OnCo
ideasIdea

Block the survival signals the tumour's neighbours provide

Cancer cells can survive a drug because surrounding normal cells feed them growth signals. Blocking those signals could make existing drugs work better and longer.

Fibroblast- and macrophage-derived factors including HGF, FGFs and neuregulin rescue tumour cells from targeted therapy in co-culture and in vivo, an effect largely invisible in monoculture screens. Environment-mediated resistance argues for combining targeted agents with blockade of the specific rescuing ligand or its receptor, selected by profiling the tumour's own stroma rather than the tumour cells alone.

Hypothesis
Stroma-directed ligand blockade added to targeted therapy deepens response in tumours whose stroma expresses the rescuing ligand, and stromal ligand expression predicts which patients benefit.
Rationale
The rescue phenomenon was demonstrated systematically in large co-culture screens; the clinical failure of some combination trials may reflect unselected populations rather than a wrong mechanism.
What would test it
Score stromal ligand expression on baseline biopsies from a completed combination trial to test the predictive hypothesis retrospectively before designing a selected prospective study.
Maturity
preclinical evidence
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
5
Bottlenecks it attacks

Connected

7top