Imagine being able to match a cancer's genes to the best treatment. That's the promise of COXEN (CO eXpression ExtrapolatioN) a computer program that looks at a panel of cancer genes in a patient's tumor to predict whether it will respond to chemotherapy. Now a clinical trial recently approved by the National Cancer Institute will open at the University of Colorado Cancer Center and nationally via the Southwest Oncology Group (SWOG) to test the COXEN model in bladder cancer can it predict which cancers will and which cancers will not respond to two common chemotherapies?
"It's an important question. Chemotherapy before surgery or radiation has been shown to have benefit overall, but picking which specific patients benefit and which have no benefit is currently not possible. If we treat a bladder cancer with chemotherapy and the tumor doesn't respond, we've lost valuable months in which we could have done surgery or radiation and have exposed the patient to toxicity," says Dan Theodorescu, MD, PhD, professor of Urology and Pharmacology, director of CU Cancer Center and a developer of COXEN.
The COXEN program is powered by data known for what is called the NCI-60. Basically, extensive genetic and drug testing has been done against a panel of 60 cell lines curated by the National Cancer Institute, representing a range of human cancers. Because we know the genetics of cancers that respond to certain drugs, we can extrapolate this knowledge to predict new cancers that will respond to these drugs based on genetic similarity between cancers, we can make accurate inferences about what will work and what will not work even for cancers not represented among the NCI-60, such as bladder cancer. In fact, because COXEN depends on genes and not on tumor types like "lung" or "bladder" or "breast" to make its predictions, it could be applied across various cancers, based only on genetic similarity.
"Bladder cancer isn't rare, but there hasn't been
|Contact: Garth Sundem|
University of Colorado Denver