Cancer researcher Dr. Peter Kuhn
Listening to Peter Kuhn describe the goal of his research on metastatic tumors gives you the distinct impression that our current cancer treatments will look like medieval medicine within a few years.
Today, he explains, a doctor with a cancer patient does a biopsy, diagnoses him or her, and then begins treatment. "All of the treatment is based on that original biopsy," says Kuhn, associate professor of cell biology. "The problem is: we know the cancer changes over time."
Kuhn's work on circulating tumor cells – cells that are programmed to break away from the original tumor, make their way into the bloodstream, and often eventually find their way to another organ in a process called metastasis – has led him to believe that a better approach to treatment is within reach.
"If I am able to take samples of cells from the original tumor in the blood, and am able to do that over and over, I can then analyze the cancer over and over and see how it changes over time," says Kuhn. "Then that means over time I can change my treatment approach based on actual information about the cancer."
The crucial moment, he says, is when one treatment stops working. Now, with only the original biopsy as reference, doctors have little to guide them when they have to choose a new treatment to fight the mutated cancer. But if doctors were able to get updated information from the circulating tumor cells, they would see when the initial treatment stops working and, very likely, what other treatment is most likely to work next.
"That scenario is where this (potential new tool) plays in most critically," Kuhn says.
Kuhn's team made a major step toward making this goal a reality last month when its most recent study made the cover of the Archives of Pathology and Laboratory Medicine, a touchstone of the pathology research community.
The study, for the first time, showed that scientists were able to detect and characterize the structural features of circulating tumor cells.
"This study is a breakthrough," Kuhn said. "We were able to find these cells and image them so clearly that they can be used as clinical biopsy material. We didn't just count them – we were able to interpret them."
Kuhn predicts these results could turn into routine medical practice within three years, if he's able to secure the necessary funding.
"Two things need to happen simultaneously," Kuhn says. "We need to keep pushing the research side and we need to initiate regulatory-compliant clinical trials."
To tackle the research goal of developing a better understanding of how circulating tumor cells operate, Kuhn has organized a group of experts in cell biology, physics, and mathematical and statistical modeling. This research will now get funded through a new signature initiative of the National Cancer Institute.
"It can be challenging," Kuhn says. "The people sitting around a table often have absolutely no idea how to talk to each other… everyone speaks a different language of medicine and science. You have to be okay with asking "stupid" questions, because only the daily process of living and working with each other in constant interaction and conversation will allow us to break through these barriers and make new scientific concepts a clinical reality. Going horizontally across these different disciplines is where the answer will lie."
The clinical side, though, may prove even more challenging. Data from clinical trials is an essential component for the government approval process, but collecting that data requires funding.
"We don't even have a regulatory-compliant laboratory right now," Kuhn says. "Getting the lab set up and running an initial program would cost somewhere on the order of $2.5 million."
Scripps Research is exploring government grant programs, as well as funding opportunities from pharmaceutical companies and investors, but Kuhn says their best hope is individual philanthropy.
"With funding, a clinical test could be approved within five years, and could be available for use even before that, in maybe three years," Kuhn says.
Revolutionary advances require commitment: a commitment to research excellence, a commitment to forging new frontiers, and a commitment to translating laboratory findings into improvements that touch lives. Peter Kuhn and his team have demonstrated their commitment time and again; now your commitment can make the difference.