He lung cancer is the most lethal in the world and the fact that this type of tumor is made up of different cancer cells, develops mutations over time and spreads through the body creating metastasis make it a very difficult disease to treat. Now, seven new investigations have unraveled its complexity, revealing why it becomes resistant to some treatments. The set of studies has just been published in the magazine Nature.
The main findings that the researchers found and that they have described in the seven articles are:
- Tumors can be made up of many different groups of cancer cells that include constantly changing sets of genes, and the greater the diversity of these tumors, the more likely it is that the cancer will come back within the first year of treatment.
- Some patterns of DNA changes in a patient’s tumor indicate how their cancer might act next.
- These patterns could help doctors predict which parts of a tumor might grow and spread to other parts of the body in the future.
- Blood tests could be used to monitor these changes in the tumor’s DNA in real time, allowing doctors to detect early signs that the cancer is recurring or not responding to treatment.
The data analyzed comes from the genomic study of 1,644 tumor samples from 421 patients with non-small cell lung cancer (NSCLC), the most common type of lung cancer, with stage I, II, or III disease who had a variety of NSCLC subtypes, including 248 adenocarcinomas of lung, and were enrolled in the TRACERx (TrAcking Cancer Evolution through therapy (Rx) project).
Charles Swantonfrom the Francis Crick Institute in London (United Kingdom) and author of the main article published in Nature, has stated that the biological mechanisms responsible for lung cancer are not well understood. “Tumors are made up of different types of cancer cells, each with different characteristics; this call intratumoral heterogeneity it can drive tumor evolution and disease progression. The goal of TRACERx is therefore to determine the relationship between intratumoral heterogeneity and clinical outcomes.”
Understanding the genomic evolution of tumors can provide insight into the factors that determine how and when cancer can recur and help improve outcomes for patients
In a separate article, these scientists looked at why some tumors come back and spread to other parts of the body or the effects of the chemotherapy with platinumone of the standard therapies for advanced non-small cell lung cancer on intratumoral heterogeneity, “proving that these treatments contribute to the evolution and heterogeneity of the tumor.”
Predict cancer recurrences to improve treatments
The findings described in some of the other articles include demonstrations of a tool capable of detecting the presence of circulating tumor DNAa potential marker of clinical outcomes, and the identification of factors that may predict the part of the tumor that may cause disease recurrence.
The researchers conclude that “understanding the genomic evolution of tumors may provide insight into the factors that determine how and when cancer may recur, and thus improve our understanding of the tumor biology. This knowledge may facilitate future attempts to improve outcomes for cancer patients.”
Alberto J. SchuhmacherARAID researcher and head of the Molecular Oncology Group at the Health Research Institute of Aragón (IIS Aragón) has highlighted in statements to SMC Spain that “one of the works has established a new technology based on the liquid biopsywhich makes it possible to read the DNA of a tumor in a blood sample, which could help establish the metastatic potential of these tumors. This advance will be important to propose new therapeutic strategies and conduct clinical trials to find new therapies and approaches”.
Rocío Bautista, a researcher at the Bioinformatics Unit of the Supercomputing and Bioinnovation Center (SCBI) of the University of Malaga, also speaking to SMC Spain, believes that this is a “good quality” investigation, which “shows how the cumulative genetic alterations during the development of the disease, from the primary tumor, can help determine the risk of dissemination and, therefore, of metastasis. These divergences could become a potential ‘metastatic hallmark’, which would make it possible to predict the risk of possible metastases”.
It is important to highlight that lung cancer is not the only cancer that presents intratumoral heterogeneity, but also other tumors, such as those of the pancreas, brain, prostate, and breast, and even leukemias, are characterized by a diversity of cancer cells to a greater or lesser extent. lesser degree, which means that the results of these studies will also contribute to improving the knowledge of these other types of cancer.