Name: cancer treatment pairings and dna-guided care
Uploaded: 2021-04-07T12:12:03.000Z
Duration: 2 min 50 s
Channel: JoVE

K12 Standards

Arizona Science Standards

High School

Life Science

HS.L1

HS.L1U3.23

combination-therapies-and-personalized-medicine

Combination Therapies and Personalized Medicine

Combination therapy combines two or more treatment regimes or cancer drugs to target cancer-related metabolic pathways in the cell.
Conventional therapies are more likely to fail because a single drug can only target one cancer-related pathway at a time. This often leads to the emergence of drug-resistant cancer cells during the course of treatment. On the contrary, combination therapy simultaneously targets different pathways and different cellular enzymes, thus reducing the chances of drug resistance.
The combination of different drugs also helps to lower their therapeutic dosage as well as increase the treatment efficiency due to a synergistic effect.
It also increases the cytotoxicity specifically in cancer cells while simultaneously reducing drug side effects on the normal cells. For example, caspase inhibitors can enter a normal cell and a cancer cell alike and inhibit apoptosis.
Similarly, the cytotoxic drug flavopiridol can induce apoptosis in both normal and cancer cells.
When both drugs are used together during therapy, the normal cells as well as cancer cells uptake both - caspase inhibitors and flavopiridol. In normal cells, both drugs cancel each other&#39;s effect, and th

combination therapies and personalized medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and acidic microenvironment. In order to overcome this, cancer cells overexpress the enzyme carbonic anhydrase that catalyzes the reversible conversion of carbon dioxide to bicarbonate and neutralizes the acidic tumor microenvironment.
Acetazolamide is a carbonic anhydrase inhibitor that inhibits the enzyme carbonic anhydrase accelerating the death of cancer cells. Another drug, sulforaphane, activates certain anti-cancer responses and suppresses tumor progression. Combined administration of acetazolamide and sulforaphane results in the enhanced killing of cancer cells and reduced tumor progression.
<h4>Personalized medicine or precision medicine</h4>
Precision medicine or personalized medicine is an advanced technique that allows treatments based on the genetic background of the disease. The treatment is designed based on specific abnormal genes or proteins in the tumor cells of each individual. The details about cancer genetics are usually obtained from a tumor biopsy. The morphology of the tumor cells followed by genome sequencing reveals mutations or changes in the specific biochemical pathways. Based on this information, drugs and treatment regimens are decided.
Personalized medicine has four significant attributes. First, it is personalized. It integrates the genetic profile of patients to strengthen and target the therapy and reduce drug toxicity. Second, it is preventive. Females with mutations in BRCA1 or BRCA2 genes have a higher disposition of developing breast cancer. Such genetic data allow disease management through early intervention. The third attribute is predictive. Gene expression profiles are used to assess the risk of metastasis in patients with early-stage cancer. Based on the expression profiles, doctors can decide whether to use hormone therapy or more aggressive chemotherapy. Fourth is participation. The personalized treatments are less toxic and more effective. Hence, patients are more likely to comply with their treatments. &#160;

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a ...

Education

JoVE Core

Molecular Biology

Unit 2

Cancer

KEY TERMS AND CONCEPTS

cancer treatment pairings and dna-guided care

Combination therapy for cancer uses two or more treatments together to improve patient outcomes. This approach can extend life span and help protect vital organs and tissue from the damage that may come from using one treatment too much. It also attacks more than one cancer-causing pathway, which can lower the chance of treatment resistance.

A clear example is the pair of acetazolamide and sulforaphane. Large tumors often have a low-oxygen, acidic center, and cancer cells respond by making more carbonic anhydrase, an enzyme that helps neutralize that environment. Acetazolamide blocks carbonic anhydrase and can speed cancer cell death. Sulforaphane activates anti-cancer responses and slows tumor growth. Together, these drugs increase cancer cell killing and reduce tumor progression.

Personalized medicine, also called precision medicine, chooses treatment based on the genetic background of the disease. Doctors use a tumor biopsy to study the tumor’s shape and then perform genome sequencing to find mutations or changes in biochemical pathways. Treatment plans are then matched to the abnormal genes or proteins found in each patient’s tumor.

Precision medicine has four important features. It is personalized because it uses a patient’s genetic profile to target therapy and reduce drug toxicity. It is preventive because genetic findings, such as BRCA1 or BRCA2 mutations, can help identify higher breast cancer risk and support early intervention. It is predictive because gene expression profiles can help estimate the chance of metastasis in early-stage cancer and guide the choice between hormone therapy and more aggressive chemotherapy. It also supports participation because less toxic and more effective treatment can improve patient compliance.

Cancer Treatment Pairings and DNA-Guided Care

cancer-treatment-pairings-and-dna-guided-care

what is cancer?

Cancer Cells and How They Spread

Cancer cells and how they spread are explained through the normal behavior of cells and tissues. In a healthy body, cells must coordinate carefully. They rest, grow, divide, differentiate, or die in ways that support the organism. Cancer begins when this control breaks down. Cells divide without stopping and invade nearby tissues or organs. Cancer cells show two heritable traits. They reproduce against normal limits on cell growth and division, and they invade and colonize other cells and...

cancers originate from somatic mutations in a single cell

cancers-originate-from-somatic-mutations-in-a-single-cell

How Mutations Drive Cancer Growth

Cancer develops when mutations change the genes that control the cell cycle and let healthy cells keep dividing. A cancer can begin from a single mutation in one starting cell. As that cell line keeps growing, it can collect more mutations and eventually become malignant. One example is chronic myelogenous leukemia, or CML. It often begins as a non-lethal rise in white blood cells and then grows worse over several years before becoming life-threatening. This shows how cancer can progress step...

tumor progression

From Polyp to Metastatic Cancer

Tumor progression is the stepwise change that can turn an early tumor into a more aggressive and malignant cancer. Foulds first described this pattern in the 1950s. Colon cancer is one of the best-known examples, because researchers can follow its changes over time. In colon cells, an early mutation in the APC gene can create a small growth on the colon wall called a polyp. Over time, this polyp may grow into a benign, pre-cancerous tumor. Later mutations in the K-ras and p53 genes can push...

adaptive mechanisms in cancer cells

How Cancer Cells Survive and Spread

Cancer cells survive and spread by gaining genetic changes that help them grow faster than normal cells. These changes build up quickly because defects in DNA repair let mutations appear at an unusually high rate. From an evolutionary point of view, this genetic instability gives cancer cells an advantage as they develop. As mutant cell lines keep changing, they collect helpful mutations that support cancer progression. These cells can divide without fully differentiating, form large cell...

the tumor microenvironment

How Tumors Remodel Their Surroundings

Tumors remodel the local tissue environment to support cancer growth. This surrounding area is called the stroma. It includes several cell types, a basal membrane, and blood vessels. As normal cells mutate and become cancer cells, the nearby environment changes with them. The tumor microenvironment, or TME, is made of the developing tumor and the stromal cells around it. Communication between cancer cells and these surrounding cells is important because it disrupts normal tissue balance and...

metastasis

How Cancer Cells Spread to New Sites

Metastasis is the spread of cancer cells from one part of the body to another. Cancer cells can move through blood vessels, called hematogenous spread, or through lymph vessels. This process helps form tumors in distant tissues. A key step in metastasis is epithelial-to-mesenchymal transition, or EMT. EMT is a normal developmental process seen in wound healing and embryogenesis, but it also appears in cancer metastasis. It is triggered by transforming growth factor-beta (TGF-β) or receptor...

cancer-critical genes i: proto-oncogenes

Oncogenes and Cell Growth Control

Genes usually make proteins that help healthy cells work properly. When mutations change how these genes are expressed, the cell’s traits can change too. If critical genes that control the cell cycle and growth signals are disrupted, cell cycle progress can go off track and cells may divide without control. Over time, these cells can form tumors. Cancer-critical genes are the genes that drive this process. They fall into two main groups: proto-oncogenes and tumor suppressor genes.

mechanisms of retrovirus-induced cancers

How Retroviruses Trigger Cancer

Retroviruses can trigger cancer by changing how host cells grow and divide. These RNA viruses have been shown to cause cancers in species such as chickens, mice, cats, and monkeys. After infection, the viral RNA genome is reverse-transcribed into DNA. It first becomes single-stranded DNA and then double-stranded DNA. This double-stranded form, called proviral DNA, integrates into the host genome. The host cell then transcribes the proviral DNA along with its own chromosomal DNA. This process...

the ras gene

Ras Proteins: Cellular Switches in Cancer

Ras proteins are small GTPase signaling proteins that help control cell proliferation, differentiation, and cell survival. In humans, the Ras gene family has three main members: HRas, NRas, and KRas. These genes produce four closely related proteins: HRas, NRas, KRas4A, and KRas4B. Ras proteins work like molecular switches. They cycle between an active GTP-bound form and an inactive GDP-bound form. Guanine nucleotide exchange factors, or GEFs, help exchange GDP for GTP and turn Ras on.

loss of tumor suppressor gene functions

Tumor Suppressor Genes and Cancer Risk

Tumor suppressor genes help protect cells from becoming cancerous. They can slow cell division, repair DNA mistakes, or trigger apoptosis, which is programmed cell death, when damage cannot be fixed. These jobs help stop damaged cells from multiplying. When a tumor suppressor gene mutates or is lost, cells may begin to grow out of control. A single working copy is usually enough for the cell to keep normal control of the cell cycle. Cancer develops when both copies are inactivated or lost. <br...

mtor signaling and cancer progression

How mTOR Drives Cell Growth in Cancer

mTOR signaling helps control cell growth by balancing building processes and breakdown processes. mTOR stands for mammalian target of rapamycin. It was discovered in 1994 because it binds directly to rapamycin. Its name also comes from a yeast protein called TOR. In mammalian cells, the mTOR protein complex responds to environmental cues such as nutrients and growth factors. It supports anabolic processes, which are the cell’s building steps. These include the synthesis of proteins, lipids,...

cancer stem cells and tumor maintenance

How Cancer Stem Cells Drive Relapse

Cancer stem cells help tumors survive treatment and return after therapy. These residual cells can remain after early diagnosis and treatment, and they often lead to tumor recurrence. They are important because they can self-renew and also produce more than one cell type, which makes them hard to eliminate. Cancer stem cells are thought to come from normal stem cells or progenitor cells in a tissue. Normal stem cells usually stay quiet, or quiescent, until a signal tells them to divide or...

mouse models of cancer study

Mouse Cancer Models in Drug Testing

Mouse cancer models help scientists study how tumors start, grow, and respond to treatment. Mice are widely used because they are similar to humans in many biological and body functions. They are also easy to keep and breed in the laboratory, so many inbred strains are available for research. Cancer research has made major use of genetically modified mice. Transgenic mice carry an added gene, while knockout and knock-in mice have genes deleted or changed with genetic engineering. If a gene...

cancer prevention

Diet and Exercise in Cancer Risk

Diet and exercise can play a major role in cancer risk. Studies show that about 50% of cancer cases may be prevented through a healthy lifestyle, regular exercise, and a modest cancer prevention diet. Populations that eat more fruits and vegetables tend to have lower cancer rates. In contrast, diets high in animal fat, red meat, junk food, or calories are linked with a higher risk of cancer. Plant compounds called phytochemicals may also help protect against cancer. These natural chemicals...

cancer therapies

Combining Cancer Treatments

Cancer treatments often combine surgery, radiation therapy, and chemotherapy. These methods are used to treat cancer patients, but they can also damage normal cells. Cancer cells can also change quickly and become resistant to chemical agents or radiation therapy. Not every cancer responds to the same therapy. Some cancer cells respond to one treatment, while others respond to another because they carry different mutations. The best treatment depends on the type of cancer and how far it has...

targeted cancer therapies

How Targeted Cancer Drugs Work

Targeted cancer drugs are designed to act on specific molecular features that help cancer cells grow and spread. They are also called molecular targeted therapies. These treatments depend on a detailed understanding of the differences between cancer cells and normal cells, so the drug can focus on the cancer cell’s driving signals without harming healthy cells as much. One major group is angiogenesis inhibitors. Angiogenesis means the formation of new blood vessels, which tumors use to get...

treatment resistant cancers

How Cancer Cells Resist Treatment

Cancer cells can resist treatment by changing how they respond to anticancer drugs. This resistance makes cancer harder to treat. It also helps explain why cancer remains a major health problem. Cancer is the second leading cause of death in the United States. Cancer cells are genetically unstable, so they can mutate quickly. They can also change their microenvironment, which helps them avoid immune surveillance. In many tumors, resistance develops when cells alter drug transport or drug...

Combination therapy for cancer uses two or more treatments together to improve patient outcomes. This approach can extend life span and help protect vital organs and tissue from the damage that may come from using one treatment too much. It also attacks more than one cancer-causing pathway, which can lower the chance of treatment resistance. A clear example is the pair of acetazolamide and sulforaphane. Large tumors often have a low-oxygen, acidic center, and cancer cells respond by making...

cancer-critical genes ii: tumor suppressor genes

cancer-critical-genes-ii-tumor-suppressor-genes

How Tumor Suppressor Genes Prevent Cancer

Tumor suppressor genes help keep cell growth under control. They can slow cell division, repair DNA errors, or trigger apoptosis, which is programmed cell death. These jobs protect healthy cells and help maintain normal cell cycle progression. When a tumor suppressor gene is disrupted, cells can lose this control. Loss-of-function mutations in these genes can let damaged cells keep dividing. Over time, that unchecked growth can contribute to tumor formation and cancer. Most tumor suppressor...

the retinoblastoma gene

Retinoblastoma Gene and Childhood Eye Tumors

The retinoblastoma gene, or Rb, is a tumor suppressor gene linked to a rare eye cancer in children. Tumor suppressor genes are normal genes that help slow cell division, fix DNA mistakes, or trigger apoptosis, which is programmed cell death when damage cannot be repaired. These genes help protect the body from damaged cells growing out of control. Rb was the first tumor suppressor gene ever identified. It was discovered through study of retinoblastoma, one of the most common malignant tumors...

rous sarcoma virus (rsv) and cancer

How RSV Uses Src to Drive Tumor Growth

Rous sarcoma virus, or RSV, is a retrovirus that can trigger tumor growth in chickens. F. Peyton Rous first discovered it in 1911 as a filterable transmissible agent. His work showed that some cancers can be caused by infectious agents. He later received the Nobel Prize in 1966 for this discovery, which also helped lead to the finding of other cancer-causing viruses in animals and humans. RSV carries two copies of a plus-strand RNA genome. Its genome has four main open reading frames, or ORFs:...

key terms and concepts

Learn how combination cancer therapies work and how precision medicine uses tumor genetics to guide safer, more targeted treatment choices.

Cancer Treatment Pairings and DNA-Guided Care | JoVE K12

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structural-organization-of-the-human-body-an-overview

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Construct an explanation for how cellular division (mitosis) is the process by which organisms grow and maintain complex, interconnected systems.

HS.L1U1.22

What is Cancer?

Cells and tissues must meticulously coordinate their activities&#160;for the normal functioning of the human body. Therefore, they exhibit socially ...

Cancers Originate from Somatic Mutations in a Single Cell

Cancer arises from mutations in the critical genes that allow healthy cells to escape cell cycle regulation and acquire the ability to proliferate ...

Mouse Models of Cancer Study

Mice have long served as models for studying human biology and pathology because of their phylogenetic and physiological similarity with humans. They are ...

Cancer Prevention

Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular ...

Cancer Therapies

Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, ...

Targeted Cancer Therapies

The targeted cancer therapies, also known as &#8220;molecular targeted therapies,&#8221; take advantage of the molecular and genetic differences between ...

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify ...

Obtain, evaluate, and communicate the ethical, social, economic and/or political implications of the detection and treatment of abnormal cell function.

Cancer Treatment Pairings and DNA-Guided Care

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