New test could predict if cancer patients are resistant to chemotherapy

A groundbreaking testdeveloped by University of Cambridge scientists, funded by Cancer Research UK and in collaboration with the Spanish National Cancer Research Centre, could revolutionise cancertreatment by personalising chemotherapy.

This test examines the DNA in apatient's cancer to identify patterns that indicate whether they are likely to respond to different chemotherapy treatments, potentially sparing thousands from undergoing ineffective therapies each year.

The test focuses on three prevalent types of chemotherapy: platinum-based, anthracycline, and taxane, which are used to treat tens of thousands of patients annually, according to NHS England data.

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In a pilot programme involving 840 patients with various cancers, the test successfully categorised individuals as either "chemotherapy resistant" or "chemotherapy sensitive". Subsequently, patients were virtually assigned to appropriate chemotherapies based on their test outcomes.

The study showed that patients with anticipated resistance to taxane chemotherapy experienced elevated failure rates in the treatment of ovarian, metastatic breast, and metastatic prostate cancer. Those with predicted resistance to anthracycline chemotherapy were more likely to see treatment failures for ovarian and metastatic breast cancer, while those with forecasted resistance to platinum chemotherapy faced higher failure rates in treating ovarian cancer.

Dr Geoff Macintyre, lead author from the Spanish National Cancer Research Centre and Tailor Bio, commented: "Our technology makes sense of the genomic chaos seen in many tumours treated with chemotherapy.

"It links patterns of DNA mutation to the mechanisms that caused the damage. This provides a read-out of the defective biology in the tumour which we can use to predict resistance to the mechanism of action of common chemotherapies."

To assist the practical application within clinics, researchers aimed to design something easily usable by professionals using existing diagnostic materials. Dr Ania Piskorz, co-lead and Head of Genomics at the Cancer Research UK Cambridge Institute, remarked: "We can adapt it to work alongside other genomic sequencing methods that are commonly used to personalise treatment for cancer."

While chemotherapy remains a potent treatment option for cancer, its effects can be as harmful to healthy cells as they are to cancerous ones, often leading to severe side-effects.

Professor of ovarian cancer medicine at the Cancer Research UK Cambridge Institute, James Brenton, pointed out the stagnation in treatment methods: "In many cases, it has been administered the same way for over 40 years.

"Sadly, there are too many cases where cancer is resistant to chemotherapy treatment, meaning unpleasant side-effects for the patient with limited benefit to them. With genomic sequencing now more widely available, we can make some of the most well-established chemotherapies work better.

"By understanding who is most likely to respond to it, chemotherapy could become a more tailored treatment across different types of cancer."

Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, emphasised the shift away from generalised treatments: "The days of chemotherapy being offered as a 'one-size-fits-all' treatment are ending. Thanks to this research, and others like it, we are moving towards a future where personalised cancer treatment is an option for many patients."