Bizarre tumor case may lead to custom cancer care

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It's a medical nightmare: a 24-year-old man endures 350 surgeries since childhood to remove growths that keep coming back in his throat and have spread to his lungs, threatening his life. Now doctors have found a way to help him by way of a scientific coup that holds promise for millions of cancer patients.

The bizarre case is the first use in a patient of a new discovery: how to keep ordinary and cancerous cells alive indefinitely in the lab.

The discovery allows doctors to grow "mini tumors" from each patient's cancer in a lab dish, then test various drugs or combinations on them to see which works best. It takes only a few cells from a biopsy and less than two weeks to do, with materials and methods common in most hospitals.

Although the approach needs much more testing against many different types of cancer, researchers think it could offer a cheap, simple way to personalize treatment without having to analyze each patient's genes.

"We see a lot of potential for it," said one study leader, Dr. Richard Schlegel, pathology chief at Georgetown Lombardi Comprehensive Cancer Center in Washington. "Almost everyone could do it easily."

An independent expert agreed.

For infections, it's routine to grow bacteria from a patient in lab dishes to see which antibiotics work best, Dr. George Q. Daley of Children's Hospital Boston and the Harvard Stem Cell Institute said in an email. "But this has never been possible with cancer cells because they don't easily grow in culture," he said.

The new technique may reveal in advance whether a person would be helped by a specific chemotherapy, without risking side effects and lost time if the drug doesn't work. "Pretty nifty," Daley wrote.

In the case of the 24-year-old, described in Thursday's New England Journal of Medicine, lab-dish tests suggested that a drug used to treat a type of blood cancer and some other unrelated conditions might help.

It's not a drug that doctors would have thought to try, because the man technically does not have cancer. But his lung tumor shrank after a few months of treatment, and he has been stable for more than a year. He still has to have operations to remove throat growths that keep coming back, but only about once every five months.

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