The results have recently been published of a study that promise to change the way we deal with cancer. Specifically, the work has been developed in a laboratory model using intestinal tissue and has been led by the renowned scientist Joan Massagué in New York. In the study it was observed that, in the normal healing process of the intestinal mucous membrane, the cells near the break in continuity begin to produce a cell adhesion protein called L1CAM. This protein is what allows the usual cells of the intestine to separate from those next to them and approach those at the opposite end, achieving healing and thus recovering the continuity of the tissue. L1CAM is not normally found expressed in the cells of the intestine or the body in general unless there is this need for healing.
Metastasis production is the step that allows a tumour that starts in a particular organ to spread either through the blood or lymph vessels to other vital organs at a distance and it is these metastases that are normally responsible for the death of the patient.
According to the data from this study, there would be tumour cells that are capable of independently producing L1CAM and these would be responsible for originating the distant metastases. That is, these cells would be able to take advantage of this mechanism of the body's tissue repair to generate new tissue which in this case would be tumoural. In turn, these tumour cells capable of producing this protein would in turn be responsible for resistance to cancer drugs.
The results and hypotheses derived from this study allow us to think of the possibility of designing specific drugs directed against L1CAM and which, therefore, could prevent the development not of the tumour itself, but of the capacity of this tumour to give rise to metastasis. Although the work has been carried out in a colon cancer model, it appears that the expression of L1CAM may be common to other tumours, so the potential benefit may be tremendous throughout oncology. We will have to pay attention to new news in the field of oncology research of drugs designed against this protein and, although the first results will take years to be transferred to patients, there is hope for the curing of many tumours.
Dr Enrique Grande, head of Medical Oncology in MD Anderson Madrid.