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For those who are in this field, I have a question, and will be grateful for an answer. How far-reaching is this technique can be for Cancer treatments? I under

For those who are in this field, I have a question, and will be grateful for an answer. How far-reaching is this technique can be for Cancer treatments? I understand Cancer is not a simple disease that can be delineated.

toufka 13y ago
As a researcher in the field, it's a big question. There are lots of answers. Most of the time, the answer will be, 'maybe, and maybe more if we can get it to the right place at the right time - but it's often hard to know where/when that is'. More specifically, and more concretely, there are certain kinds of cancers (and diseases/disorders) that this will be very effective against. And some advanced iteration of this technology will be curative - entirely. This is of an entirely different kind of medicine than bathing trillions of cells in a potent chemical in the hopes that one of those molecules might slow another molecule - somewhere. This kind of genetic engineering would enable a biological feature to be entirely restored, changed, or removed. Those cancers this will be effective against are those where a particular, knowable, and targetable gene has a known and particular mutation. And this is actually a large class of cancers. Cancers often initiate as mutations that destroy the elaborate series of 'checkpoints' your body has instituted to prevent runaway growth. If one of those proteins that guards against runaway growth gets damaged, then there are far more ways to get cancer. If you can repair that checkpoint (via (genetic) therapies), you can halt, slow, or even destroy what caused that (particular) cancer. The analogy of the cells in your body as a society is not a bad one. And cancer, as a 'criminal' is not particularly dangerous to the whole. It only becomes dangerous when the police, the courts, and the military are also crippled. And we have learned a lot about how those regulatory objects function in the past two decades. However being able to restore them or affect them in a living being has been orders of magnitude more difficult than simply watching to see what they do. It would be fair to say we know understand most of the key elements, and many of the details of their roles of what's happening in the society of your body. However making direct changes to that society in a living being is still tricky, and our tools blunt. What you see here is the sharpening of these new tools - tools that offer the opportunity to restore (or improve) those regulatory objects to a broken system. To say it another way - there is no way I could imagine a cancer to be 'cured' by small molecules (alone). Small molecules work great against 'the different' - but by definition, cancer is not different from its host. I think this is why the drugs of the 20th century were so ineffective against cancer while simultaneously so effective against parasites, bacteria and even viruses for the most part. The only way I could (from first principles) expect to prevent or alter a process like cancer is using tools like the ones talked about here.
- infectoid 13y ago
  Great question. Excellent answer. The analogies you used made this all much easy to understand. Thanks.
- jstsch 13y ago
  How can knocking out a certain gene (for all cells in your body) kill a cancer cell? For instance, for many cancer cells with a defect in 'P53' (a gene which can induce cell death), knocking out this defective gene would not help - would it? Or would you need a two step process, like a molecule which connects to the marker and then use a second step to knock-out a gene essential for cell survival? Or can this technique be used to repair a certain gene?
  - toufka 13y ago
    The most interesting part of the above tool is not its ability to knock out a specific gene, but its ability to knock out a specific gene. The key word is 'specificity'. Knocking out is just the easiest proof of principle thing you can do once you find a sequence. Finding it with specificity in a live organism is the magnificent part. There is an entire field dedicated to editing genetic code - and it's getting really good. The issue is targeting it to the right spot in a live organism (and conversely, not targeting your editing machinery to the wrong spot). If you can get to it, there's lots you can do besides knocking out a gene. If we call the p53 gene the judge or head executioner in our scheme above, it's finding him that's the problem. If you can pinpoint the corrupt judge, you can easily (relative to finding him) install a replacement. What you don't want to do is accidentally replace your police force or your teachers with judges/executioners (even if they're good ones) - and that ability to target is the greatest issue with engineering the genetics of live cells currently. (As a side note, this is EXACTLY what the HPV virus does - it runs around assassinating that judge with relentless precision - and thus is a prime cause for allowing cancer to run rampant. The vaccine against HPV prevents these assassinations.) Further, and only slightly more in the future, once you have access to the genetics, you can start to run logic programs inside the cells. You can start to release the (genetically encoded) tools IFF the cell is $cancerous, where $cancerous is defined as a further set of genetic conditions within the cell. In this way you could surveill the entire society while only targeting the bad guys.
aheilbut 13y ago
Initially, these new genome editing techniques are going to be (and already are becoming) extremely useful to more efficiently set up genome-wide screens and do basic science to discover new targets and understand the biology of cancer. Applying genome editing directly as a therapy is a more speculative proposition for the time being.
jostmey 13y ago
Scientist may never discover a single "cure". Cancer cells tend to exhibit a greater variety of traits than the healthy cells in your body. In other words, cancer cells represent a more diverse population of cells in your body than your healthy cells, which should be near identical copies of each other (assuming that the healthy cells are all part of the same tissue of course). That is one reason why cancer is so hard to effectively treat. How do you find a drug that kills all the cancer cells in your body given that there is so much variety among the cancer cells? Even if you discover a drug that kills most of your cancer cells, and you use the drug, you will then be left with cancer cells that are immune to your drug.

toufka 13y ago

As a researcher in the field, it's a big question. There are lots of answers. Most of the time, the answer will be, 'maybe, and maybe more if we can get it to the right place at the right time - but it's often hard to know where/when that is'. More specifically, and more concretely, there are certain kinds of cancers (and diseases/disorders) that this will be very effective against. And some advanced iteration of this technology will be curative - entirely. This is of an entirely different kind of medicine than bathing trillions of cells in a potent chemical in the hopes that one of those molecules might slow another molecule - somewhere. This kind of genetic engineering would enable a biological feature to be entirely restored, changed, or removed. Those cancers this will be effective against are those where a particular, knowable, and targetable gene has a known and particular mutation. And this is actually a large class of cancers. Cancers often initiate as mutations that destroy the elaborate series of 'checkpoints' your body has instituted to prevent runaway growth. If one of those proteins that guards against runaway growth gets damaged, then there are far more ways to get cancer. If you can repair that checkpoint (via (genetic) therapies), you can halt, slow, or even destroy what caused that (particular) cancer. The analogy of the cells in your body as a society is not a bad one. And cancer, as a 'criminal' is not particularly dangerous to the whole. It only becomes dangerous when the police, the courts, and the military are also crippled. And we have learned a lot about how those regulatory objects function in the past two decades. However being able to restore them or affect them in a living being has been orders of magnitude more difficult than simply watching to see what they do. It would be fair to say we know understand most of the key elements, and many of the details of their roles of what's happening in the society of your body. However making direct changes to that society in a living being is still tricky, and our tools blunt. What you see here is the sharpening of these new tools - tools that offer the opportunity to restore (or improve) those regulatory objects to a broken system. To say it another way - there is no way I could imagine a cancer to be 'cured' by small molecules (alone). Small molecules work great against 'the different' - but by definition, cancer is not different from its host. I think this is why the drugs of the 20th century were so ineffective against cancer while simultaneously so effective against parasites, bacteria and even viruses for the most part. The only way I could (from first principles) expect to prevent or alter a process like cancer is using tools like the ones talked about here.

infectoid 13y ago
Great question. Excellent answer. The analogies you used made this all much easy to understand. Thanks.
jstsch 13y ago
How can knocking out a certain gene (for all cells in your body) kill a cancer cell? For instance, for many cancer cells with a defect in 'P53' (a gene which can induce cell death), knocking out this defective gene would not help - would it? Or would you need a two step process, like a molecule which connects to the marker and then use a second step to knock-out a gene essential for cell survival? Or can this technique be used to repair a certain gene?
- toufka 13y ago
  The most interesting part of the above tool is not its ability to knock out a specific gene, but its ability to knock out a specific gene. The key word is 'specificity'. Knocking out is just the easiest proof of principle thing you can do once you find a sequence. Finding it with specificity in a live organism is the magnificent part. There is an entire field dedicated to editing genetic code - and it's getting really good. The issue is targeting it to the right spot in a live organism (and conversely, not targeting your editing machinery to the wrong spot). If you can get to it, there's lots you can do besides knocking out a gene. If we call the p53 gene the judge or head executioner in our scheme above, it's finding him that's the problem. If you can pinpoint the corrupt judge, you can easily (relative to finding him) install a replacement. What you don't want to do is accidentally replace your police force or your teachers with judges/executioners (even if they're good ones) - and that ability to target is the greatest issue with engineering the genetics of live cells currently. (As a side note, this is EXACTLY what the HPV virus does - it runs around assassinating that judge with relentless precision - and thus is a prime cause for allowing cancer to run rampant. The vaccine against HPV prevents these assassinations.) Further, and only slightly more in the future, once you have access to the genetics, you can start to run logic programs inside the cells. You can start to release the (genetically encoded) tools IFF the cell is $cancerous, where $cancerous is defined as a further set of genetic conditions within the cell. In this way you could surveill the entire society while only targeting the bad guys.

aheilbut 13y ago

Initially, these new genome editing techniques are going to be (and already are becoming) extremely useful to more efficiently set up genome-wide screens and do basic science to discover new targets and understand the biology of cancer. Applying genome editing directly as a therapy is a more speculative proposition for the time being.

jostmey 13y ago

Scientist may never discover a single "cure". Cancer cells tend to exhibit a greater variety of traits than the healthy cells in your body. In other words, cancer cells represent a more diverse population of cells in your body than your healthy cells, which should be near identical copies of each other (assuming that the healthy cells are all part of the same tissue of course). That is one reason why cancer is so hard to effectively treat. How do you find a drug that kills all the cancer cells in your body given that there is so much variety among the cancer cells? Even if you discover a drug that kills most of your cancer cells, and you use the drug, you will then be left with cancer cells that are immune to your drug.