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Drug to patient

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Drug to patient: UW effort to develop personalized cancer care

Experts study micro-culture of tumor cells to find best treatment for each patient

· Feb 22, 2016
A group of University of Wisconsin scientists are collaborating to develop a new test system, which matches specific cancer drugs to the need of different patients.

Shigeki Miyamoto, UW oncology professor and lead researcher, said while there are ample drugs available, it is unclear which drugs work best for each patient.

“One of our goals is trying to develop methods that will help determine the full benefit of each drug, so that the patients don’t have to try different drugs,” Miyamoto said.

The research team is starting with multiple myeloma. With this type of cancer, malignant white blood cells develop in the bone marrow and spread in the blood, Miyamoto said.

Miyamoto said it is the second most common type of blood cancer, and about half of the the 22,000 multiple myeloma patients in the U.S. die each year from the disease.

The reason the group is studying multiple myeloma first, Miyamoto said, is because it has liquid cancer cells that are easier to extract from patients than other solid cancer cells, such as breast cancer and lung cancer.

“[Solid cancer cells] are basically embedded inside tissue structures, so they’re more difficult to obtain as pure cell populations, whereas liquid cancer types are much easier to obtain from patients,” Miyamoto said. “We can study their interactions and drug effects much more effectively and readily because the cells are already separate from each other.”

The main goal of the research is to develop a testing system, known as an assay, to help doctors prescribe cancer drugs according to patient response.

The assay is not a treatment in itself, but rather it takes a patient’s cancer cells and examines which drugs will work best through experiments.

Miyamoto’s team is trying to target the cancer cells with a drug called Bortezomib. If the method works for multiple myeloma, Miyamoto said they will likely expand the research to other kinds of drugs and types of cancer.

But one challenge of the research is cancer cells are hard to keep alive once they are isolated from the patient, which means scientists need to cultivate a specific microenvironment to maintain those cells, Miyamoto said.

Typically, cancer research labs grow millions of cells called “cell lines,” Miyamoto said, which are immortal, available in abundance and can grow for unlimited amount of time. But cancer cells extracted from real patient samples don’t replicate as well, he said.

“We had to really use very small culture environments so that we can increase the number of conditions that we can test from each patient,” he said.

To solve this problem, Miyamoto worked with Jay Warrick, a UW bioengineer who develops different microculture environments for cancer cells.

Warrick is an expert in microscopy and imaging analysis. He used informatics, a practice of information processing, to observe the behavior of cells and predict whether or not patients will respond to a certain drug, Warrick said.

To predict patient response more accurately, Warrick said scientists found it helpful to study not only tumor cells in the microculture environment, but also the non-tumor cells surrounding them.

“The tumors exist within the body, in and around other cells, and there’s always communication,” Warrick said. “It’s just a complex ecosystem and these tumor cells don’t live completely independent of their surroundings. ”

The inclusion of non-tumor cells is exactly why this research is unique from prior efforts, Warrick said. It’s a growing trend on the national scale to study the microenvironment of cancer cells.

Using microscale culture devices means scientists can do many experiments with a small sample from a patient, Warrick said.

“It has important implications in terms of reducing the burden on patients and being able to do more studies with fewer samples,” Warrick said.

This research project is a huge joint effort on UW campus, Miyamoto said. For example, he said his lab is working with clinicians to provide clinical examples, bioengineers like Warrick to develop test conditions and statistics experts to analyze test results.

Warrick said the team will be recruiting patients in the next few years to improve clinical trials. They will be able to give clinicians much more information to help cancer patients find the best personalized remedy.

“We have a promising initial result, which we published recently. But such a study needs to be repeated with many more patients and with many more conditions to make sure our experiments and assays are really useful in terms of predicting clinical outcomes,” Miyamoto said.

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