For two decades, scientists have been able to identify the molecular signature of specific cancers by isolating the RNA, responsible for dictating which proteins are produced and, by extension, how the cells behave in the body.
Now, Neil Hayes, MD, MS, MPH, director of the Center for Cancer Research at at the University of Tennessee Health Science Center, and a colleague at Washington University in St. Louis, Jose P. Zevallos, MD, MPH, have identified a specific signature in frequently recurring cancers of the mouth.
“We have been able to identify a set of patients who otherwise would be considered low risk because their tumors are small and have not affected the lymph nodes, and yet, we are showing their tumors are recurring at almost the same rate as patients with the highest-risk characteristics,” said Dr. Hayes who is also chief of the UTHSC Division of Hematology and Oncology.
Dr. Hayes and Dr. Zevallos have been invited to present their findings at the American Association for Cancer Research annual meeting, April 8-13, in New Orleans.
With backing from industry partner GeneCentric Therapeutics (a startup with large biomedical investors LabCorp and Bristol-Myers Squibb), the plan is to create a diagnostic test that can be easily used in the clinical setting to identify whether the signature is present in patients with cancers of the lip, tongue and mouth.
If so, doctors might consider adding more aggressive anti-cancer measures, such as chemotherapy and radiation, which are usually reserved for tumors that have spread to the lymph nodes, Dr. Hayes said.
Up to 50% of patients with mild cancers of the mouth with this RNA signature are likely to have their cancer return less than two years after surgery.
“Those are the patients who would appear to benefit from more aggressive post-surgical treatment. We don’t need to treat everyone, but we certainly need to consider treating these patients more aggressively,” he said.
RNA signatures hold the power to transform cancer treatment because they give scientists and physicians ways to see the cancer’s behavior more clearly.
“Almost all cancers of the mouth have cells that are flat and look like a scale,” Dr. Hayes said. “Under the microscope, they all look the same, but when you look at gene expression, they have very different patterns. What we are doing is taking gene expression patterns and adding that to the other diagnostics to make better decisions about how to manage the patient.”