Personalized cocktails vanquish resistant cancers

Doctors may be able to overcome drug resistance in cancer by growing cells from a patient's own tumour and then blasting the cells with an array of compounds to see which ones work.

A study published on 13 November in Science heralds this ultra-personalized future of cancer therapy. International efforts to sequence cancer genomes have yielded a weighty catalogue of mutations that drive tumour growth and provide tantalizing drug targets.

But attempts to develop therapies that hit those targets have been frustrating: many of these drugs initially shrink tumours, but the cancer often resurges. A seemingly miraculous cure can give way to heartbreak in only a matter of months, with tumours growing back as vigorously as before.

It is a problem that has long dogged cancer researcher and physician Jeffrey Engelman of the Massachusetts General Hospital in Boston. To learn more about how cancer becomes resistant to therapy, Engelman and his colleagues devised a way to culture lung cancer cells from patient samples and then test those cells against a battery of 76 different drugs.

For most of the cell lines, the researchers were able to find a cocktail that worked. The approach sometimes yielded unexpected results: for example, more than half of the cell samples that were resistant to therapies targeting a protein called ALK were felled by different drugs that inhibited another protein called SRC. “There were no genetic results that would have pointed to that combination,” says Engelman.