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Small cell lung cancer (SCLC) is a highly invasive lung tumor, especially in heavy smokers. Due to its rapid spread, most patients can only be treated with chemotherapy, and its initial anti-tumor effect is very significant. However, as treatment progresses, patients often experience recurrence.
Recently, a research report titled "Evolutionary trajectories of small cell lung cancer under therapy" was published in the international journal Nature. Scientists from the University of Cologne and other institutions have identified for the first time the molecular mechanisms behind controlling this phenomenon. Due to the dominance of cancer cells sensitive to therapy during diagnosis, treatment is usually effective at the beginning. In addition, researchers have pointed out that these large sensitive cell populations hide a larger and different number of cancer cells, which usually originate from early precursors of primitive cells, have a certain tolerance to therapy, and can proliferate uncontrollably after successful treatment.
Scientists reveal human small cell lung cancer
The mystery behind drug therapy reactions
Image source:
Nature (2024).
DOI:10.1038/s41586-024-07177-7
Researcher Professor Julie George said that understanding the exact process of tumor occurrence in a single patient's body during treatment and recurrence is a huge challenge and important goal, and our analysis reveals mechanisms that may be associated with many advanced cancers. For example, tumor recurrence (which occurs in almost all patients' bodies) usually shows different dominant cell populations. During further treatment processes (such as radiotherapy), cancer cells exhibit genetic damage caused by the first chemotherapy. In addition, researchers have also detected individual genetic characteristics in tumor cells, which may be directly related to specific tolerance to chemotherapy.
The research findings of this article suggest that the potential success of further treatment development may always be limited by the large number of cells that are tolerant to the therapy. Therefore, one treatment approach is to provide as concentrated initialization therapy as possible to reduce the number of cancer cells that will later develop tolerance. Dr. Roman Thomas stated that we have taken a decisive step towards understanding the occurrence of diseases, and we are very eager to help develop new therapeutic strategies to prolong patient survival; Although some of the current research findings are thought-provoking, they also provide certain choices and opportunities for the development of new therapies in the future.
In summary, this study reveals the key process of genomic evolution in human small cell lung cancer under treatment, identifies common ancestors or sources of clonal diversity that can serve as cancer recurrence, and reveals genomic patterns associated with cancer sensitivity and tolerance to chemotherapy.
Reference
George, J., Maas, L., Abedpour, N. et al. Evolutionary trajectories of small cell lung cancer under therapy. Nature (2024). doi：10.1038/s41586-024-07177-7
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