Recently, President Joe Biden announced a new federal goal to reduce cancer mortality by at least 50% over the next 25 years. It’s a bold goal, and I applaud it.
According to the CDC, over the past 20 years, the cancer death rate has fallen by 27%, from 196.5 to 144.1 deaths per 100,000 people. That’s the good news. Now for the bad: In 2022, you’re less likely to have advanced solid cancers like pancreatic or lung cancer than when my 1955 41D Buick Special rolled off the assembly line in Detroit.
Despite this thought-provoking update on our real situation, I am very encouraged by some of President Biden’s comments. His administration has rightly targeted the real potential of combining existing drugs for more effective cancer treatments. This is underutilized, but has enormous potential if applied properly.
as Biden pointed out, we need to be able to determine which combination of treatments is best for a particular person. For now, Biden said, we know very little about why the treatment works for some patients but not for others with the same diagnosis of cancer.
The President’s awareness is commendable and fits well with our success using human tumor testing to select the best chemotherapy drugs and combinations for each patient.
As the president said, a drug that works for one patient may not work for another, even if the two patients have the exact same diagnosis. This is why each patient should be tested to select the most effective and least toxic drug regimen for that individual before starting treatment. This is an approach that the cancer industry must take now.
To determine the best combination or sequence of drugs, I think the cancer industry should apply human tumor explant assays such as our ex vivo assays for programmed cell death. This provides a dynamic assessment of cancer cell response using live cancer cells from each patient to select chemotherapeutic drugs. While the concept may seem new to some, we’ve successfully applied this technology to over 10,000 patients — many with difficult-to-treat cancers — and increased their chances of a response doubled.
One reason for this, as the President noted, is because every cancer patient is unique and responds differently to treatment. When patients are treated without testing, treating physicians must rely on general guidelines and protocols that do not capture the individual characteristics of each patient.
Ex vivo analysis of programmed cell death is markedly different from the tests offered by most medical centers, which rely on DNA profiling called genomic analysis. These use a patient’s chromosomal material to look for mutations and other changes in each patient’s genetic makeup that could guide drug selection. Despite the appeal of the concept, in reality, only a small number of patients have genetic changes that can actually be used for treatment.
Every human cancer reflects all of its genes, mutated and normal, that work together to produce what we think of as malignant tumors. Only functional analysis can capture each patient’s tumor in real time and provide insights that can inform drug selection and treatment decisions.
In one of our studies of metastatic lung cancer, the average response rate to conventional off-patent therapy was 30%, and when patients received the drug selected for them in the laboratory, they had a response rate of 64.5% (p<0.001 ), thereby advancing their treatment. Live for months to years.
The role of laboratory and functional analysis is to ensure that the most effective and least toxic treatments are selected the first time. This increases the likelihood of a reaction and can help avoid choosing toxic treatments when other milder drug combinations appear to be effective.
Widespread use of this technology has the potential to improve patient outcomes, reduce costs, limit futile care and simplify drug development. We agree with President Biden that we need to change the way we treat cancer. Analysis of human tumor explants may be just the answer the president is seeking.
Photo: Julio C. Valencia via National Cancer Institute
