The Tricky Business of Targeting Cancers' "Master Regulators"

Over the past few decades, cancer therapies have become increasingly targeted, with protein and antibody drugs targeting specific proteins with exquisite selectivity. Often, however, the utility of targeted therapies is limited; there are many different paths to outwardly similar cancers, and targeted therapies are often only effective against very specific cancer subtypes. An alternative strategy, championed by cancer researchers at Columbia University, is to target mutated genes that are common among a large number of subtypes. Therapeies developed to target these genes should work on broad classes of cancer. In their review, the researchers identified 10 possible “master regulator” genes for each of 30 cancer types.

On the plus side, targeting these commonly mutated genes can broaden the utility of newly developed therapies, which is is good for patients and big pharma alike. However, this strategy does come with several caveats. The authors of the review admit that it will likely be challenging to develop drugs to target many of the genes. For example, the gene RUNX1, which is a target for the malignant brain cancer glioblastoma, is involved in the regular control of blood production from bone marrow stem cells and neuron growth among other important functions. To eliminate the side effects of drugs targeting these “master regulators,” drug developers will need to deliver drugs only to the cancer – a challenging task. In addition, these drugs will likely slow or stop the growth of tumors, but may not actually kill them, meaning that such therapies would need to be taken chronically or be combined with other, costly medications.

Managing Correspondent: Bing Shui

Original article: The recurrent architecture of tumour initiation, progression and drug sensitivity – Nature Review Cancer

Media Coverage: A new type of molecular medicine may be needed to halt cancers – The Economist