Recommendable! Cancer is a mighty foe, but human ingenuity will make sure that cancer is history (soon)!
The following BBC article is way too pessimistic! BBC interviewed the wrong professor! When it comes to cancer you do not interview worry warts or defeatists! It may take only one serendipitous discovery and cancer is history!
Lessons learnt (again):
- Screen early for cancer to catch a cancer at the earliest possible
- Continue to screen frequently after cancer treatment
"Cancer Research UK said early detection of cancer was vitally important.
The study - entitled TracerX - provides the most in-depth analysis of how cancers evolve and what causes them to spread. ...
The research showed:
Highly aggressive cells in the initial tumour are the ones that ultimately end up spreading around the body
Tumours showing higher levels of genetic "chaos" were more likely to relapse after surgery to other parts of the body
Analysing blood for fragments of tumour DNA meant signs of it returning could be spotted up to 200 days before appearing on a CT scan
The cellular machinery that reads the instructions in our DNA can become corrupted in cancerous cells making them more aggressive. ..."From the abstract:
"Metastatic disease is responsible for the majority of cancer-related deaths. We report the longitudinal evolutionary analysis of 126 non-small cell lung cancer (NSCLC) tumours from 421 prospectively recruited patients in TRACERx who developed metastatic disease, compared with a control cohort of 144 non-metastatic tumours. In 25% of cases, metastases diverged early, before the last clonal sweep in the primary tumour, and early divergence was enriched for patients who were smokers at the time of initial diagnosis. Simulations suggested that early metastatic divergence more frequently occurred at smaller tumour diameters (less than 8 mm). Single-region primary tumour sampling resulted in 83% of late divergence cases being misclassified as early, highlighting the importance of extensive primary tumour sampling. Polyclonal dissemination, which was associated with extrathoracic disease recurrence, was found in 32% of cases. Primary lymph node disease contributed to metastatic relapse in less than 20% of cases, representing a hallmark of metastatic potential rather than a route to subsequent recurrences/disease progression. Metastasis-seeding subclones exhibited subclonal expansions within primary tumours, probably reflecting positive selection. Our findings highlight the importance of selection in metastatic clone evolution within untreated primary tumours, the distinction between monoclonal versus polyclonal seeding in dictating site of recurrence, the limitations of current radiological screening approaches for early diverging tumours and the need to develop strategies to target metastasis-seeding subclones before relapse."
Fig. 1: Sample distribution and mutational overview in the paired primary metastasis TRACERx 421 cohort
Fig. 2: Timing metastatic divergence
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