Metastasis Doesn't Always Mean the Worst

microRNA analysis for metastasis treatment viability

(RxWiki News) Metastasis means a lot of different things to people. But one thing it does not have to mean is the end.

One doctor in particular has vigorously researched metastasis, and accumulated the science to back up his claim that some types of metastasis are still curable.

Now he has developed a lab test to show what type of chemotherapy would be most effective in people whose cancer has spread.

"Ask your oncologist about microRNA analysis."

Ralph Weichselbaum, M.D. is the director of the Ludwig Center for Metastasis Research at the University of Chicago. He has argued over the past decade that patients in the worst stage of cancer, stage IV, should not all be classified together.

Dr. Weichselbaum uses the term oligometastasis to describe cancers that have only spread to a few locations and remain treatable.

A study he conducted from 2004-2008 on patients with only a few metastases, showed that 20 percent of patients were able to stay cancer free after aggressive treatment.

His research, begun in 1998, indicates that there are several subsets of cancer metastasis, which he ranks by aggression. Dr. Weichselbaum's new laboratory test looks at levels of a certain molecule to classify those cancers.

In analysis of patients that were successfully treated, a small molecule known as microRNA-200c was low. The opposite held true as well, with further testing showing that high levels of the same molecule meant a cancer would spread rapidly.

In theory, monitoring levels of microRNA-200c will allow doctors to determine how patients should be treated after metastasis. Researchers believe that microRNA-200c is a protein that suppresses several cancer-fighting mechanisms of the cell.

"We [have] previously demonstrated that we could provide lasting disease-free survival to a percentage of patients with metastatic disease," said Dr. Weichselbaum, "This finding means we can have a pretty good sense in advance of which patients we can help."

Additional results published in 2011 showed that seven years after the beginning treatment, 18 percent of patients had seen no further growth of existing tumors, and another 27 percent had no new tumors.

"Our findings are an initial step in discriminating between patients with a few treatable sites where the tumor has spread and those who will develop widespread metastasis," Dr. Weichselbaum said.

Results were published in the open-access online medical journal PLoS ONE in December, 2011.

No statements were made about availability or cost of the lab test for microRNA-200c.

Funding was provided by the Ludwig Center for Metastasis Research Grant, the Center for Radiation Therapy, the Chicago Tumor Institute, Dr. Lloyd Old, Mr. and Mrs. Vincent Foglia and the Foglia foundation, Lung Cancer Research Foundation, the Cancer Research Foundation and several National Institutes of Health Grants.

The authors have declared that no competing interests exist.

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Review Date: 
January 26, 2012