Addressing genetic tumor heterogeneity through computationally predictive combination therapy.

in Cancer discovery by Boyang Zhao, Justin R Pritchard, Douglas A Lauffenburger, Michael T Hemann

TLDR

  • The study uses RNA interference to model heterogeneous tumors and demonstrates that for many such tumors, knowledge of the predominant subpopulation is insufficient for determining the best drug combination. The study confirms examples of cases where the optimal drug combination does not include drugs that would treat any particular subpopulation most effectively, challenging straightforward intuition. The study provides new insights about how to design drug regimens that maximize tumor cell death while minimizing the outgrowth of clonal subpopulations.

Abstract

Recent tumor sequencing data suggest an urgent need to develop a methodology to directly address intratumoral heterogeneity in the design of anticancer treatment regimens. We use RNA interference to model heterogeneous tumors, and demonstrate successful validation of computational predictions for how optimized drug combinations can yield superior effects on these tumors both in vitro and in vivo. Importantly, we discover here that for many such tumors knowledge of the predominant subpopulation is insufficient for determining the best drug combination. Surprisingly, in some cases, the optimal drug combination does not include drugs that would treat any particular subpopulation most effectively, challenging straightforward intuition. We confirm examples of such a case with survival studies in a murine preclinical lymphoma model. Altogether, our approach provides new insights about design principles for combination therapy in the context of intratumoral diversity, data that should inform the development of drug regimens superior for complex tumors. This study provides the first example of how combination drug regimens, using existing chemotherapies, can be rationally designed to maximize tumor cell death, while minimizing the outgrowth of clonal subpopulations.

Overview

  • The study aims to develop a methodology to address intratumoral heterogeneity in the design of anticancer treatment regimens using RNA interference to model heterogeneous tumors. The hypothesis being tested is that computational predictions for how optimized drug combinations can yield superior effects on these tumors both in vitro and in vivo. The study uses survival studies in a murine preclinical lymphoma model to confirm examples of cases where the optimal drug combination does not include drugs that would treat any particular subpopulation most effectively, challenging straightforward intuition. The primary objective of the study is to provide new insights about design principles for combination therapy in the context of intratumoral diversity, data that should inform the development of drug regimens superior for complex tumors.

Comparative Analysis & Findings

  • The study compares the outcomes observed under different experimental conditions or interventions detailed in the study. The results show that for many such tumors, knowledge of the predominant subpopulation is insufficient for determining the best drug combination. Surprisingly, in some cases, the optimal drug combination does not include drugs that would treat any particular subpopulation most effectively, challenging straightforward intuition. The study confirms examples of such a case with survival studies in a murine preclinical lymphoma model. The key findings of the study are that combination drug regimens, using existing chemotherapies, can be rationally designed to maximize tumor cell death, while minimizing the outgrowth of clonal subpopulations.

Implications and Future Directions

  • The study's findings have significant implications for the field of research or clinical practice, as they provide new insights about design principles for combination therapy in the context of intratumoral diversity. The study identifies limitations that need to be addressed in future research, such as the need to develop more sophisticated computational models to predict drug response in heterogeneous tumors. The study suggests possible future research directions that could build on the results of the study, explore unresolved questions, or utilize novel approaches, such as the development of personalized drug regimens based on individual tumor characteristics.