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“Laboratory in a Patient” Could Allow Simultaneous Testing of Multiple Mesothelioma Drugs

Mesothelioma Applied Research

Personalized cancer therapy allows doctors to target treatment to a patient’s unique mesothelioma characteristics. Oncologists can personalize and adjust care based on the efficacy of a treatment for the patient. However, determining the right treatment or how well a drug is working can take time, leaving the patient with precious little time if the drug is not effective at fighting off the deadly cancer.

Now, researchers at MIT, Beth Israel Medical Center and Fred Hutchinson Cancer Research Center and Presage Biosciences in Seattle have found a way to determine whether a patient’s tumor will be sensitive to a sampling of cancer drugs through an “implantable device” that can return nearly immediate results. The “laboratory in a patient” can contain samples of multiple drugs and simultaneously expose the tumors to all the drugs at once to assess the impact on the cancer, allowing the doctor to find the optimal drug for the patient.

In an April 22 article in MedlinePlus, researchers report two separate tools have been developed that can quickly detect whether a patient will respond to a treatment. With this approach, no biopsies are needed, several drugs are tested at once, and the patient is not exposed to side effects.

“Different patients can respond completely differently to the same drug,” said the lead author of one of the studies, Oliver Jonas, a post-doctoral associate in the Robert Langer Lab at the Massachusetts Institute of Technology’s Institute for Integrative Cancer Research. “So you have to test therapies sequentially. And it can take several weeks to many months to see the effect of a single therapy,” Jonas said.

So the motivation of this whole study was to find ways to identify the optimal therapy in a patient before a treatment decision is actually made,” Jonas said.

Mesothelioma, often called asbestos cancer as the signature cancer of the mineral, is highly aggressive, with no known cure. Most often, the cancer resists the selected treatment, leaving the oncologist scrambling to find another option that may prove effective. Unfortunately, this gives the mesothelioma time to grow and divide, impacting the patient’s survival.

One device, that can hold 16 different cancer drugs, according to MedlinePlus, was tested on mice using melanoma, prostate and breast cancer tumors. The results showed “a reliable and accurate way to predict each drug’s effectiveness.” However, Jonas warned that the test comprised a mere millionth of a full dose, although he added, that the amount “correlated strongly” with the impact of a full dose used in treatment.

Personalized care targeted to a patient’s unique mesothelioma characteristics optimizes the potential for success of the treatment and offers treatment options that may not otherwise have been considered. The use of this device could allow oncologists to personalize treatment to each patient’s reaction to the therapies.

The second device, from the Seattle team, is a handheld microinjection device designed to test up to eight drug samples in tumors located near the surface of the skin, such as skin cancer, breast cancer, and lymphoma. Initial tests have been conducted in four humans with no serious side effects.

The researchers concluded, “Because these effects are crucial to predicting drug response, we envision that these devices will help identify optimal drug therapy before systemic treatment is initiated and could improve drug response prediction beyond the biomarkers and in vitro and ex vivo studies used today.”

Dr. Peter Kozuch, associate professor of medicine, hematology and medical oncology at Beth Israel Medical Center in New York City, adds that more research must be done, and they must see the same benefits and results in people as they have seen in the lab.

“The field of oncology is increasingly trying to become more precise,” said Dr. Kozuch. “But this is brand new technology, ” he cautions, “And unfortunately there is simply no shortcut to clinical development.”

Findings from both studies were published online April 22 in Science Translational Medicine (http://stm.sciencemag.org/content/7/284/284ra57).

See Mouse Models That Mimic Human Tumor Growth Could Lead to New Approach to Personalized Mesothelioma Care for a study where researchers tested parallel tumor progression in patients suffering from the disease in an animal laboratory mice.

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