When the life of a loved one is in jeopardy, there are almost no limits to what people will do or try in order to save them. When an unnamed friend of James Eshleman, Associate Director of Johns Hopkins Molecular Diagnostics Laboratory and researcher for the Departments of Oncology and Pathology, was stricken with an ultra-rare form of cancer, his friend’s uncle, who happened to be Vice President of a major pharmaceutical company, asked Eshleman to provide him with a personalized cell line on which he could test every drug his company owned. Eshleman willingly complied with the request to save his friend.
Their paper, published in Clinical Cancer Research, details this novel approach to chemotherapy that may improve the effectiveness and economic feasibility of cancer treatments in the future.
“[The] concept we’ve been trying to extrapolate to cancer for many, many decades,” Eshleman explained. “[So] it’s not really a new concept to cancer, it’s just that with the general approach … what’s being studied the next day is really cells that have been badly damaged through all the processing.”
Normally drugs are selected based on the location of the cancer. Tissue samples are surgically removed directly from the human tissue, stored in an oxygen-less tissue culture medium full of preservatives and transported to laboratories for drug testing. The shipment process, as well as the chemical additives used for tissue preservation, may interfere with the tissue’s drug response, and therefore skew the results of the drug panel.
The new method of drug testing employed by Eshleman and his colleagues instead grew the patient’s tissue in the lab, bypassing the need for sample travel and thus preventing the damage caused during handling or storage. A strain of immunodeficient mice with a mutated HPRT1 gene was bred to grow injected human cancer cells, which could then be extracted to provide an undamaged sample tissue for drug screening.
Previous studies have already shown how some non-traditional drugs, such as one drug commonly used to treat for fungal infections, demonstrate a surprising effectiveness in fighting certain cancer cells when tested in a drug panel.
“It requires an oncologist who is willing to work on out-of-the box therapy because the drugs that come out of the screen may be an antimicrobial drug or an anti-hypertensive drug,” Eshleman explained.
Eshleman reports that while they are not yet at the stage to implement clinical trials for pancreatic cancer, it might be possible for them to begin clinical trials for a more treatable type of cancer that has more options for currently-approved drugs. Eshleman’s lab has already applied for funding to begin testing the personalized cancer cell lines with a panel of 3100 FDA-approved drugs.
“[The] cost of chemotherapeutic agents is so high in general that if you can get the correct regimen to which the patient’s cancer responds well and regresses it could substantially help patients,” Eshleman said.
Personalizing cancer cell lines could potentially require less and more effective treatment in the long run — saving time, money and, most importantly, lives.