The Mechanism of Cancer Cell Resistance to Therapy Revealed

Researchers have discovered why the disease returns again and again.

The problem of the effectiveness of malignant tumour treatment lies in the fact that, having successfully dealt with cancer, the patient cannot be completely insured against the recurrence of the disease. Cancer cells demonstrate a high ability to adapt and survive, ceasing to respond to drugs that previously destroyed them.

This problem is the basis of a recent study conducted by an international team led by Lucio Miele, head of the genetics department at the College of Medicine in New Orleans, and Justin Stebbing, professor of medical oncology at Imperial College London. The data from their work was published in the journal PLOS One. The researchers are confident that their findings should form the basis of a new approach to cancer treatment.

Why Cancer Cells Are So Resilient

It has long been known that there is a special mechanism for the mutation of cancer cells, known as driver mutations. These occur in genes that control the life processes of cancer cells, ensuring their survival in adverse conditions.

In the new study, forty-four cases of cancer in patients for whom anticancer therapy had ceased to be effective were analyzed. The researchers conducted a thorough analysis of genes in various types of tumours: lung cancer, neuroendocrine tumours, sarcoma, breast cancer, ovarian cancer, and stomach cancer. The collected research results led to the conclusion that at late stages of tumour development, previously unknown driver mutations occur, which contribute to the tumour's failure to respond to previously successful treatment. Regardless of the type of cancer, cancer cells retain the ability for driver mutations at any stage. For this, scientists believe, the tumour produces many clones of the cancer cell: each one tests a different way to survive. And when doctors begin to apply a certain type of treatment, cancer cells activate the mutation mechanism, selecting one that becomes insensitive to therapy. These new genetic mutations may serve as unique biomarkers that will be ideal targets for the targeted destruction of cancer with targeted drugs, the researchers believe.

The Solution Lies in Genetic Testing

In light of the study's results, the authors believe there is a proven need for genetic testing of various forms of cancer, ideally at the earliest possible stage – before cancer cells initiate new driver mutations. "This approach will help select the most optimal therapy in each specific case," says Professor Miele, "moreover: in the event of a recurrence, it is necessary to conduct genetic testing again to understand whether new mutations have arisen that were not observed during the first testing when the diagnosis was made."

This implies a personalized approach to each case of oncopathology. After all, the same type of cancer in different people can produce completely different mutations, and thus the therapy that will be effective in one case may lead to the return of the disease in another. The information obtained from genetic studies will contribute to the appointment of adequate, individualized treatment that is highly likely to ensure complete recovery.