the effectiveness is increased and the side effects are reduced. Herceptin is one of the earliest of the targeted drugs and is used only where the specific genetic profile of the breast cancer shows that the cancer has an excess of HER2 receptors that the Herceptin can shut off. Without the excess of receptors, Herceptin can't help.
• This increasing understanding of the genetic make up of cancer has also shown that the mechanisms that control cell behavior are extremely complex and have many redundant paths, which makes it difficult to kill a cell and cure the cancer.
• Fundamentally – we are at the beginning of a new age of understanding cancer. This will lead to a new age of more powerful treatment, although the complexity of cancer's biology means that progress will take longer than we would all hope.
Posted July 21, 2010.
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