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Addressing Genetic Tumor Heterogeneity, Post-Therapy Metastatic Spread, Cancer Repopulation, and Development of
Dennis Christoph Harrer1, Florian Lüke1,2, Tobias Pukrop1,3
1Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
Cancers
|January 11, 2024
Summary
Cancer progression is driven by post-therapy metastatic spread, repopulation, and acquired resistance (M-CRAC). Tissue editing strategies, like low-dose chemotherapy, show promise for treating refractory or relapsing cancers.
Area of Science:
- Oncology
- Cancer Biology
- Translational Medicine
Background:
- Tumor progression is often driven by post-therapy metastatic spread, cancer repopulation, and acquired resistance (M-CRAC).
- M-CRAC arises from tumor cell heterogeneity due to genetic damage and tissue repair post-therapy.
- Conventional chemotherapy, at maximum tolerable doses, can exacerbate M-CRAC.
Purpose of the Study:
- To review the M-CRAC concept as a key factor in cancer therapy resistance.
- To discuss tissue editing as a potential therapeutic strategy to overcome M-CRAC.
- To highlight clinical trial evidence supporting tissue editing approaches.
Main Methods:
- Review of the M-CRAC concept and its role in tumor progression.
- Exploration of tissue editing therapeutic strategies, including low-dose metronomic chemotherapy and transcriptional modulators.
- Analysis of clinical trial data for refractory or relapsing (r/r) malignancies.
Main Results:
- M-CRAC significantly contributes to resistance against conventional and precision cancer therapies.
- Tissue editing approaches demonstrate potential clinical benefit in r/r malignancies like non-small cell lung cancer and leukemia.
- Tissue editing targets M-CRAC drivers by engaging tumor cell differentiation, immunomodulation, and inflammation control.
Conclusions:
- The M-CRAC concept provides a framework for understanding treatment resistance in cancer.
- Tissue editing represents a promising therapeutic paradigm for patients with refractory or relapsing cancers.
- Tissue editing offers a multi-pronged approach to combat M-CRAC, distinct from conventional treatments.
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