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Predict the Spread

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In a recent opinion piece in Nature Reviews Cancer, Moffitt Cancer Center researchers wrote that resistance to treatment would always be a problem for oncologists and their patients, because tumors are subject to the same processes of evolution and natural selection as any other organism. However, says the UK Science Museum Group's Roger Highfield in a column at The Telegraph, these same processes may be the key to successfully treating cancer. Highfield cites a paper recently published in Nature by Johns Hopkins University's Bert Vogelstein, which suggests that researchers can use their knowledge about evolution to predict the spread of cancer, and therefore treat it more effectively. "In the Nature study of 28 advanced colon cancer patients treated with the monoclonal antibody panitumumab, Prof Vogelstein's team found that drug-resistant tumour cell mutations appeared in the blood of patients five to seven months later," Highfield says. "Working with [Harvard's Martin] Nowak, Ben Allen, and Ivana Bozic, the team calculated when and where these mutations originated — and crucially, they were able to determine that they were present before treatment rather than developing in response to it." Vogelstein tells Highfield that since there is a limited number of pathways that can go wrong in cancer, it should be possible to develop a few agents that can treat large numbers of patients. Nowaks adds that while hundreds of agents may be needed to completely cure all cancers, only a few would be needed to control various patients' diseases.

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