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  • Writer's pictureDr. Robert A. Nagourney, MD

A Year-End Reflection

2022 has nearly ended and I take a moment to reflect.

Among our most important accomplishments in 2022 was the installation of a world-class Mass Spectrometry research program, replete with a clean room, technical support, and a thousand plasma samples processed on-site to date.

Our laboratory’s long-standing focus on cancer biology at the level of cellular function, known scientifically as the cell phenotype (not to be confused with DNA profiles conducted at most centers known as cell genotype) led seamlessly to our interest in the most profound measure of cell function, cancer metabolism.

Our first formal study examined 1225 individuals to identify metabolic signatures for breast cancer as we published (DaSilva, I et al Oncotarget, 2018). Our next study examined the relationship between drug response and cell metabolism in advanced ovarian cancer. Not only did we predict clinical resistance to platinum-based chemotherapy using our EVA/PCD platform but also showed that drug resistance could be predicted by measuring metabolites in the blood (D’Amora, P. et al Gynecologic Oncology, 2021).

To further connect cellular drug resistance with metabolism we conducted a unique study. Since our laboratory already conducts cancer cell cultures in a blood-like media, leaving them to consume nutrients and give off byproducts, we decided to actually measure what these cancer cells were eating and making by extracting the culture media and running our mass spectrometry metabolic profiles.

As we reported at the American Association for Cancer Research (AACR) the cancer cells left behind unique signatures in their micro-environment that predicted which patients would achieve complete remission and be cured with chemotherapy. These rather striking results showed that each cancer patient’s outcome is driven by their cancer cell’s energy production. The cancer micro-environment predicts each patient’s survival, all within a week of diagnosis (Nagourney A, Proc AACR, April 2022).

Extending this work into the realm of infectious disease we were able to predict which patients with COVID-19 would suffer severe complications or death. In a study of 131 individuals, metabolic signatures from the blood in newly diagnosed patients with COVID-19, cut across all other categories like age, obesity, and cardiovascular disease to identify the people at the greatest risk from the infection as we reported (D’Amora, P et al PlosOne, December 2021). This was also the subject of a CBS News story that aired on December 9, 2021.

The implications of these findings can hardly be overstated. Here in 2022, we are on the verge of an entirely new understating of human disease. Combining these tests with our cancer culture techniques offers a heretofore unknown level of rigor. Indeed, these tests may enable us to detect cancers years, even decades before any signs or symptoms arise. Moreover, these metabolic studies may provide insights into all human maladies as we begin to see broad commonalities that cut across all medical diagnoses.

2023 could prove to be the year that cancer medicine steps beyond gene profiles and DNA tests to an era of truly personalized care. Welcome to the future of modern medicine.


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