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Renowned scientists are embarking on a new war on cancer that does not necessarily heal it, but makes it a condition people can live with.
The world-renowned Cancer Institute is launching what it calls the first-ever "Darwinian" cancer control program. As with antibiotics, they say, cancers can progress to become resistant to the drugs used to treat them. Cancer cells that are not killed by chemotherapy or even immunotherapy will eventually mutate and adapt to form new tumors. The cancer recurs in metastatic or advanced form, often elsewhere in the body, and is usually fatal.
The ICR wants to reorientate its work not only to kill cancer cells, but also to destroy their ability to evolve. The goal is to eliminate the lethality of cancer and turn it into a disease that – if treatment is not possible – will not shorten or ruin lives in the same way that HIV is controlled for millions of people on antiretrovirals.
Professor Paul Workman, general manager of the ICR, said his team was extremely enthusiastic. "This is the biggest challenge we face in cancer treatment and cancer biology, drug resistance," he said.
Their first drug to slow down or stop cancer cell evolution could be available in 10 years, they say. It will target a molecule called APOBEC, essential for the proper functioning of the immune system, but which is also diverted from more than half of the types of cancer to accelerate the development of drug resistance.
The drug may be given at the same time as other anticancer drugs. "We believe that this will be the first treatment in the world that, rather than coping with the consequences of cancer evolution and resistance, aims to directly confront the ability of the disease to adapt and to evolve, "said Dr. Olivia Rossanese, of the ICR.
Dr. Rossanese will be responsible for biology at the new Center for Cancer Drug Discovery, next to the Royal Marsden Hospital in Sutton, Surrey, which the ICR is currently building to advance this program of work. It will welcome scientists from many disciplines, from artificial intelligence and advanced mathematics to the biological sciences.
Workman said that they needed 15 million pounds more to complete the center, in addition to the 75 million pounds already invested by ICR. He is hoping for philanthropic donations. If they receive the money, he said, "we can bring together under one roof cancer treatment experts and others who are studying the evolution in animals, cells and patients, to create a new generation of cancer treatments. "
Researchers are already working on several projects. Dr. Andrea Sottoriva, who will be deputy director of cancer development in the new center, said that they were exploring "the idea of using existing drug combinations at the same time or in sequence to do what we call an evolutionary flock. " They want, he said, "to play for us and to make cancer evolve into an evolutionary impasse". They could, through AI, find a way to stimulate the development of cancer cells to more drug-sensitive forms.
Workman said that fighting cancer is a fundamentally new approach. "What we are really looking at here is a culture shift – among cancer researchers and clinicians, as well as among patients," he said. "We will always strive to cure cancer, but in advanced diseases where this may not be possible, an evolutionary approach opens the prospect of long-term control with a good quality of life.
"We would like to dispel some of the fear of advanced cancer and hope that patients will benefit from new approaches that will not always give them" clear to everyone "but that will prevent cancer for many years . "
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