Irving, Columbia University Medical Center and New York-Presbyterian researchers have created patient-specific organelles of cancer of the bladder, which mimic many of the characteristics of the actual tumor. Using the organelles, tiny three-dimensional spheres, derived from the patient's own tumor, it may be useful in the future for the treatment of patients.
The research is published today in the online edition of Cell.
The precision medicine molecular profiling of the individual patient tumor is used to identify genetic mutations that lead to human cancer. This knowledge could help doctors choose the best drug to fight cancer, but the analysis is not always predict how a patient will respond to specific therapies.
"The big advantage of organelles is that they are essentially avatars patient's tumor", - said study leader Michael M. Shen. "With these personalized laboratory models, which we can do in a few weeks, we will check a number of different drugs at the tumor that will help us to bring precision medicine for people with bladder cancer."
Shen began to develop organelles bladder cancer about four years ago. The problem with the creation of any type of organelles is to determine a unique blend of nutrients, growth factors, and tissue culture techniques that convert patient tumor cells in tumors miniature organelles petri dish. The exact conditions may vary greatly from one type of cancer to another.
In the current study, the organelles are made of tumor cells in 22 patients with invasive bladder cancer.
Organelles that can grow up to 1 mm in diameter proved to be similar to the parental tumor and had many of the same molecular and genetic characteristics.
Importantly, organelles developed the genetic changes that occur over time, a phenomenon known as clonal evolution. "Clonal evolution is a factor in tumor progression and drug resistance It is difficult to simulate solid tumor." - Shen said. "With these organelles we will study how tumors develop bladder, and learn to prevent tumors resistant to treatment."
The researchers were able to do the organelles from three patients before and after treatment. "It offers a new way to study the molecular mechanisms associated with drug reactions and drug-resistant" - Shen said.
Bladder cancer is the fifth most common cancer in the United States, but it is one of the least understood.
"Creating organelles bladder cancer is an important step forward in this area", - said study co-author James M. McKiernan. "This should improve the understanding of the genomics of bladder cancer, these tumors respond to drugs and how they develop drug resistance. Ultimately, this will allow us to develop new treatments for this disease and to predict individual patient response to treatment."
The researchers plan to test the predictive ability of organelles to "soklinicheskih" studies, in which patients and their respective organelles are treated with the same drug. "This determines whether organelles used to predict how an individual patient will respond to a particular therapy," - Shen said. "Now it is difficult to know in advance which drugs may be most effective for a given patient."
The current standard of care for patients with bladder cancer that had not invaded the muscle, - an operation to remove the tumor, plus the immunotherapy or chemotherapy. These tumors have a high rate of recurrence, requiring retreatment. Some of these tumors progress and invade the tissue of the bladder. This disease is difficult to treat and it is fatal.
Patients with muscle-invasive cancer is recommended to undergo surgery bladder removal and chemotherapy. "Since the removal of the bladder has a profound effect on quality of life, the majority of patients tend to avoid this", - said Shen. "We desperately need a better, more targetedtherapy for bladder cancer . "