A vast number of cancer patients are found with distinct gene mutations that may include advanced cancer in the brain, breast, pancreas and colon. These kinds of mutated cancers are complex to understand. Treatment for each individual varies on the type of cancer. Providing an accurate treatment that would have the best outcome without understanding the progression of the disease could be challenging.
Until now, some cancer patients are being treated with repeated rounds of ineffective treatments because the precise condition of the patient could not be predicted. Trials and errors cause vast amount of side effects, which are also financial and time loss, especially for cancer treatment journey.
After finding ways to solve this issue, researchers have discovered an approach known as “cancer avatar”. Cancer Avatar in animal is done by taking cancer cells from the patient’s tumor after detecting the type of cancer. The retrieved cancer cells will then be transplanted to the animal to recreate the cancer cells inside its body. This is to identify the most effective cancer drug for each patient.
Before using an animal as avatar, researchers prefer to implement the combination of AI, organoid and cell cultures to reduce the use of animals in research studies. However, this method has some limitations as more data are needed for analysis and combination of AI and organoid deliver inadequate information. Avatar becomes more beneficial to patients as it narrows down the treatment options and helps obtaining the most effective treatment method for cancer patients.
Eventually avatar can create an evidence-based rationale for some clinical trials. Use of personalized PDX models known as avatars are powerful investigational platform for co-clinical trials to revolutionize healthcare process. For some tumor types, researcher needs large amount of tumor material to increase the accuracy of the diagnosis and still fail until now. Moreover, it is expensive and time-consuming for not knowing what the result will be.
Recently, researcher used a different animal avatar called ‘Zebrafish patient avatars’. The process of these clinical trials has stronger advantage than mice PDXs in terms of scalability, costs, maintenance and speed of model development. Zebrafish avatar is a good model for cancer according to the preliminary data because the cell grows rapidly and naturally.
Fruit flies are one of the possible avatar models. Researchers can genetically engineer flies to develop cancers with the same genetic mutations as the patient’s. Robotic equipment with a combination of drugs can be used and test on a large number of flies as they are small in size and have rapid breeding rate. Hence, the test can generate a massive number of clinical trials. They are particularly amenable to robotic screening methods and by replacing species such as mice is a step forward in animal welfare, although the relative simplicity of their immune system can limit the effectiveness of the treatment. Cancer Avatar in animal is costly and requires massive amount of infrastructures and expertise.
Precision Medicine is a cancer treatment approach that focuses on determining the treatment option, dosage, and time that are most appropriate and effective for each patient. Treatment with such guidelines may classify the patients into subgroups based on disease mechanisms, which are identified by biomarkers derived from molecular heterogeneity data, disease characteristics, and response to treatment. Precision medicine can predict the progression of the disease and patient’s response to certain drugs. In addition, precision medicine is also used in individual patient care. This is because the tumors are molecularly different in each patient even if they have the same cancer. Therefore, molecular examinations such as a mutation test gene expression or quantification of certain proteins in cancerous tumors are vital. It provides useful data on the selection of anticancer drugs that are specific to the molecular characteristics of the tumor.
Although the molecular detection of cancerous tumors is one of the methods of treating patients with precision medicine, genotype-guided treatment, in some patients with more than one molecular profile, who may have more than one appropriate anticancer drug regimen, sometimes it could be a tough decision to make. Using additional procedures to assist physicians in planning treatment and choosing the right medication for each patient will help ensure the most effective treatment of precision medicine. A three-dimensional model of cell cultures from patients, known as organoid, has been developed, which is characterized by cells growing and organizing themselves in a three-dimensional system. The self-organizing 3D cell culture system has similar histology and pathology to the underlying cancer biopsy. And it can increase the number much more easily than using animals. This makes it possible to test a wider range of drug formulations than using laboratory animals in conditions that are closer to the lump in the body than the two-dimensional cells.
To determine if cancer avatar can be implemented for the patient, consulting with the doctor about the stage of cancer and possible health risks of each individual is vital when planning the treatment. Researchers are continuously discovering new finding about cancer avatar and other methods for cancer treatment, thus, recommendation may change.