Cancer Metastasis

Chasing the Leader Cells

As a child we all played follow the leader; however, it may surprise you to learn that cancer cells may engage in a similar behavior. Researchers, Adam Marcus, PhD and Jessica Konen at the Marcus Laboratory at the Emory Winship Cancer Institute are looking into just that.

Adam Marcus, PhD
Adam Marcus

Marcus and Konen recognized that the cell make-up of any single cancer mass is heterogeneous. They suspect that some cancer cells are chiefly responsible for instigating the spread or reoccurrence of the disease. This prompted them to separate and study particular cancer cells that exhibit a certain morphology, physical appearance, or behavior pattern. They identified and characterized these particular cancer cells as leader cells since they ‘lead’ an invasive pack of cells. They then took these extracted cells and studied their genetic make-up to try and classify certain genetic mutations that may be responsible for the unique role that these particular cancer cells play in metastasis.

Presently, most cancer treatments view a tumor as homogenous. Cliff Michaels, assistant director in the Office of Technology Transfer explained, “The way we treat tumors now, we hit them with one drug that kills off most of the tumor, enough so that it looks like the whole tumor is gone, because the cells left are in such a low number. But, down the road the tumor comes back or spreads because some cells, particularly these types of rare cells, may have been left behind and missed by the initial drug treatment.” In fact, in some cases, it is often these types of rare cells that are the ones that survive because they have a unique genetic make-up that may allow them to persist and survive an initial medical drug treatment.

Cancer Cells
Cancer Cells graphic

Most cancer patients die from cancer metastasis or reoccurrence. Using knowledge developed from Marcus and Komen’s research, physicians and medical lab workers may be able to identify the specific genetic biomarkers in a patient’s tumor cells to establish the presence or absence of rare or leader cancer cells. This would allow doctors to more effectively treat patients, especially those who have shown previous resistance to treatment, and decrease the risk of cancer metastasis or reoccurrence.

“The way we envision the endpoint of this research is to have a screen or genetic test for these rare cells, that allows us to look in patients and see if they have these specific cell mutations. If they do, then we can design treatment based upon this discovery,” explains Marcus. Konen expands on this by saying, “It may also help us better stratify patients. So, that if we do have patients with these rare cells, we can possibly have different treatment plans or different follow-up plans than other cancer patients.” The development of this type of screen or genetic test is still a few years down the road, but the research going on at the Marcus Lab holds great promise in changing the field and techniques of cancer treatment in the near future.

Read more and see a video explaining this work in this Emory Medicine piece.

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