Breakthrough In Cancer Genetics Could Lead To Bespoke Immunotherapy Treatment

Macrophages identifying a cancer cell Credit: National Cancer Institute

Ground-breaking research is narrowing down on core markers to target with immunotherapy, and new ways to harness the wrath of your immune system

Cancer isn't really one disease, it's a whole bunch of complex, individually specific conditions in which a group of cells turn against their host. As technology has improved, we've started to learn that tumours are extremely heterogeneous - meaning that they contain many cells with different mutations. This makes any cancer exceptionally difficult to destroy precisely because it's a constantly evolving entity. Because of this immense variety a small remnant of any cancer usually survives a round of treatment and later comes back; triggering relapse.

A landmark in cancer therapy

 In a breakthrough study by an international team, after extensive genetic analysis researchers have discovered that even heterogeneous cancers have core mutations that hang around differentiating cancer cells from their surroundings. These make tumours vulnerable to a targeted assault. What's more, they also found that in many patients small numbers of immune cells had recognised certain markers and mounted an assault - they were simply too low in number to do anything.

Lymphocytes frequently infiltrate tumours as part of immune-surveillance, but sometimes the response is ineffective or too little, too late

"This is exciting. Now we can prioritise and target tumour antigens that are present in every cell - the Achilles heel of these highly complex cancers. This is really fascinating and takes personalised medicine to its absolute limit, where each patient would have a unique, bespoke treatment"

 

2 potential new treatments

The possibility that even complex tumours retain specific markers on cells which we could instruct an army of immune cells to focus on, is extremely hopeful. Combined with ever improving sequencing technology, this means in the future every cancer therapy could be bespoke for each patient.

Sowing the seeds of destruction

Immunotherapy approaches have demonstrated fantastic results on specific cancers, but harnessing the power of the immune system has the potential to revolutionise the way we treat cancer. The team found that scout immune cells were actually present in many of these tumours but had simply been engulfed - outnumbered and outgunned.

"What we’ve found for the first time is that tumours essentially sow the seeds of their own destruction. And that within tumours, there are immune cells that recognise those flags which are present in every tumour cell”

What does this mean? Well, another possible treatment could be isolating these immune cells that are able to recognise the cancer, and multiplying them outside of the body before infusing them back in. In that way you might not have to scan and develop your own targets because some of the work has already been done for you. Providing your immune system with more firepower and numbers and the tide could turn.

"Many cancers are not standing still but they keep evolving constantly. These are moving targets which makes it difficult to get them under control. Cancers that can change and evolve could lose the initial antigen or maybe come up with smokescreens of other good antigens so that the immune system gets confused"

Looking ahead

Because cancer is such a mobile condition and constantly in flux, there is a good chance it could evolve to escape such targeting. We also need clinical trials based on this concept to ascertain whether such an approach is effective, but it's certainly a welcome addition to the anti-cancer arsenal.

Read more at BBC News