personalized medicine Archives - Sanford Burnham Prebys
Institute News

Human tumors in mice may improve search for new cancer drugs

AuthorSusan Gammon, PhD
Date

August 21, 2017

Developing anti-cancer drugs has always depended on testing new drug candidates in mice. Unfortunately, only about 5% of drug candidates that look promising in mice ever prove to be successful in humans. This emphasizes the need to develop better mouse models of cancer—ones that more accurately reflect the properties of human cancers, so that the effects of drugs can be predicted more successfully.

According to Garth Powis, D.Phil, director of SBP’s NCI-designated Cancer Center, “Mouse models with tumors derived from cancer cell lines are largely responsible for the cancer drugs that we currently have. However, the tumors produced in these models are genetically too simple to adequately mimic the complexity of human tumors, which spells trouble for useful drug testing.”

In trying to solve this problem, Powis recently co-authored a report in Molecular Cancer Therapeutics that evaluated the feasibility of a patient-derived xenograft (PDX) approach, in which surgical samples of human colorectal cancers were implanted to initiate tumors (i.e. xenografted) in mice. Powis explains that, “Our thinking was that these patient-derived tumor samples would have all the genetic complexity of the original human tumors, and could therefore be more accurate predictors of the effects of experimental drugs to treat cancer.”

The report establishes several reasons for optimism about PDX-based studies.

  • First, human tumors can be successfully established in mice using samples from both primary tumors and tumor metastases. Since tumors may change properties when they metastasize to other organs, it’s important to test drugs on both types of tumors.
  • Second, specimens from patients undergoing cancer therapy can still produce tumors in mice. This is important because cancer therapy may change the properties of a tumor, including its sensitivity to the new drugs.
  • Third, for successful tumor initiation in mice, tumor samples used 24 hours after surgery were as effective as samples used 2 hours after surgery. This is important to researchers who may have limited access to tumor specimens or who lack immediate access to surgically removed tumors.

Powis emphasizes that, “These results show that PDX models can be established from a wider range of tumors than we initially expected, which really expands our horizons for future drug testing. In addition, PDX strategies are in line with the goals of personalized medicine, since discovering biomarkers in susceptible tumors will allow us to predict which patients are most likely to respond to a drug therapy. 

Institute News

Ashima Shukla wins fellowship for research to improve B cell lymphoma treatment

AuthorJessica Moore
Date

February 9, 2017

Although every tumor is different, diffuse large B cell lymphomas are generally treated as a single disease. One reason is that advanced genomic sequencing—a method to examine individual tumors—isn’t available in many treatment centers. Fortunately, Ashima Shukla, PhD, a postdoctoral researcher at Sanford Burnham Prebys Medical Discovery Institute (SBP), may have found a new, simple way to personalize therapies for this type of B cell lymphoma. Her promising research won her a fellowship from the Leukemia and Lymphoma Society, one of only a handful given each year.

“B cell lymphomas expand because their growth signaling becomes altered to stay ‘on’ all the time. That signaling is normally triggered by activation of receptors on their surface. Since those receptors—which are actually antibodies attached to the cell membrane—fall into different classes called IgM, IgG, and IgA, we wanted to see if the later signaling events differ depending on the type of receptor,” says Shukla, who works with professor Robert Rickert, PhD “Our results so far suggest that B cells with receptors from different Ig classes behave differently from one another. That suggests that the best therapy for an individual B cell lymphoma may depend on whether it has IgM, IgG, or IgA receptors.”

B cell receptors are responsible for recognizing invaders—viruses or bacteria. Normally if a B cell detects an invader, it starts to divide and increase its numbers to fight disease. But if the B cell becomes cancerous, signaling through B cell receptors actually fuels the cancer.

Shukla will first test whether the type of B cell receptor affects the likelihood of lymphoma development using mouse models. Then she will use human lymphoma cell lines to assess the impact of receptor type by using CRISPR—a gene-editing tool—to switch IgM lymphoma cells to IgG and measuring cancer cell growth.

“Since we’re looking in detail at signaling in different subtypes of lymphoma, we also have a good chance of identifying new therapeutic targets,” adds Shukla.  “Ultimately, we may be able to treat B cell lymphomas based on the type of B cell receptor they have on their surface.”

“I am very excited to advance the understanding of lymphoma, and being selected for this award is really great for the lab,” Shukla comments. “It shows that we’re working on something important that might help lymphoma patients.”

Institute News

A promising personalized approach to treat small cell lung cancer

AuthorJessica Moore
Date

January 25, 2017

Small cell lung cancer (SCLC), which accounts for 10-15 percent of all lung cancer cases, is extremely aggressive, with a five-year survival rate of about two percent.  Although SCLC can arise from a diverse range of genetic mutations—meaning each patient’s tumor is unique—all patients are treated the same way, with platinum-based chemotherapy.

A new study that includes contributions from Robert Wechsler-Reya, PhD, professor at SBP, makes an important advance toward a better, more precise therapy for patients whose tumors share a key genetic alteration—extra copies of a gene called MYC. The research, published in the journal Cancer Cell, suggests that combining Aurora kinase inhibitors, a relatively new class of anti-cancer drugs, with chemotherapy may improve outcomes for patients with MYC-driven tumors.

The research comes from the lab of Trudy Oliver, PhD, an assistant professor at the Huntsman Cancer Institute at the University of Utah (and a former graduate student of Wechsler-Reya’s).  With the help of mice generated by Wechsler-Reya’s lab, Oliver created a new model of MYC-driven SCLC, and used it to demonstrate that the combination of Aurora kinase inhibitors and chemotherapy was more effective in slowing tumor progression than either drug alone.

“The new findings suggest that this drug combination may be effective in patients with this devastating form of lung cancer, which accounts for 20 percent of small cell cases,” says Wechsler-Reya. “And since several Aurora inhibitors are already in clinical trials for other cancers, trials in SCLC patients could start soon.”

The research builds on prior results from another collaborator on the paper, Martin Sos, PhD, junior research group leader at the University of Cologne, whose in vitro studies found that SCLC cell lines with extra MYC are susceptible to Aurora kinase inhibitors. The new study looked at whether that’s also true of MYC-driven tumors in vivo, using the new mouse model that was created with the help of Wechsler-Reya’s lab.

The research also establishes the relevance of the mouse model by showing that MYC-driven SCLC, as suggested by studies in patients, is particularly bad—it grows and metastasizes very rapidly. Just as importantly, they found that this subtype is distinguishable by its appearance and by a combination of markers, which could help identify which patients will benefit from Aurora inhibitors.

“Clinical trials of Aurora kinase inhibitors alone have yielded mixed results in SCLC patients,” adds Oliver. “Our findings suggest that those drugs may work better if they’re combined with chemo and given only to patients whose tumor morphology and markers indicate they’re driven by MYC.”

The paper is available online here.

Hear Wechsler-Reya discuss his lab’s contribution:

Institute News

Will you be part of the largest-ever clinical research study?

Authorjmoore
Date

March 23, 2016

It’s called the Precision Medicine Initiative (PMI) Cohort Program, and it was just announced in February by President Obama. If you join the cohort (group of subjects tracked over a long period of time), you can help researchers improve precision medicine, in which doctors select the treatments and preventive strategies that will work best for each patient. This program is just one component of the larger Precision Medicine Initiative announced during last year’s State of the Union address.

What’s the goal? According to NIH Director Francis Collins, the cohort program “seeks to extend precision medicine to all diseases by building a national research cohort of one million or more U.S. participants,” all enrolled by 2019.

Why recruit so many people? Since the program is intended to benefit people affected by many diseases and conditions, it must include large, representative samples of people with each type. Large samples increase the likelihood that studies using these data will find new associations and interactions among genes, environmental factors, and disease risk.

What will participants do? Volunteers will share their health records, complete surveys on lifestyle and environmental exposures, undergo a physical, and provide a biological sample (e.g. blood) for genetic testing.

How will people benefit? Participants will be considered partners in research—they’ll have access to their genetic data and, where possible, how their genes, surroundings, and habits affect their health. They’ll also have a say in how the research is conducted and what questions it should address.

Who’s running it? The NIH is overseeing the whole program, but it will be directly run from multiple institutions (which are currently being selected). The pilot phase will be led by Vanderbilt University and Verily (formerly Google Life Sciences).

What’s the cost? $130 million has been allotted in this fiscal year, but more money will be needed to keep the program going.

Should I be excited about it? Maybe. Some leaders in the health field have criticized the program for throwing money at the latest big thing instead of more low-tech problems like unequal access to healthcare, but such a huge data resource is bound to lead to answers to many important questions. 

What are the challenges for the PMI?

  • Scale—The program will generate one of the largest clinical databases yet, and it’s not clear how difficult it will be to make systems that can store and analyze it.
  • Privacy—Data will be anonymized, but keeping the health information of a million people in one place might represent a target for hackers sophisticated enough to figure out participants’ identities.
  • Interoperability—Health record systems are notoriously incompatible with one another. Though the PMI also has provisions to correct this, it likely won’t be a quick fix.

How can I sign up? Enrollment has not yet begun, but the NIH will announce when the public can get involved. So stay tuned…