In a story reported in News Medical Life Sciences,
researchers attempting to treat rare diseases often find themselves with a dilemma- while there aren’t many patients to test treatments on in the first place, it may also be that one drug will not be effective for everyone with the same disease. Rather patient’s with the same issues can have unique mechanisms, and treatments and dosages must be tailored to address that root cause. At Wake Forest, researchers are creating a personalized approach to chemotherapy trialed on artificial organs to more precisely tailor tumor treatment for patients with appendix and colon cancer.
The researchers are testing the chemotherapy on customized organoids, artificial 3D organs used to model diseases to use to test the efficacy and toxicity of drugs. So far, they’ve found tailoring the chemotherapy to the specific tumors makes a dramatic difference- with the temperature of the therapy proving extremely effective for some tumors, which effects are barely noticeable for other.
The first author on the work, Steven Forsythe, said, “Using a patient-specific tumor organoid model will eventually allow patients to be treated with the best available chemotherapy while sparing the toxicity of drugs that are not effective for their specific tumor.”
Current Options for Colon and Appendix Cancers
The current treatment approach for these cancerous tumors first requires removing the tumors entirely through a cytoreductive surgery. Then the patient undergoes a type of chemotherapy, HIPEC (hyperthermic intraperitoneal chemotherapy). This type of chemotherapy involves heating the drug to a specific temperature before administering it into the abdomen. Before this two-part treatment became available, the relevant patient population only had access to symptomatic treatment options.
However, the exact temperature of the chemotherapy is not one size fits all. In this study, the researchers found that some tumors respond entirely differently to the heat than others- with some showing great improvement, while others remain unaffected. They suspect this is due to the cancer cells specific biological mechanisms that fight hyperthermia, which are encoded in the cells genetics.
Customized Organoids Make for Customized Treatment
For this reason, researchers are expecting further insights using customized organic models of the tissue. This will allow them to precisely match the method and dosage so as to mitigate the harm of therapy while utilizing its curative effects.
Senior author of the study, Dr. Konstantinos Votanopoulos said,
“With this organoid platform, we can quantify the impact of each drug in killing cancer cells. We can select the correct drug for the correct patient at the correct concentration and temperature, or even spare the patient from a procedure that will not substantially improve his or her outcomes.”