Useful write-up, I learned new things, thanks! It would be great if you could expand on “Cancer is a relentless evolutionary process”. Does that mean that cancer evolves like viruses do and that modern medicine could have cured people of some cancers would it not be mutating? I’m not a specialist so I lack understanding of fundamentals. Thanks!
hey Stefan, thanks for reading my post. I'm happy that you found it useful and learned something from it. Regarding your question, yes, something like this. Cancers mutate in response to therapy, much like viruses do, by evolutionary principles: therapy kills most cancer cells, but not all; the ones that do not die are adapted to the new environment and have all resources/nutrients to themselves.
Excellent synopsis and very excited about the new blog!!!
Why haven’t we made more progress treating cancer?
1. Many cancers are really multiple distinct subtypes of cancer co-occurring. Killing off one type can promote the other. Combining drugs is essentially impossible beyond 4 drugs because of compounding toxicities. However, exciting new work from chemical biologists like Kevan Shokat make drugs active only in specific tissues like the brain. I have high hopes for the generalization of this strategy to a lot more drugs.
2. Cancer is a genetic disease but metastasis is an epigenetic disease. And most of the deaths are coming from metastasis. Epigenetics is inherited horizontally as well as vertically and can allow cancer cells to gain properties and functions of other cell types like immune cells and neurons. These quasi-cancer cells can plug into allostatic networks which protect them from immune recognition and stimulation. Luckily neuroscience has spent the last 30 years developing the tools needed to understand rapidly evolving cell non-autonomous networks in live tissue and identified the insular circuits regulating allostasis. This work is essentially applied AI and a lot of the approaches they use can be applied to study the behavior of new AI models.
Hey Matt, thanks for your comment, these are excellent points. I think 1. is really the gist of the problem, and that's why I am really really excited about the tumor prevention direction: steering human biology before cancerous lesions are formed. And 2. is very very interesting as well, do you have any examples of this neuroscience work you're mentioning that can be applied to metastatic disease?
thanks, yes I saw that! lots of excitement about it now, especially in light of the latest GBM works on how tumors “rewire” thought 😳. Super interesting
Useful write-up, I learned new things, thanks! It would be great if you could expand on “Cancer is a relentless evolutionary process”. Does that mean that cancer evolves like viruses do and that modern medicine could have cured people of some cancers would it not be mutating? I’m not a specialist so I lack understanding of fundamentals. Thanks!
hey Stefan, thanks for reading my post. I'm happy that you found it useful and learned something from it. Regarding your question, yes, something like this. Cancers mutate in response to therapy, much like viruses do, by evolutionary principles: therapy kills most cancer cells, but not all; the ones that do not die are adapted to the new environment and have all resources/nutrients to themselves.
Excellent synopsis and very excited about the new blog!!!
Why haven’t we made more progress treating cancer?
1. Many cancers are really multiple distinct subtypes of cancer co-occurring. Killing off one type can promote the other. Combining drugs is essentially impossible beyond 4 drugs because of compounding toxicities. However, exciting new work from chemical biologists like Kevan Shokat make drugs active only in specific tissues like the brain. I have high hopes for the generalization of this strategy to a lot more drugs.
2. Cancer is a genetic disease but metastasis is an epigenetic disease. And most of the deaths are coming from metastasis. Epigenetics is inherited horizontally as well as vertically and can allow cancer cells to gain properties and functions of other cell types like immune cells and neurons. These quasi-cancer cells can plug into allostatic networks which protect them from immune recognition and stimulation. Luckily neuroscience has spent the last 30 years developing the tools needed to understand rapidly evolving cell non-autonomous networks in live tissue and identified the insular circuits regulating allostasis. This work is essentially applied AI and a lot of the approaches they use can be applied to study the behavior of new AI models.
Cheers!
Hey Matt, thanks for your comment, these are excellent points. I think 1. is really the gist of the problem, and that's why I am really really excited about the tumor prevention direction: steering human biology before cancerous lesions are formed. And 2. is very very interesting as well, do you have any examples of this neuroscience work you're mentioning that can be applied to metastatic disease?
Neurosurgeon Dr. Michelle Monje and Neuroscientist Dr. Rebecca Mancusi just published an excellent review on the new neuro-onco field! https://www.nature.com/articles/s41586-023-05968-y
thanks, yes I saw that! lots of excitement about it now, especially in light of the latest GBM works on how tumors “rewire” thought 😳. Super interesting