A new editorial paper was published in Oncoscience (Volume 11) on February 9, 2024, entitled, “A very long and winding road: developing novel therapeutics for metastatic tumours.”

In this editorial, researcher Paul Dent from the Department of Biochemistry and Molecular Biology at Virginia Commonwealth University writes that tumours that have metastasised to distant locations, such as the brain, are most often impossible to treat and cure, although immunotherapeutic approaches have had recent successes in some tumour types such as NSCLC and cutaneous melanoma.

There is, however, also considerable evidence that immune therapy may cause hyper-progression in some NSCLC patients, potentially including Dr. Blagosklonny, whose tumour comprises METex14 and amplification of MDM2, as well as in melanoma and NHSCC patients. 

“There are several issues that presently preclude more effective control of solid tumours both in situ and as metastatic disease.”

The first is that the mutations which drive a cancer phenotype are generally the combination of subtle alterations in cell biology, any one of which, if targeted, if it can be targeted, will only have modest effects on tumour growth and survival.

Conceptually, this calls for an immediate use of two- and three-drug combinations blocking key signaling pathways to achieve effective tumour control regardless of whether resistance mechanisms evolve.

Second, a corollary of altered cell biology, and highlighted in the article, is that fewer tumours have a single recognisable driving oncogene to which the tumour cell is specifically addicted for growth and survival, e.g., mutant RAS proteins, mutant EGF receptors and other mutant receptors of MET, RET, and HER2. 

“And even under these circumstances based on a large body of evidence from the past 20 years is that such tumours also require treatment with two- and three-drug combinations that simultaneously interdict the primary driving oncogene, block signalling from the primary evolving resistance mechanism and even block signalling from a secondary survival pathway.”

Source: Impact Journals LLC