Predicting Chemotherapy Success

Colorectal cancer chemotherapy response may become predictable

(RxWiki News) When chemotherapy is prescribed for colorectal cancer, doctors don’t always know if it will work for an individual treatment. A new tool might help predict success.

A new study has discovered a tool that seems to be effective in forecasting which colorectal cancer patients will benefit from chemotherapy. The tool is a complex math model that calculates massive amounts of information about the patient.

This tool may become useful in personalizing chemotherapy treatment for colorectal cancer patients.

"Start colorectal cancer screening at age 50."

Researchers at the Royal College of Surgeons in Ireland conducted the study. Jochen J.M. Prehn, PhD, director of the Centre for Systems Medicine at the College, led the study.

“Our study demonstrates that systems medicine approaches (i.e., quantitative analysis of multiple factors in patients’ samples combined with mathematical modeling) have a significant advantage over other approaches in predicting therapy responses in patients,” Dr. Prehn said in a statement.

The approach centers on how the body programs its cells to die. This is called apoptosis, and is at the heart of why chemotherapy agents don’t work in some patients.

A family of proteins known as BCL-2 is the kink in the system. These proteins play a constant shell game – some proteins promoting cell death and others preventing it. And the fun doesn’t stop there. These guys are chameleons and can work together and even switch roles with one another in a way that’s complex and confusing. So it’s hard to know whether or not cells are more likely or less likely to die.

In comes the new tool. It takes in all this data about a patient’s molecules, including their levels of BCL-2 proteins. The model then calculates what needs to happen in order to achieve apoptosis. They’re looking here at what’s known as genotoxic stress.

Researchers tested this tool – what they call “DR_MOMP” – on tumor and healthy cells in 26 patients. They said the tool enabled them to “robustly predict patient outcome.”

The authors wrote, “DR_MOMP may aid in predicting the optimal dose of chemotherapy that preserves healthy, normal tissue while killing cancer cells and predicting which patients respond to classical chemotherapy."

The researchers said additional and larger studies are needed to validate these findings.

This research was published January 17 in Cancer Research, a publication of the American Association for Cancer Research. The work was supported by grants from the Health Research Board and Science Foundation Ireland. No conflicts of interest were reported.

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Review Date: 
January 16, 2013