Novel precision medicine tool could help personalize cancer treatments

By measuring how vigorously tumor cells turn on “self-destruct” signals when exposed to different cancer drugs, a novel lab test can predict within less than 24 hours which agent is most likely to work against a particular tumor, say researchers from Dana-Farber Cancer Institute.

The scientists say this technique could lead to more reliable and rapid tools for “personalizing” cancer treatments than are now available. Clinical testing has already begun.

A team led by Dana-Farber oncologist Anthony Letai, MD, PhD, reported in the February 26 online edition of the journal Cell that the test consistently predicted the “winner” among many drugs tested against a wide variety of cancer cells in the laboratory. In most cases, the answer emerged 16 hours after the anti-cancer compounds were mixed with tumor cells.

“We demonstrated that [the test] can be exploited to select among many therapies the one that it is best for a single tumor,” the researchers wrote. “We also demonstrated that it can select among many patients those that are most likely to respond to a single therapy.”

The technique is called Dynamic BH3 Profiling, or DBP. It is designed to detect the earliest signs that a cancer cell treated with a drug is beginning to destroy itself through apoptosis, a natural quality-control process that rids the body of unneeded or dangerously abnormal cells.

Although abnormal, cancer cells can survive by blocking the “pro-death” molecular signals that trigger apoptosis. Most chemotherapy treatments work by inducing a wave of pro-death signals in cancer cells to overcome the survival signals. The death process may take several days, but with the DBP test, scientists can identify which drug or drug combination has most effectively jump-started pro-death signaling.