In an article published today by SAGE Publishing, investigators from The Nagourney Cancer Institute and The Albert Einstein Israelite Hospital in São Paulo, Brazil, announced a new approach to identifying effective treatments for patients with advanced metastatic cancers. A drug commonly used to treat kidney and liver cancer was discovered effective for breast cancer, which may open new drug therapies to patients regardless of tumor type. The full article can be found at https://journals.sagepub.com/doi/10.1177/2050313X19838739
The study reports the use of 3-dimensional-human-tumor derived organoids that were isolated directly from a patient's drug resistant breast cancer. The drug identified, sorafenib (Nexavar®), is widely used for the treatment of kidney and liver cancers but has not been found active, used, nor approved for patients with breast cancer.
"The finding of sorafenib activity was unexpected," said Dr. Robert Nagourney, one of the authors of the paper and the director for the laboratory where the studies were conducted.
When the patient with disease that had spread throughout her body had a near complete remission with only two months of oral therapy, a remission that lasted for over a year, the researchers examined possible mechanism for the response and believe that it reflects an entirely new form of cancer cell death known as "ferroptosis." This iron-mediated process of cancer cell death is uniquely activated by sorafenib.
"Of the many targeted drugs that we tested on the cancer cells from a woman who had few options remaining, it was only sorafenib that had this effect, prompting our colleagues in São Paulo to begin therapy immediately," said Dr. Nagourney. "We are fortunate to have fantastic collaborators in Brazil who tested this therapy to such good effect."
The results could not have been more dramatic as the patient showed compete metabolic response by PET/CT only weeks later.
"We are witness to a new concept in cancer medicine where drugs can be identified and selected for individual patients in the laboratory regardless of the tumor type, that is, breast versus kidney versus lung. Drugs do not know what disease for which they were invented," he added.
The drug selection technique employed by Dr. Nagouhttps://www.nagourneycancerinstitute.com/rney was developed by scientists in his laboratory in California. It uses fresh biopsies removed directly from patients to study each cancer patient's biology to select from amongst dozens of drugs and combinations, those that will work the best. This is but one more example of what is known as repurposing drugs, allowing physicians to outsmart cancers by going around their defenses.
"It is the availability of the EVA/PCD testing platform that for this first time is making it possible to make rational drug choices for cancer patients based upon each individual's unique features," Nagourney concluded.