The expression of different proteins stained in red and green indicates the variation in the make-up of a patient-derived model of a tumor. Such models can be used to determine the most effective treatment for individual patients. © 2018 A*STAR Genome Institute of Singapore

A powerful new approach to individualized cancer treatments has been demonstrated by A*STAR researchers. It involves growing micro-models of tumors outside a patient’s body, testing their response to various treatments, then applying the most effective ones.

Traditionally, medical treatment has been based on a ‘one size fits all’ mentality, but clinicians are increasingly realizing that patients often respond differently to the same therapy. This has led them to pursue the concept of personalized medicine, which seeks to give the right drug to the right patient at the right dose and at the right time.

To date, personalized medicine has largely been driven by genomics. This means that researchers sequence the DNA of the tumors from many patients, identify key mutations and then develop therapies and drugs that target these genes. While this approach is very important for making new discoveries, it is expensive and takes many years before it benefits patients.

Ramanuj DasGupta at the A*STAR Genome Institute of Singapore and co-workers have now demonstrated a complementary approach that provides information with the potential that can benefit patients immediately.

The researchers took tumor cells from 24 patients with head and neck cancers and grew models of the tumors in dishes. They then tested these micro-tumor models to see how susceptible they were to a range of treatments, including chemotherapy, radiotherapy and targeted anti-cancer drugs. Of the 24 patients, two went on to receive tailored treatments in clinical trials. Both patients responded very well to their respective treatments.

These results demonstrate that patient tumors can be used to generate critical information that can help clinicians prescribe the best treatment options. “It is akin to making a cancer ‘crystal ball’ that can help to predict whether a tumor will respond to standard chemotherapy; how the tumors might progress under treatment; whether the cancer will recur, and, if so, whether alternative treatments can be administered to the patient,” explains DasGupta.

The researchers are excited about the potential of their approach. “Our work highlights the tremendous promise of precision medicine for treating cancer,” says DasGupta. “Our dream is to make cancer into a chronically managed disease so that patients can enjoy a good quality of life while being treated with the most effective drugs. We strongly believe that our approach will go a long way toward realizing this dream. This is just the beginning.”

The team wants to extend the study to include many more patients, as well as finding multiple indicators of cancers.

The A*STAR-affiliated researchers contributing to this research are from the Genome Institute of Singapore and the Biological Resource Centre.