Even in the bleak world of cancer, there are terrible and less terrible diagnoses, with nothing grimmer than finding that a just-discovered tumor has already spread to vital organs like the lungs, liver, bones, or brain. It’s not just the extent of the cancer. Worse, such metastases were long thought to be genetic Towers of Babel, each speaking such a different genetic language that no one DNA-targeted drug could treat all of them.
That assumption, it turns out, is probably wrong: Scientists reported on Thursday that, in any one patient, untreated metastases are driven by the same genetic mutations, whether they’re in the lung or liver or anywhere else. That conclusion, based on the most extensive analysis to date of metastatic tumors, bodes well for targeted therapies, because it means a single drug should work against all of a patient’s metastases — and it is the metastases, not the primary tumor, that are responsible for 90 percent of cancer deaths.
The findings also suggests that taking a biopsy from one metastasis and analyzing it for the cancer-causing mutations is enough to let a physician choose a molecularly targeted therapy such as bevacizumab (Avastin) or erlotinib (Tarceva). If the results hold up, that would spare patients with advanced cancer significant risks and pain, since metastases are often in very hard (or dangerous) to reach areas, such as the bones and brain.
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