A research group from Israel and Scotland reported a breakthrough that may influence the treatment of metastatic leukemia spreading to the brain.
The research reported in Nature Cancer includes hematological-oncological experts from Schneider Children’s Medical Center and Tel Aviv University and scientists from the Technion-Israel Institute of Technology and the University of Glasgow.
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Their research focuses on acute lymphoblastic leukemia (ALL), which is the most common type of cancer among children. Although the recovery rates for this disease are relatively high, the treatment is harsh and accompanied by numerous side effects that can persist years after the patient is cured.
Since one of the main risks is that cancer will metastasize to the brain, children diagnosed with this disease receive a prophylactic treatment that protects the brain from metastasized cells. Currently, this treatment consists of injecting chemotherapy drugs into the spinal fluid, and sometimes also radiation to the skull, which carries the risk of side effects for damaged brain function since these chemotherapy drugs also harm healthy brain cells. For this reason, a worldwide effort is underway to develop more selective treatments that will only affect the leukemia cells and not the brain cells. The current research reveals for the first time that the solution lies in fatty acids.
Fatty acids are an essential resource for cells, including leukemia cells. Leukemia cells obtain sufficient fatty acids in the bone marrow and blood, but when they travel to the brain in a metastatic process, they reach an area that is very poor in fatty acids. According to the recently published research, in order to continue to thrive and flourish in the brain, the ALL cells develop an ability to produce fatty acids on their own.
Based on these findings, the researchers infer that treating the patient with drugs that block the production of fatty acids will prevent the leukemia cells from producing fatty acids and will thereby “starve” them and stop them from flourishing in the brain. Indeed, the use of such drugs in mice has stopped the spread of metastatic leukemia to their brains.
The drugs used in the current research are still being developed and therefore not yet approved for use in humans. However, the research findings provide hope for more precise treatment that will most likely be less toxic for preventing the spread of leukemia to the brain.
The research findings are also relevant for several other types of cancer, since most mortalities from cancer are not caused by the primary tumor but, rather, by the spread of metastasized cells to distant organs. This research, which demonstrates that cancer cells adapt to the organs to which they spread, paves the way for biological treatments that block these adaptation mechanisms, thereby stopping the cancer cells from metastasizing.