Towards a Personalized Cancer Gene Therapy: A Case of Clear Cell Renal Cell Carcinoma

摘要

An ideal cancer gene therapy would selectively destroy the cancer nodules with negligible effects on the surrounding not yet compromised tissue. This would be possible if the targeted genes are in command positions in the cancer but not in the normal cells. Logic dictates that, while being strongly protected by the homeostatic mechanisms, expression of a commander gene governs most major functional pathways by regulating the expression of numerous other genes. Owing to the cancer dependence on race, sex, age, genetic heritage, medical history, environmental and lifestyle associated risk factors each patient has most likely a distinct, dynamic and never repeatable set of commander genes. Here we introduce the "gene commanding height" as a measure of gene rank in the cell hierarchy and test our procedure on a surgically removed metastatic clear cell renal cell carcinoma. Results indicate that each histopathologically distinct region has a unique set of commander genes and that cancer cell commanders are in low positions in normal cells. We believe that the genomic oncology should identify the cancer cell commander genes of the individual patient instead of testing for the biomarkers selected from most frequently altered genes in large populations.