In a report published today as the Featured Article in the journal Cancer Cell, investigators at the Oregon Health & Science University (OHSU) reveal interesting new findings for a kind of cancer called sarcoma. The most common sarcoma of children occurs in the muscle and has an appearance of muscle (rhabdomyosarcoma). In adults, sarcomas are often even more primitive appear (undifferentiated pleomorphic sarcoma). In their report, the Keller Laboratory reveals that childhood and adult sarcomas are linked in their biology, mutations and the cells from which these tumors first start.
Childhood muscle cancer, or rhabdomyosarcoma, is a condition that when spread throughout the body leads to a low survival rate – only 20 – 40%. In adults with soft tissue sarcomas, survival can be even lower. Now, for the first time, scientists and doctors know from where these tumors arise and what drives them to grow and spread. Armed with this new information, the researchers in the Pediatric Cancer Biology Program at OHSU are looking for ways to stop or eradicate these sarcomas.
“A commonly held belief is that cancers should be cut out, burned out or killed. There is a fourth option – to have cancer cells choose to become normal cells, in this case muscle cells,” says Dr. Keller, who led the study. “A least for a subset of patients, possibly the ones with hereditary cancer, one approach suggested by our research might be to administer drugs that muscle cancers to convert into non-cancerous muscle fibers. This is a minority opinion, but one held by a small group of careful scientists throughout the US and abroad.”
The survival rate for childhood muscle cancer that has spread has remained unchanged for more than 40 years. It has reached the point that increasing the intensity of chemotherapy, radiation or surgery is no longer having any improved effect. A novel approach taken by Keller and his colleagues in the laboratory as well as in new clinical trials is to use non-chemotherapy medicines to inhibit “molecular targets” such as growth factor receptors in this disease. Suman Malempati, Director of the Oncology Developmental Therapeutics Program at OHSU’s Doernbecher Children’s Hospital, is the lead on a national clinical trial of one such growth factor inhibitor. This study is the first trial to incorporate a molecularly-targeted drug into a clinical trial for childhood muscle cancer for the Children’s Oncology Group/Curesearch, a nationwide network of hospitals, doctors and leading scientists that develop new treatments for childhood cancer. This type of therapy tailored to a cancer’s mutation was first pioneered at OHSU by DeBakey-Lasker Award Recipient, Dr. Brian J. Druker. Dr. Druker and his colleagues developed a non-chemotherapy pill, Gleevec, which when taken each day causes a form of blood cancer, chronic myelogenous leukemia, to remain dormant indefinitely. Personalized Cancer Care for children and adults is the primary mission of the Knight Cancer Institute at OHSU.
We are grateful to the Scott Carter Foundation for the fellowship support of Jinu Abraham and Koichi Nishijo that has made these studies possible.