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For most cancer patients, even the best anti-cancer drugs can't extend their lives for long once the cancer has metastatic.
, however, there are some "lucky people" in cancer patients who have multiple tumors in their bodies that disappear after treatment and are able to live healthy lives for many years.
these patients are known as cancer super-responders.
, then, what causes the "magical" disappearance of tumors in their bodies, and what insights can their research provide for the development of future cancer treatments? A team led by scientists from the National Cancer Institute and NCI studied 111 super-respondents.
26 of the patients, the researchers found clues that might explain the mechanism by which the tumor disappeared.
study was recently published in Canser Cell.
the NCI-led study, which began in 2014, researchers collected case information from super-responders and analyzed the genomes of their tumors and other cells using a variety of technology platforms.
according to NCI's definition, the tumors of these super-responders shrink or disappear completely after receiving specific treatments, which typically have an effect on less than 10 percent of patients in clinical trials.
or these patients had more than three times the duration of remission in a typical patient.
By analyzing patients' DNA mutations, RNA expression levels, changes in the number of DNA copies, changes in DNA methylation status, and analysis of immune cells in tumor micro-environments, the researchers found that in 26 patients, multiple mechanisms could mediate super-responses, including specific genetic variants and changes in immune cell behavior.
the DNA damage repair mechanism is abnormal Many super-responders in the tumor carrying genetic mutations lead to the loss of the cell's DNA damage repair mechanism, which makes tumor cells particularly sensitive to chemotherapy drugs that damage DNA.
a glioblastoma patient was treated with a DNA methylation agent called temozolomide when the disease returned after surgery, radiotherapy and local chemotherapy.
patient then survived for more than 10 years.
analysis of his tumor genome found that two complementary signaling paths to repair DNA damage were a disordered due to genetic mutations.
Interestingly, another colon cancer patient in this study had a period of nearly four years of remission after receiving a combination of thymosamine and a new drug, and although only one signaling path to repair DNA damage in his tumor was abnormal due to a genetic mutation, the treatment successfully inhibited another path to DNA injury repair.
that the results suggest that for some patients, using combination therapy to block different DNA repair signaling path paths may be an effective strategy.
in six patients who had a super-response to platinum-containing chemotherapy, the researchers found mutations in the BRCA1, BRCA2, or PALB2 genes.
these genetic mutations have demonstrated the potential of targeted DNA damage repair mechanisms in another way.
mechanisms mediate super-responses, including THE PATH of DNA damage repair and the intervention of the immune system (Photo source: Reference: Reference) Cancer immunotherapy for the emergence of specific immune cells in the tumor micro-environment has become one of the main pillars of cancer treatment.
the study, the researchers also found that the number of immune cells in the tumor micro-environment of multiple super-responders was different from that of the average patient.
the number of B lymphocytes and natural killer cells in the tumor micro-environment of multiple super-responders increased significantly compared to samples from the Cancer Genome Atlas (TCGA).
that the involvement of the immune system may be one of the reasons for the super-response.
"Our findings demonstrate the importance of molecular biology testing of patient tumors," said study co-author Dr. Louis M. Staudt of NCI. "Molecular biology testing of tumors can provide us with information that cannot be provided by looking at tissue slices under a microscope."
", a proof-of-concept study, shows that research on super-respondents is not only feasible, but can also help us get as much information from them as possible.
senior author of the study, NCI's S. Dr Percy Ivy added.
, researchers in North America, Europe and Australia are currently working on similar super-responder research projects, and NCI researchers hope to pool the data for analysis.
Staudt hopes to conduct a study of at least 1,000 patients.
"There are still a lot of puzzles waiting to be answered," he said.
" References: 'Exceptional' cancer patients yield clues to better drug treatments. Retrieved November 29, 2020, from Study of “exceptional responders” yields clues to cancer and potential treatments. Retrieved November 29, 2020, from Wheeler et al., (2020). Molecular Features of Cancers Exhibiting Exceptional Responses to Treatment. Cancer Cell, follow Medicinal Conde on WeChat Public No