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In general, blood cancers are more accessible than solid tumors. With blood cancers, the majority of the cancer cells are in the blood or in very well perfused
by forgotpwagain 11y ago
In general, blood cancers are more accessible than solid tumors. With blood cancers, the majority of the cancer cells are in the blood or in very well perfused tissues (bone marrow, spleen, thymus, etc), meaning that drugs/treatments can get to the targets very easily.
With solid tumors, you have to deal with the complexities of the tumor microenvironment. The tumor microenvironment is the complex environment of the cancer tumor tissue. Of particular note, decreased lymphatic drainage, increased connective tissue, and aberrant angiogenesis (growth of new blood vessels) create very high interstitial fluid pressures within the tumor, limiting the ability of drugs or cells to penetrate within the tumor and "work their magic" by reaching the cells/target molecules of interest, etc.
Blood cancers are a good proof-of-principle for many cancer therapies; translation to solid tumors is difficult (see challenges with CAR-T cell immunotherapy).
As for gene manipulation in blood--yes, it is relatively easy to manipulate genes in blood. Hematopoetic Stem Cells (which differentiate into all different kinds of blood cells) can be withdrawn without too much difficulty, manipulated in the lab, and then reinjected into the patient.
- agumonkey 11y agoPardon the naive question, I don't know how localized therapies are today, but hasn't there been research into developing fake foreign capillaries to be implanted non invasively to deliver drugs right on target ? ps: I remember seeing more 'barbaric' version of the idea, namely metal pipes planted in the patient as a direct path. I was wondering about something more organic.
- forgotpwagain 11y agoI'm not an expert, but I think there's been a variety of attempts for vascular renormalization--to restore the normal flow of vessels to allow for drug delivery, etc. Rakesh Jain's lab (at MGH) is a big player in this field and is worth looking up if you're interested. I'm not personally familiar with work in developing capillary devices, but it wouldn't surprise me at all if this was an approach under development--it certainly makes a lot of sense.
- agumonkey 11y agoI was more thinking about artificial pathways, not renormalization (which sound very very difficult) but I'm happy to learn it's considered. Thanks a lot for the name too.