Searching for Gentler Cancer Treatment

Less-toxic treatments may be on the horizon

Yogen Saunthararajah, MD, of Cleveland Clinic’s Taussig Cancer Institute, is studying how cancer cells grow in an effort to develop gentler treatments with fewer side effects.

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Instead of targeting and killing all rapidly dividing cells, he and his colleagues in the Department of Translational Hematology and Oncology Research are taking a new approach by selectively destroying malignant cells while sparing normal stem cells.

 Dr. Saunthararajah received FDA approval earlier this year and has begun a clinical trial with an oral version of the chemotherapy drug decitabine.

Though the trial currently is limited to patients diagnosed with a form of blood cancer, Dr. Saunthararajah and his colleagues have discovered that the difference between cancer cells and normal stem cells holds true for all cancers from different tissues and organs.

This finding gives rise to Dr. Saunthararajah’s suspicion that a less-toxic, potentially more effective treatment will work for almost all cancers, including brain, prostate, kidney and melanoma.

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The hope is that, through the use of mechanism-based treatments, cancer will become a chronic disease — something that can be controlled with minimal side effects for the life of the patient — rather than a diagnosis that can  lead to death, either from cancer or from treatment side effects.

Practical benefits

“This treatment is elegant,” says Dr. Saunthararajah. “It is based on the essential character of cancer cells and uses their own internal energy and genes to stop their reproduction. We’re the first group to recognize key elements of cancer-cell strategies and to integrate them into a coherent map toward cancer treatment that does not kill normal stem cells.”

How does it work? Taking decitabine orally produces lower peak drug levels, lengthening exposure time and the effects of treatment while reducing the possibility of toxicity and side effects. The oral version also is much more affordable, decreasing the need for expensive management of treatment complications and making it more practical for global application.

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Funding is vital

“We believe that in five to 10 years, this map will guide most first-line cancer treatment and will influence the development of additional drugs that work in a similar fashion,” says Dr. Saunthararajah. He envisions a future in which patients diagnosed with cancer can receive effective treatment without adverse side effects and expensive medical bills.

Dr. Saunthararajah says he is excited but concerned that there are fewer sources of federal and corporate support for medical research than there were in the past.

 “There’s so much we can — and hope — to do, but we’re limited by the availability of funds.”

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