According to researchers at the Gustave Roussy center, it is becoming urgent to stop classifying metastatic cancers according to the organ affected by the initial tumor.
- Researchers from the Gustave Roussy Institute believe that the classification by organs of metastatic cancers – those which have spread beyond the original organ affected by the tumor – no longer has any reason to exist today. .
- This classification would, according to them, go against current scientific literature: certain cancers must instead be defined by their molecular and genetic profile.
- Additionally, it makes it more difficult for patients to get medications that could help them.
Will we soon no longer say “breast” or “lung” cancer? Researchers from the famous Gustave Roussy Institutethe first cancer center in Europe, located in Villejuif (Val-de-Marne) believe that the classification by organs of metastatic cancers – those which have spread beyond the original organ affected by the tumor – no longer has any reason to exist today.
Put an end to the classification of cancer according to the organ affected by the tumor
On the one hand, because this goes against current scientific literature: certain cancers must instead be defined by their molecular and genetic profile. “Mutations in the TP53 gene, for example, are a hallmark of most types of cancer, as defined by the organ where the cancer originated, write the authors in the journal Nature. Additionally, most types of cancer can be subdivided into different molecular subgroups.” A transversal approach would, according to them, be more suited to describing the biological processes at the origin of diseases.
On the other hand, because “classifying cancer based on which organ the tumor affects makes it more difficult for patients to get medications that could help them.” For example, “we have known since 2012 that sensitivity to certain immunotherapies is linked to high levels of PDL1 protein present on tumor cells, explains Fabrice André, who heads the research division of the Institute, in the columns of Ouest France. It took more than ten years for patients with cervical cancer with PDL1 expression to have access to this therapy.” The cause of this failure? Clinical trials were carried out, and therefore authorizations issued organ by organ: melanomas (skin cancers), followed by lung cancers, then gradually other areas of the body.
Cancers: “300,000 untreated patients because we reasoned by organ”
Same problem regarding PARP inhibitor drugs, effective against tumors carrying specific gene mutations (BRCA1 and 2). If these treatments were used for tumors of the ovary, then the breast, the prostate and finally the pancreas, “we now know that these mutations occur in several ‘types’ of tumors, and not only in these cancers”, writes the researcher in Nature. Result, “we can consider that 300,000 patients did not have this treatment because we reasoned by organ”he explains to West France.
According to researchers, it is becoming urgent to stop listing metastatic cancers according to the organ of the initial tumor. What Gustave Roussy started to do: “In addition to the groups of experts by organ, we have a first so-called agnostic committee, which takes into account cancers with common anomalies”underlines Professor Fabrice Barlesi, its general director, in the regional daily.
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