Taking the guesswork out of treating cancer

Taking the guesswork out of treating cancer

7 Dec 2010

One of the greatest challenges in treating cancer is not knowing how a patient will respond to therapy. Recent research by scientists at the Malaghan Institute of Medical Research, Wellington, and the Peter MacCallum Cancer Centre in Melbourne, has provided a vital new tool for oncologists that will aid them in selecting the appropriate treatment for patients with acute myeloid leukaemia (AML).

“Being able to predict which AML patients will respond to a particular treatment will remove some of the guesswork and improve patient outcomes,” said Malaghan Institute senior cancer researcher Prof Mike Berridge.

AML is a cancer of the white blood cells and is the most common type of acute leukaemia diagnosed in New Zealand adults.

It is treated using chemotherapy or bone marrow transplantation, however for reasons that are not completely understood, a treatment that works well for one patient may have little effect in another patient with the same cancer. This is due in part to the many different strategies used by cancer cells to evade treatment and survive.

“Cancer cells grow and divide frequently and therefore require a lot of energy,” said Prof Berridge. “Normally this energy comes from specialised energy factories within the cell called mitochondria, however AML cells have found other ways of meeting their energy needs.”

In work just published in the international Journal of Leukocyte Biology, lead scientist Dr Patries Herst and Prof Berridge from the Malaghan Institute, and Assoc Prof David Ritchie and colleagues from the Haematology Immunology Translational Research Laboratory at the Peter MacCallum Cancer Centre, showed that the way AML cancer cells meet their energy needs can influence a patient’s outcome.

“Our research group has developed a fast and simple colour assay to determine the extent to which cells use their mitochondria for energy production,” said Dr Herst. “Previous research has shown that some cancer cells that do not rely on their mitochondria for energy production are more aggressive and invasive and result in poor prognosis for patients.”

“In this project we wanted to see if we could use this simple assay to predict patient outcomes,” she said. “This is important because a favourable prognosis may mean using a lower dose or less aggressive drugs to treat a patient, thereby decreasing side-effects and generally improving their quality of life.”

“Our research was successful because we were able to predict patient outcomes,” said Dr Herst. What is really interesting however is that we found the opposite of what we expected!”

Dr Herst’s research showed that patients whose cancer cells did not rely on their mitochondria for energy production did much better than patients whose cancer cells were reliant.

“We believe that this is because of the specific micro-environment of leukaemic cells in the bone marrow,” said Dr Herst. “Leukaemic cells in the bone marrow are starved of nutrients, so relying on the more efficient mitochondrial energy pathway is a plus for the cancer cells but bad for the patients.”

“There are eight types of acute myeloid leukaemia with each having its own treatment regime, and prognoses vary per type,” she said.

“Predicting patient outcome regardless of AML type means that the assay can be used widely to predict outcomes for all AML patients before they start treatment.”

This work was supported in part by the Department of Radiation Therapy, University of Otago, Wellington, and the Genesis Oncology Trust, New Zealand.

ENDS

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