Better Together: Statewide Tumor Board Unites Cancer Research and Treatment
Imagine having surgery to remove a tumor, and by the time you’ve recovered from the operation, your oncologist has determined a specific drug regimen that is targeted to treat your cancer.
“If you get diagnosed with a bacterial infection, we take a culture, grow the bacteria in the lab, and treat the cultures with antibiotics,” said Dustin Deming, MD, a gastrointestinal oncologist and researcher with the UW Carbone Cancer Center. “This helps us learn what antibiotic will best treat an infection. Why can’t we do the same thing for cancer?”
Shifting “trial and error” treatment approaches from patients to cell cultures could spare patients time and unnecessary side effects while providing a personalized form of treatment.
The challenge to this approach has traditionally been the difficulty of growing cancer cells in the lab, but research in Deming’s lab, which focuses on gastrointestinal cancers, is overcoming this limitation.
“If you take cancer cells and put them on a plastic dish, only 10% of those cells will grow, but we’ve developed a technique where we lock cancer cells in a gel-like substance where we can provide them with all the different nutrients and growth factors they need to grow,” Deming said. “By doing this, we can grow cells from 70-90% of cancers.”
Now that they can grow and maintain cancer cells at high success rates, Deming and his research team are studying if drugs that are effective at killing patients’ cancer cells in the lab will work to treat individual patients in the clinic.
This research, funded in part by Garding Against Cancer, is an offshoot of the Precision Medicine Molecular Tumor Board (PMMTB), which was launched in 2015 by Deming and Mark Burkhard, MD, PhD, an oncologist and researcher at UW Carbone. The PMMTB is supported by the UW Collaborative Genomics Core, the UW Carbone Cancer Center and nearly $500,000 in annual state funding.
Patients across Wisconsin who have advanced cancer and looking for treatment options are eligible to have their tumor’s genetic information sequenced and their case submitted to the PMMTB. Based on any unique or specific genetic features in the tumor cells, a board of researchers and clinicians determine which drugs or clinical trials would have a high chance of targeting a patient’s cancer. The PMMTB creates a closer relationship between patients and researchers and has helped bring Deming’s research to the clinic.
“We have a protocol where if a patient is getting a new biopsy to do the sequencing for the PMMTB, the patients can also consent to do additional biopsies to have their tissue sent to our lab so we can do testing,” Deming said. “What we’re trying to do, now that we can grow these cells in the lab, is to see if our cultures actually predict response for patients.”
For a recent colon cancer patient, Deming’s cell culture protocol provided an unexpected treatment route. The patient was no longer responding to therapies, and after the tumor was sequenced and reviewed by the PMMTB, they found no mutations that could be targeted with available drugs.
“We needed other options,” Deming said. “We tried a panel of drugs on the patient’s cells in the lab. Four years ago, the patient’s cancer had shown resistance to a standard chemotherapy drug. However, in our cultures, we found that his cancer cells were sensitive to the drug again! When we tried the drug on the patient, his tumor shrunk substantially.”
Deming was recently awarded a grant to continue this research on a larger scale for colon cancers, but he and his colleagues are working to apply their findings to other cancers as well. For example, biomedical engineer Melissa Skala, PhD, an investigator with the Morgridge Institute for Research and UW Carbone, is working to predict patients’ response to cancer therapies with tumor cell cultures from PMMTB patients who have pancreatic cancer.
Deming says that the infrastructure and relationships that the PMMTB has built have been key to developing this work.
“The ability to get more patient samples into the lab and move our research forward has been a game changer,” he says. “For the patients where we find targeted options, we’re changing lives.”
Date Published: 04/30/2019