FRETting about how to classify cancers

FRET stands for “fluorescence resonance-energy transfer.” It’s a way to assess interactions between individual protein molecules, and allows researchers to find out how many receptors of specific types there are in a specific cancer specimen as well as how active those receptors are.

An article in (of all places) yesterday’s edition of The Economist discusses work by Parker and colleagues that may, after the necessary refinements, allow us to diagnose and to reclassify most types of cancer according to their molecular origin and their biochemical capabilities instead of which part of the body they originally occurred in. This might be particularly important in understanding how best to treat prostate cancer effectively in its earliest stages.

Parker and his colleagues originally proved that this technique was possible using data from patients with head and neck cancers. In September this year, they will be initiating a large-scale trial to investigate the ability of FRET to accurately “hindcast” the clinical outcomes associated with 2,000 breast-cancer biopsies. If patterns of receptor activation for this and other types of cancers can be appropriately characterized, the technique might become applicable for all solid tumors.

Historically, most cancers have been classified in terms of the part of the body in which the initial tumor originates (breast cancer, prostate cancer, liver cancer, etc.) but we have long known that, in fact, it would be easier to understand cancers if we could classify their by their molecular characteristics. To use a couple of examples that you may be familiar with, think in terms of “HER2-positive” cancers (commonly a specific subtype of breast cancer that expresses the HER2 gene and responds to the targeted drug Herceptin) or “EGFR-expressing” cancers.

We already know that certain genes are more commonly expressed in some types of prostate cancer, and so a system like this, which allowed us to classify prostate cancers by the way they behaved biochemically, would be a means to allow us to subclassify prostate cancers into categories that might to known to behave more or less aggressively and then target apropriate drugs to treat them accordingly.

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